Learning Disability and Autism

To help someone with a learning disability in a care home stay well, care home staff, GPs, and wider health and social care professionals must:

• Ensure all residents are registered with a GP practice and that they are on the GP’s learning disability register.
• Ensure all residents receive their Learning Disability Annual Health Check (AHC), which includes receiving a Health Action Plan.
• Ensure that whoever is supporting residents with their AHC appointment is educated on what an AHC is and what should be covered in it, so they can advocate for the individual. This also includes a completed Health Action Plan to be produced from the AHC.
• Have awareness of the needs of autistic people for medical and social care appointments, reasonable adjustments that would support them and the available Serious Mental Illness annual health checks, if relevant and appropriate.  There is currently no specific annual health check available for autistic people without a learning disability, though pilot work is in progress in some areas of England to look at setting this up.
• Advocate for vaccinations that are due; these can often be discussed and/or done during an AHC.  This includes COVID, Flu and the Pneumococcal vaccines.
• Advocate for screening they are eligible for, e.g. for cancers, abdominal aortic aneurysm (AAA) and diabetic eye screening.
• Complete a Health & Care Passport (also known as a Hospital Passport) together with the resident or a family member where possible and ensure these are kept up to date and taken to all appointments.
• Be aware of the importance and value of reasonable adjustments being made for the resident, to support access to health and social care.
• Support the physical and mental wellness of people living in care homes by encouraging physical activity in a form suited to a person’s interests or sensory needs e.g.:

- Gardening, baking/cooking

- Bingo, reading, music

- Creative activities e.g. painting

- Swimming, walking, exercise classes

• Be aware of ways to signpost individuals for weight management support and refer into the community dietician service as required  
• Ensure all residents have regular weights taken either at the home or as part of the GP appointments
• Be aware of the principles of STOMP

Available training:

The Oliver McGowan Mandatory Training on Learning Disability and Autism. 

Learning Disability Awareness sessions (aimed at GP practice staff; via Microsoft Teams, occurring four times a year). Search on the GP Training Hub for booking details.

The local charity, Grapevine can offer bespoke training to some organisations.

Whilst the general signs and symptoms of someone with a learning disability or an autistic person becoming unwell would be similar to the general population, there are some differences to be aware of:

• They may have a different pain threshold or express pain differently e.g., become quiet and withdrawn
• They may not be able to use words to express how they are feeling and will therefore demonstrate this in other ways e.g., pointing to pain or using Makaton/sign language
• Their behaviour might change e.g., becoming more frustrated or angry than usual, or become confused

Please watch this short video:
Recognising deterioration in people with a learning disability

There are specific conditions that are more prevalent in someone with a learning disability. These include:

• Constipation
• Respiratory diseases including Pneumonia and Aspiration Pneumonia 
• Sepsis
• Cardiovascular disease
• Cancers (often due to lack of screening)

Soft signs of deterioration:

• Health and social care professionals should always trust those that know the individual the best as it will often be subtle signs that an individual is becoming unwell.
• Early signs of physical “unwellness” can be recognised intuitively by carers as evidenced by staff saying, “I know something is wrong, I just don’t know what”. Even people without training, but who are familiar with someone’s usual behaviour and habits, can often sense a problem resulting in them reporting that the relative, child or person in their care “just isn’t themself”.

Please watch this short video:
Soft signs of deterioration

Most GP practices will have Learning Disability Champions that can support with appointments and any concerns.

For any guidance or advice on supporting a person with a learning disability, please contact the Community Learning Disability Team:

Coventry & Rugby: 02476 324380.

North Warwickshire: 02476 315867.

South Warwickshire: 01926 317746.

If a care home resident is admitted to hospital, there are Acute Liaison Nurses, specific to supporting someone with a learning disability at each NHS acute trust across Coventry and Warwickshire.

The Acute Liaison Nurse should be automatically alerted for any admission, but if this does not happen, make ward staff aware.

A Health and Care passport (also known as a Hospital Passport) is designed to give any health and social care staff helpful information about someone’s health, key contacts and lists of their likes/dislikes, amongst other helpful information for both parties.
Ensure all residents have an updated version of this to support with:

• Any health and care appointment
• Acute emergency admissions

• Learning Disability Annual Health Checks
• Learning Disability Friendly Badge (GP practice accreditation scheme)
• CWPT Easy reads 
• Mental Capacity Act easy-read document
• LeDeR reports