Making reasonable adjustments

Prompts for making reasonable adjustments for learning disability patients

In a busy environment, simple things can make a big difference. These prompts are to help you ensure that patients with learning disabilities receive reasonable adjustments to their care if needed. This information can also be recorded in the Patient Passport.

1. Admissions to A&E

  • How does the person communicate? Do they have complex communication needs? If so, speak to carer.
  • Is the information appropriate to the current situation/has it been updated?
  • Has the person been offered a flag on their record? Would they like this adjustment to their record?
  • How do you know if the person is in pain?
  • What is 'usual' or unusual—ie have behaviours changed, have eating/drinking changed, bowel movements, urine frequency changed, more seizures?
  • Is the person focused on one area of their body—ie if you touch arm/leg do they react differently? (Explain and ask permission before you touch them.)
  • If complex communication please listen to carers, as they have the complex medical history
  • Who else is working or linked into the person’s life?

2. Before admitting to a ward from A&E ask the patient and carer what they might need, such as:

  • A cubicle due to behaviour problems
  • A corner bed within a bay
  • A hoist
  • Support while in hospital—is a full time carer needed?
  • Carer’s bed required—2 beds in bed store
  • Will the carer have support while caring in a hospital setting—ie is someone such as a friend or staff member known to the patient to allow them to have a break
  • Emergency contact details including projects people are involved in—ie schools/colleges, overnight/day services, advocacy projects if appropriate
  • Does the person have a hospital/communication passport or their own communication passport?
  • Does the person or the carer need something to drink or eat?

3. Outpatient clinics—does the patient need:

  • First appointment/last appointment
  • Would a volunteer be helpful?
  • A quiet space before or after appointments
  • Will they need support while with the clinician (please remind a carer that it might be easier if they can bring another person with them if possible so that they can speak to the doctor, and if the patient needs to leave the room they have backup)
  • Will they need a hoist/bed or any other services that may be required for personal care
  • How are they getting to and from the hospital?
  • Are emergency contact details up to date? Please try to include overnight and day respite services, so if something happens to carers these may give you further information
  • Does the person have a hospital communication passport or a health action plan?
  • Are families linked into local organisations for support?
  • Is there anything else?

4. Planned inpatient admission—does the patient need:

  • To be first on a theatre list
  • To be admitted the night before a procedure (sometimes due to high anxiety it’s better if admitted the night before into a cubicle)
  • A cubicle due to behaviour problems
  • A corner bed within a bay
  • A hoist
  • Towels, pads, toiletries
  • Help bathing—ie hoist or supervision while bathing
  • Help eating and drinking
  • Support while in hospital—is a fulltime carer needed
  • Carer’s bed required (please book it)—2 beds in bed store
  • Will the carer have support while caring in a hospital setting—ie is someone such as a friend or staff member known to the patient to allow them to have a break
  • Emergency contact details including projects people are involved in—ie schools/colleges, overnight/day services, advocacy projects if appropriate
  • Does the person have a hospital communication passport or their own communication passport? Has it been updated?
  • Do they have a communication passport?
  • Is the information appropriate to the current situation/has it been updated?
  • Has the person been offered a flag on their record? Would they like this adjustment to their record?
  • Does the person have complex communication needs—if so speak to carer
  • Is the person known to LD team?
  • Are parents/carers linked into local organisations for support?
    Contributors
    rhian George Vasilopoulos