Adult learning disability and autism services

We provide a person-centred community based service to adults with a learning disability in Coventry, Warwickshire and Solihull. Each of the five teams consist of nursing, psychiatry, psychology, speech and language therapy, occupational therapy and physiotherapy. Other services can be accessed depending on location, for example art therapy and music therapy.

Address: Various locations across Coventry, Warwickshire and Solihull,

About us

Telephone number: 0300 131 2320
Email address: LDreferrals@covwarkpt.nhs.uk
Referral criteria: adult learning disability referrals

The multidisciplinary teams offer services to adults with a learning disability, and comprise of psychiatrists, psychologists, community nurses, occupational therapists, physiotherapists, support workers, and speech and language therapists. Music and art therapy is also available in some areas.

The teams operate an open referral system, meaning that anyone can make a referral to them for support with their healthcare. The team will assess the person referred to assess the health care need and to see what interventions, if any, will help to reduce the impact of their problem. These interventions may be behavioural in nature, for example, supporting a person to understand their condition or to support an individual or their carers to do things differently. The intervention may be more traditionally medical, for example, medication may be prescribed or a particular treatment may be suggested.

North Warwickshire - The Loft, Manor Court Road, Nuneaton, CV11 5HX
Tel: 02476 315 867

South Warwickshire - Whitnash Lodge, Royal Leamington Spa Rehabilitation Hospital, Heathcote Lane, Leamington Spa, CV34 6SR
Tel: 01926 317 746

Solihull - Brian Oliver Centre, Moorend Avenue, Marston Green, B37 5RY
Tel: 01217 284 891

Coventry - Windmill Point, Windmill Road, Coventry, CV6 7AT
Tel: 02476 324 380

Rugby - Stephenson House, The Railings, Woodside Park, Rugby, CV12 2NP
Tel: 01788 513 730

To access services an individual needs to have an identified health need and a learning disability (an IQ at 70 or less).

We do not provide services to people who have dyslexia, ADHD or autism unless they also have an additional learning disability.

If you need support with housing, care needs or social activities please contact your local social services department.

Psychiatry

What is psychiatry?

Psychiatry is a medical field concerned with the diagnosis, treatment and prevention of mental health conditions.

Unlike other mental health professionals, such as psychologists, psychiatrists must be medically qualified doctors who have chosen to specialise in psychiatry. This means they can prescribe medication as well as advise on other forms of treatment.

A psychiatrist gives an accurate diagnosis and suggests appropriate treatment plans. They're experts in their field and have knowledge on research, medications and other treatment therapies that may help the person. A psychiatrist will work with the person to determine a treatment plan that's best for them.

What we do

We help assess and treat people with intellectual disabilities who present with a wide range of psychiatric disorders and associated behavioural challenges, in particular, looking at issues that change the way a person thinks, feels and behaves.
We also support people with intellectual disabilities who also have autism and/or ADHD with their mental health.
We assess and treat conditions that affect the way the brain works such as dementia.
We can offer medication to treat psychiatric conditions.
We also work very closely with other members of the multidisciplinary team to help the individual get back to their day to day lives.

Psychological services

Clinical psychology

What is a clinical / counselling psychologist?

Clinical and counselling psychologists in learning disability services work with a range of psychological difficulties and potential mental health problems. They may work with the individual themselves or the system around them to offer specialist psychological assessments and to develop an understanding of someone's distress. They will then develop interventions to promote outcomes such as improved emotional wellbeing or physical health, or to help improve an individual's safety and quality of life. They will often work as part of a multidisciplinary team taking a person-centred approach to achieve these outcomes.

What do we do?

Psychologists in learning disability services can offer individual and group therapy by integrating many evidence-based therapies and models to meet the needs of the individual. For example:

Cognitive behaviour therapy with sometimes a greater emphasis on behavioural and practical approaches.
Ideas from acceptance and commitment therapy, in particular connecting with values and mindfulness.
Psychodynamic ideas particularly supporting people with understanding and improving relationships.
Systemic ideas for working with the individuals, their families, carers and other professionals.

