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What is this service?

The Community Learning Disabilities Team (CLDT) provide specialist health services directly to people with learning disabilities. We are a centre of expertise, linking and liaising with other services and offering support and training on how to work with people who have a learning disability and how to make reasonable adjustments. We work closely with GPs to make sure that people with learning disabilities are offered annual health checks and health screening.

The CLDT see people in the community including day centres, work places, and home, college or health venues. We also run some clinics and therapy groups and sessions from our team bases.

We have three teams based within Bristol. Please contact the team depending on where you live (North, South or Central Bristol). Details can be found at the left of this page.

What does this service offer?

All members of the Community Learning Disabilities Team work together to meet the health needs of our service users. Some people may only need to be seen by one part of the team, some people may have more complex needs and get support and treatment from several different people within the team. The team consists of:

Bristol Intensive Response Nurses (BIRT) - who work with people in crisis

Bristol Intensive Response Nurses are a team of Registered Learning Disability Nurses and support workers who support adults who have a learning disability. Some have additional training in Positive Behaviour Management (PBM).BIRT assess individual service users who display behaviours that may be perceived as ‘challenging,’ have deterioration in their mental health, or support individuals who are at risk of placement breakdown/admission to hospital. We develop proactive strategies, Positive Support Plans (PSP), Comprehensive Risk and Management Plans (CRAMP) and provide support until crisis situation in resolved. We can also develop reactive strategies, de-escalation techniques and breakaways with service users, carers and families.

Community Nurses

Community Learning Disabilities Nurses (CLDNs) promote the wellbeing of people with learning disabilities by supporting them to improve or maintain their physical and mental health. They are first level registered nurses who have undertaken a three year nursing qualification specific to the needs of people with a learning disability. Within the CLDT they lead a skill mix of qualified and assistant nurses.

CLDNs help to reduce the health inequalities associated with having a learning disability by facilitating access to mainstream health services and advising on how reasonable adjustments to care can be made. Taking an inclusive and collaborative approach they address barriers to health, providing specialist support based on a comprehensive health needs assessment.

CLDNs improve awareness of the health needs of people with learning disabilities through the provision of training to generic health teams, care staff teams and to the undergraduate nursing program in the University of the West of England. Learning disabilities nurses respond to individuals with learning disabilities, their families and carers in a creative, flexible and effective manner ensuring interventions are informed by the most recent evidence- and values-based practice. They have a commitment to lifelong learning and promote the empowerment of people with learning difficulties, their families and carers in all aspects of care.

Creative Therapists

The arts therapies involve a psychotherapeutic relationship between the therapist and the individual. Central to this relationship is the use of a creative medium that allows for additional and alternative means of communication and expression. One of our strengths is that we can work with those whose main form of communication is not verbal.We can offer assessment, individual and group work. This includes short-term and preventative work as well as long-term therapy.

Dietitians

Registered Dietitians assess, diagnose and treat diet and nutritional problems at an individual and wider public health level. We work with clients on an individual basis or in groups and also provide training for care staff.Individual client work involves those with severe eating and drinking difficulties and those unable to access mainstream services for conditions that can be treated by diet.

Occupational Therapists

Occupational Therapists within the Learning Disability Service assess the impact of the person’s learning disability on their occupational performance, health and wellbeing. Occupational Therapists are experts in occupational wellbeing, assessment of function and activity analysis working alongside carers, families, health and social care professionals supporting a person centred approach.

Physiotherapists

CLDT physiotherapists work holistically to support and promote physical independence for adults with learning disabilities that are unable to access generic services. We use a combination of individualised positioning, posture management, exercise, mobility, hydrotherapy and respiratory programmes. We assess for and recommend suitable equipment including mobility aids, seating and wheelchairs. We work alongside other mainstream services to promote access. We also invest time training and educating carers regarding the physiotherapeutic needs of the individual service user.

Psychologists

Our psychology team offer psychological therapies to promote positive mental health. We provide a range of psychological assessments, formulations and interventions to support clients to maintain their psychological wellbeing and quality of life within the community. We work with clients one-to-one, or in groups and often with their carers and families. We provide psychological consultation and advice to staff and the multi-disciplinary team.

We work with a range of psychological issues, including loss and bereavement, trauma, mental health (e.g. low mood, anxiety), relationship difficulties and assertiveness. The adults we work with may be expressing their distress through behaviour that poses a risk to themselves or others. We offer learning disability specialist input that is tailored to the individual’s learning and communication needs.

Speech and Language Therapists

The speech and language therapy team work with adults who have difficulties with speech, language, communication, or eating and drinking. We work closely with individuals, families, carers and other professionals to promote positive interaction and to enable participation and choice. We offer assessment, individualised therapeutic programmes and training packages to reduce the impact of communication difficulties on the individual’s quality of life. We also work as part of a multidisciplinary team to ensure that adults with learning disabilities can eat and drink as safely and enjoyably as possible.

Who is this service for?

The Community Learning Disability Team (CLDT) is for people with a learning disability aged 18 or over, but we can work with people from 17 to ensure a smooth transition into adult services. We have a Transitions group to help this happen. The patient must be registered with a Bristol GP.

A learning disability includes the presence of a significantly reduced ability to: understand new or complex information; learn new skills (impaired intelligence) or to function independently (impaired social functioning). This started before adulthood, with a lasting effect on development.

The presence of a learning disability is not a sufficient reason for deciding that an individual should be provided with additional health and social care support.

When someone is referred to us for the first time we will arrange to meet with them to carry out an initial assessment to check that they are;

• Eligible for our service
• Make sure we understand their needs
• Check that we are the most appropriate service for them. If we are not, we will always try to identify other services that may be able to help

Are there any types of disabilities that you do not provide for?

• Acquired brain injury - acquired post 18 years of age.
• Where mental health or physical impairment is the primary diagnosis, in which case we will work to support other more appropriate services to work with the service user and their family and carers.
• Dyslexia, ADHD and Autism without a Learning Disability

How can I access this service?

Referrals can only be accepted with the consent of the person being referred or if the decision to refer has been made through the best interest process.

Please use the contact details on the left hand side of this page to contact the relevant CLDT, depending on where you live in Bristol (north, south or central Bristol).