Community Learning Disabilities Team (CLDT)

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What is this service?

The Community Learning Disabilities Team (CLDT) provides 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 sees 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 two community bases, one in the north and one in the south of Bristol. Details can be found on the left of this page.

Art therapy session

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, while others may have more complex needs and require coordinated support and treatment from several different people within the team.

More information on the specialisms within our teams can be found below.

Updates to our service in 2019

From April 2019, each person referred to the team will have a designated care coordinator who will be the key point of contact.

In addition,  going forward, the Community Learning Disabilities Team will prioritise three pathways of care:

  1. Helping people whose mental health or behaviour places them at risk
  2. Supporting people whose health needs cannot be met with reasonable adjustments by other health services
  3. Enabling people to access other health services, and supporting  those services to make reasonable adjustments

When someone is referred to us for the first time we will need to assess whether they are eligible for our service. This means:

  1. We will need to assess if they have a learning disability; and,
  2. If they have an identified health need, which cannot be met by other services, even with reasonable adjustments.

For more information on who we provide support for, please take a look at the section ‘Who is this service for?’ below.

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 assesses 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.


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.


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.


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.

The person must also have an identified health need and it needs to be evidenced that this health need cannot be met by other services, even with reasonable adjustments. Our referral form and guidance will provide you with a framework to support you with this.

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.

Tell us what you think

Bristol Community Health would like to learn from your experience of this service. Your comments and suggestions will help us see what we are doing well and what we could improve. To give feedback please click here.

Bristol South CLDT

Bishopsworth BS13 8QA, United Kingdom

The Withywood centre
Queens Road

Bristol North CLDT

Stapleton BS16 1EQ, United Kingdom

New Friends Hall
Heath House Lane