They will often work in creative ways to make psychological therapy more meaningful and accessible for individuals who have cognitive or communication difficulties.

Clinical and counselling psychologists in learning disability services may also work with the families or carers of a person with a learning disability. This might be to help understand reasons for a person's behaviour and to help better meet the person's needs. They will often use positive behaviour support as an approach to do this, to help enhance quality of life and to reduce restrictive practices and risks. They will always integrate an understanding of attachment and trauma when working with an individual or their support network. Psychologists will often offer teaching, training, consultation and supervision to others on psychological issues. They will often have assistant psychologists or trainee psychologists supporting them in their work.

Psychologists within learning disability services may also take part in research to improve understanding of clinical issues and to use this to inform the development of interventions and services.

Art therapy

What is art therapy?

Art therapy is a psychotherapeutic intervention which uses art as a form of expression, alongside talking with an art therapist.

It allows individuals to develop a voice, especially for those with non-verbal communication who may have traditionally been deemed as 'hard to reach'. It allows individuals to explore their feelings and communicate complex thoughts through art making to build a therapeutic relationship, whilst gaining insight and understanding around difficult and traumatic experiences.

How can art therapy help?

Art therapy may help individuals with a learning disability or whose lives have been affected by traumatic personal or cultural experiences, illness, disabilities and/or have an additional psychological need. These may include anxiety, a change in behaviours, bereavement issues, dementia, trauma, communication issues, attachment or relational difficulties, depression, eating disorders or sensory needs.

Art therapy can support individuals with emotional expression, without verbal communication in a safe and non-judgemental space. The session will offer individuals a space to be heard and listened to whilst offering and sharing skills to build on self-expression and boost self-esteem.

Do you have to be good at art?

No. Individuals do not need to be skilled in art, as long as the person is willing to engage with the art materials and the creative process.

What to expect at your appointment?

An appointment will be arranged to meet with the art therapist to introduce what art therapy is, what to expect throughout the process, and how work is confidentially stored.

Once clients have given their consent, there will be an assessment period of 3 weeks. If an individual has engaged with the art materials and the therapy process, and give consent to continue the process, individuals will be offered a further 20 sessions which will be reviewed regularly by the therapist.

If the therapist feels that there is no evidence of engagement or the individual wishes to discontinue with therapy at any point, individuals have the option to end therapy. All individuals have the option to take their work home or have their work confidentially stored or disposed of.

Music therapy

What is music therapy?

Music therapy is a psychotherapeutic intervention that uses music as a form of self-expression. Music therapy enables individuals to explore their feelings, to process difficult experiences and to feel understood, all within a supportive relationship.

What do we do?

Music therapists create music with their clients. Through playing music together and listening to music, the therapist aims to support positive changes in the clients' emotional wellbeing, communication and self-awareness.

Music therapists can engage those who may have traditionally been deemed 'hard to reach' because they work with non-verbal forms of communication. They can also work with people who are verbal but who, for a variety of reasons, find traditional talking therapies difficult to access.

Who is music therapy for?

Within community learning disability services, music therapists work with anyone who has a learning disability with additional needs such as mental health issues, trauma, dementia and attachment issues.

Does the person need to be good at music?

Not at all. Music therapy works for anyone who is willing to make music and explore the language of sound. Music therapists do not teach anyone how to play music, rather the clients are encouraged to play music of their own and find their own voice within the music making.

What to expect at the appointment?

Usually, both clients and therapists take an active part in the sessions by playing, singing and listening. A wide range of instruments are available and clients will be encouraged to use these to express themselves, explore how they are feeling and to gain an understanding of how they respond to difficult and traumatic experiences.

Song writing may also be used to support clients to tell their own narratives and to gain insight about themselves as they process their experiences.

Community nursing

What is a community learning disability nurse?

