title: Working with people with learning disabilities in varying degrees of security: nurses' perceptions of competencies.
abstract: OBJECTIVE
  To identify and discuss the competencies required by learning disability nurses to work effectively with people with an offending background in low, medium, high secure and community settings.
  
  
  BACKGROUND
  Research into the competencies required by nurses working with individuals with an offending background, particularly those with a learning disability, is limited. There is some uncertainty as to whether there should be differentiation according to specific setting.
  
  
  METHODS
  A qualitative study addressing the perceptions of nurses on the knowledge, skills and competencies required to effectively work with people with learning disabilities and an offending background in different settings.
  
  
  METHODS
  Seven focus groups were conducted across the four settings to inform the construction of the semi-structured interview schedule. Thirty-nine interviews were subsequently undertaken with nurses across settings to develop a fuller understanding of the competencies and ascertain if these were influenced by the specific setting where the nurses worked. Data were collected over 1-year in 2010 and analysed using a structured thematic analysis supported by the software package MAXqda.
  
  
  RESULTS
  The thematic analysis produced four over-arching competencies: knowledge assimilation and application; team working; communication skills; and decision-making. A further competency around personal attributes constitutes the basis of a future paper.
  
  
  CONCLUSIONS
  The first three competencies combine well to inform the work of nurses and appear transferable across settings, but the fourth appears more complicated, specifically in terms of the role of risk in supporting or detracting from decision-making capacity.
authors.affiliation: Faculty of Health & Social Care, University of Chester, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lovell
authors.affiliation: Faculty of Health & Social Care, University of Chester, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Bailey
authors.affiliation: Cheshire & Wirral Partnership NHS Foundation Trust, Macclesfield, Cheshire, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Kingdon
authors.affiliation: Harper Adams University College, Newport, UK.
authors.forename: Domenica
authors.initials: D
authors.lastname: Gentile
mesh_terms: D003142:Communication; D017144:Focus Groups; D006801:Humans; D007859:Learning Disabilities / Q000523:psychology*; D009723:Nurse-Patient Relations; D009740:Nursing Staff / Q000523:psychology*; D011361:Professional Competence
keywords: competencies; forensic; learning disability; nursing; secure setting; skills