Social care occupational therapy and learning disabilities: professional perspectives on communication, collaboration and making a difference

PURPOSE: Adults with learning disabilities experience a poorer quality of life than the general population. Social care can critically support such adults and their informal carers, but limited literature exists about occupational therapy provision. This study explored the extent to which social care occupational therapists support communication and collaboration, and make a difference. METHODS: Eight social care occupational therapists were recruited through professional networks. Online interviews were undertaken using topic guides co-designed with professionals and experts by experience. Reflexive thematic analysis was employed, informed by critical realism. FINDINGS: Therapists pursued inclusive practices with adults with learning disabilities and valued informal carers. The communication challenges increased the reliance on carer input and raised doubts about interventions reflecting the wishes of adults with learning disabilities. Carer disagreements were navigated through diplomacy and positive risk-taking, but concerns about moving and handling safety led to faltering collaboration. Therapists felt that they enhanced community engagement and reduced carer burden, but workload limited their scope of practice. CONCLUSIONS: Social care occupational therapists strive to work inclusively with adults with learning disabilities and their informal carers, with beneficial outcomes, requiring various profession-based and interpersonal skillsets. However, communication difficulties create uncertainty. Practice-improvement opportunities include additional training and enhanced multidisciplinary working.