The role of a community learning disability nurse is to support individuals and their families to ensure health needs are met and individuals are able to live healthy and meaningful lives, as independently as possible.

Learning disability nursing differs from other fields of nursing as we do not focus on 'fixing' or 'curing' the person but on changing the environment, our communication and the perceptions, attitudes and values of others to ensure that person is fully supported to live a healthy and fulfilling life.

What we do

We work across the lifespan, working with young adults to older adults. This population has a diverse range of health needs, including physical disabilities, mental wellbeing, neurological conditions and specific syndromes. We play a vital role working within a multidisciplinary health team and with partners in social care and other agencies.

Our main role will include:

Improving and maintaining a person's physical and mental health.
Reducing health inequalities that lead to the premature death of people with learning disabilities.
Reducing barriers to health and care services to promote an individual's wellbeing.
Supporting the person in living a fulfilling life.
Supporting individuals to access health and social care services: assessing, planning, delivering and evaluating holistic, person-centred care.
Education around health needs for individuals, their support teams and professionals, such as GPs and social workers.
Inputting into Positive Behavioural Support Plans.

We work with a range of individuals such as GPs, psychologists, social workers, teachers, occupational therapists, physiotherapists, speech and language therapists and many other speciality teams to ensure that the individual's needs are met.

Health facilitation and acute liaison

What is an acute liaison nurse?

An acute liaison nurse is a nurse who works mainly within the hospital setting. We can visit the person if they are in hospital and will also support them with any general hospital appointments.

We ensure that adults with learning disabilities receive the healthcare they need to live healthy lives and are treated as equal citizens within society. We provide specialist advice and support to both people with a learning disability and to health services in order to reduce the health inequalities and premature mortality that people with a learning disability face.

The team has identified nurses, who work and liaise with the local acute hospitals. They cover University Hospitals Coventry and Warwickshire, George Eliot Hospital in Nuneaton, Warwick Hospital, Solihull Hospital, Good Hope Hospital and Heartlands Hospital. The nurses support people through hospital admissions.

What we do

We help staff to understand the needs of adults with a learning disability to ensure that they have a positive experience whilst in hospital.
We promote the rights for the individual.
We can help to plan their hospital appointments and come to appointments with them.
We help support people who have fears and/or anxieties around medical interventions and their general health.
We can advise hospital staff in relation to the Mental Capacity Act (2005) including best interest meetings and the referral process for an Independent Mental Capacity Advocate (IMCA), if needed.
We can provide appropriate information and easy read materials to help the person get effective care and treatment.
We can support the individual, family, care providers and/or professionals to ensure that appropriate reasonable adjustments are made.
We can attend pre-discharge meetings to promote safer discharges.

Speech and language therapy (communication)

What is speech and language therapy?

Speech and language therapists provide treatment and support for people who have difficulties with communication, eating, drinking or swallowing. Speech and language therapists assess and treat speech, language and communication problems, to help them communicate better. They also assess, treat and develop personalised plans to support people who have eating, drinking and swallowing problems (please see the dysphagia section).

What we do:

We work directly with clients, their family and carers to assess, treat and provide them with tailored support.
We work with the person at their level to support them and help reduce communication difficulties and breakdowns.
We will advise the people who support the person on the best ways of communicating with them. This might involve using signing systems (such as Makaton), visual resources, high tech communication aids, objects of reference, photos or symbols, amongst many other things.
We also work closely with other health professionals, such as doctors, nurses, other allied health professionals and psychologists to develop individual treatment programmes.
We may write reports and provide information so that people know how to communicate with the person in the best way.
We offer support and training to the people who support the person.

Speech and language therapy can help if:

The person you support has difficulties talking and/ or understanding.
They have difficulty coping when things change.
They need pictures, symbols or any augmentative or alternative forms of communication to help them communicate.

What to expect at the appointment:

We may do an assessment using activities such as games or looking at pictures and objects, to find out which things the person finds easy and what they find difficult.
We will talk with people who know the person well to get to know them better.
We might use symbols, pictures or other resources to make communication easier.

We can make the following visual resources to help the person.

Communication passport or profile - information about how the person communicates and what people can do to help.
Visual timetable - symbols and pictures to help understand daily events and activities.
Symbols - symbols or pictures to help the person tell people what they want or to understand what someone is saying to them.
Easy read information - simplified information with symbols or pictures.
Social stories - step by step outline of an activity to help the person get ready for what will happen.
Talking mats - using symbols and pictures to help the person make decisions or choices.

Where will we see the person?

We can see them wherever they prefer!

This could be at:

home
a day centre
college
the person's local community team base.

Swallowing difficulties (dysphagia)

What is dysphagia?

Dysphagia is a difficulty with eating or drinking. This could include a difficulty coordinating lip, tongue and jaw movements to chew or to move food or drink around the mouth, or a difficulty with swallowing.

Signs that someone with an eating, drinking or swallowing difficulty may show:

Coughing or choking during or after eating or drinking.
Changing colour or noisy breathing during or after eating or drinking.
Gurgling, or rattling voice or breathing, when eating or drinking.
Difficulty chewing and refusing food.
Gagging when eating or drinking.
Prolonged mealtimes.
Regular chest infections.
Weight loss.

What we do

If the person agrees to working with the team or it is in their best interests:

We work with the person, their family and carers to see why they are having problems eating, drinking and swallowing.
We will assess the person's swallow on foods and drinks.
We will try different textures of foods to find the ones they find easier.
We will try different thickness of drinks to see which they find the easiest.
We will work with the person to see if a different way of sitting or using different cups or cutlery helps them.
We will work with other therapists and nurses in the learning disability team to make a plan that helps the person the most.
We will review how the person's eating, drinking and swallowing is after they use the new plan.
We will refer the person for other tests or to other professionals if we think this will be an extra help for them.

When the carers feel that the person's eating, drinking and swallowing is getting better, we will discharge them. They can come back to the team if things change again (a new referral is needed).

Who is dysphagia support for?

Within community learning disability services, dysphagia support is for anyone who is struggling with eating and drinking or has difficulty swallowing.

What to expect at your appointment

The therapist will visit the person at home or at the day centre.
They will be wearing a uniform and may also be wearing a mask.
They will talk to the person and their family and carers to get information about how they eat and drink.
They may ask the person to copy some actions with their tongue and lips.
They will watch them eat and drink to see how easy or difficult it is for them.
If the person agrees, they will gently put their fingers on their throat, to feel their swallow.
If the person agrees, they will put a stethoscope on their throat, to listen to their swallow.
If the person agrees, they will put a pulse oximeter on their finger, to measure their blood oxygen.
They may ask the person to try other foods or drinks.
They may change how the food is prepared, to look for the easiest texture for the person.
They will explain what they feel is the difficulty for them and the ways that would help.
They will leave some easy read information about textures and ways of eating to help them.
After the assessment, they will write a report and a support plan for eating and drinking for them and their carers and healthcare professionals.
They will see the person for another assessment if this would be helpful.
Every assessment will follow the same pattern.

Occupational therapy

What is occupational therapy?

Occupational therapy helps a person live their best life at home, work and everywhere else. It's about being able to do the things they want and have to do. That could mean helping a person overcome challenges learning at school, going to work, playing sport or simply doing the dishes. Everything is focused on their wellbeing and their ability to participate in activities.

What are occupations?
An occupation is any activity that we need, want or like to do to live and to look after our physical and mental health and our emotional and spiritual wellbeing. We do occupations from the moment we're born on our own or with others.

Occupation isn't just a job or activities of daily living. An occupation can be self-care, such as washing, eating or sleeping; productive, such as work, study, caring or domestic activities; and leisure, such as playing sports, hobbies or socialising.

We're all different and so are the occupations that matter to us. They vary depending on our environment, interests and values, talents and skills. Our occupations also change throughout our lives.

Why do occupations matter?

Occupations are essential to living. They give our lives meaning, purpose and structure. They help shape who we are, connect us with others and help create our identity and sense of belonging. Through occupation we enhance our health and quality of life.

Focusing on occupation leads to improvements in our ability to do the things we need and want to do, our social relationships, communication and connections as well as our mood, rest and sleep.

Occupations are particularly important when we're going through times of change. When we can't do an occupation anymore or we need to adjust the way we do it, because of ill health or other barriers, our sense of self and purpose may change. This is where occupational therapy comes in.

What we do

An occupational therapist helps people of all ages overcome challenges and complete everyday tasks or activities - what we call 'occupations'.

Occupational therapists see beyond diagnoses and limitations to hopes and aspirations. They look at relationships between the activities a person does every day - their occupations - alongside the challenges they face and their environment.

We give advice and support with barriers to a person's daily occupations, for example, work, homemaking activities, leisure skills, self-care and accessing the community. We support with understanding and strategies to overcome these barriers.

We help people with their routines and to have meaningful roles.

We help adapt the environment so people can cope better.

We advise carers how to support people more effectively and promote the person's participation in occupations.

Physiotherapy

What is physiotherapy?

Learning disability physiotherapists give specialist assessments, treatment and management to adults with a learning disability whose needs cannot be successfully met by mainstream services, even if reasonable adjustments have been made.

Physiotherapists will work jointly with the person, their care team, mainstream health services and the multidisciplinary team to improve, enhance and support the person's physical presentation, function and quality of life.

What we do

24-hour postural management.
Management of mobility problems.
Rehabilitation from acute injuries and conditions.
Falls prevention and intervention.
Complex and therapeutic manual handling.
Spasticity and hypertonia (abnormally high level or muscle tone or tension).
Health promotion.
Supporting transition from children's services to adult services.
Provision of specialist equipment.
Training and education of adults with a learning disability, their network of care, other health and social care professionals.
Supporting multidisciplinary management of dysphagia (swallowing difficulties).
Advice about managing excess oral and respiratory secretions.

Helpful videos

Speech and language therapy (communication)

Getting started with communication books:

Objects of reference:

Visual timetables:

Now and next:

Choice board training:

Nursing:

Why do we need to relax?

Relaxation - stretching techniques

Relaxation - breathing techniques

Relaxation session

Psychiatry:

Good doctors and bad doctors:

Good doctor

Bad doctor

Top tips

Swallowing difficulties (dysphagia):

But can I have still have chocolate?

Dynamic Support Register (DSR)

What is the Dynamic Support Register (DSR)?

The Dynamic Support Register (DSR) is a register which identifies children, young people and adults who:

have been formally diagnosed as Autistic and/or having a Learning Disability and
who are at risk of admission to a specialist Mental Health or Learning Disability Hospital.

The goal of the register is to ensure the right level of support is identified and provided, to enable the person to live their life in a way that they would like to at home.

The Dynamic Support Register helps to:

Identify people at risk of admission to a specialist Mental Health or Learning Disability Hospital and understand these risks.
Organise Care Education and Treatment Reviews (CETR) for children and Care and Treatment Reviews (CTR) for adults.

What is a C(E)TR / CTR?

The CETR/CTR is a person-centred approach to planning support that is needed. The meeting may include the person, parent or key people, health, education, social care, voluntary and the private sector.
The CETR and CTR will identify support needed to help prevent a child/adult from being admitted to a specialist Mental Health or Learning disability Hospital.

How do I make a referral onto the Dynamic Support Register?

Referrals can be made online - by an individual requiring support, their carer or by a health or social care professional.

For Solihull referrals:

Birmingham and Solihull DSR: Dynamic Support Register

For Coventry and Warwickshire referrals:

Coventry & Warwickshire DSR: Dynamic Support Register

Adult learning disability and autism services

Search the Coventry and Warwickshire Partnership NHS Trust website

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