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Improving quality of life outcomes in supported accommodation for people with intellectual disability: what makes a difference?
- Authors:
- BIGBY Christine, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(2), 2018, pp.e182-e200.
- Publisher:
- Wiley
Background: The quality of life (QOL) of people with intellectual disability living in supported accommodation services is variable, influenced by many possible factors. Various frameworks have attempted to identify these factors without assigning value, direction of influence or relative impact on outcomes. Methods: A realist review of the literature aimed to expose different propositions about variables influencing QOL outcomes and review the strength of supporting evidence for these, to identify their relative influence. Evidence was reviewed for and against each of five clusters. Results: Evidence was strongest for the presence of staff practices (use of Active Support), front-line management practice (use of practice leadership), culture (enabling and motivating), human resources policies and practice (that support front-line leaders and recruitment of staff with the right values), adequate resources, and small, dispersed and homelike settings. Conclusions: The evidence informs policy and practice but in some clusters remains limited, warranting further research which measures outcomes on all QOL domains. (Publisher abstract)
Individual planning: an exploration of the link between quality of plan and quality of life
- Authors:
- ADAMS Lynn, MANSELL Jim, BEADLE-BROWN Julie
- Journal article citation:
- British Journal of Learning Disabilities, 34(2), June 2006, pp.68-76.
- Publisher:
- Wiley
In this study individual plans for people with intellectual disabilities were evaluated for quality and effectiveness in improving quality of life. Quality was assessed by rating whether goals were relevant, observable, age appropriate, necessary, timetabled, developmental, measurable, realistic, assigned to staff and improving at least one of O'Brien's five service accomplishments. Effectiveness was assessed by examining quality of life outcomes for participants with and without individual plans rated as higher quality. No significant difference in outcomes associated with having a higher quality individual plan was found. Findings present a challenge to current expectations that presence and quality of individual plan goals are associated with improved outcomes. Written individual plan goals may not be directly correlated with actual practice, and further research is required to examine this.
Outcomes and costs of skilled support for people with severe or profound intellectual disability and complex needs
- Authors:
- BEADLE-BROWN Julie, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.42-54.
- Publisher:
- Wiley
Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time, and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality. (Edited publisher abstract)
Deinstitutionalization and community living: outcomes and costs: report of a European study: volume 3: country reports
- Editors:
- BEADLE-BROWN Julie, KOZMA Agnes, (eds.)
- Publisher:
- University of Kent. Tizard Centre
- Publication year:
- 2007
- Pagination:
- 599p.
- Place of publication:
- Canterbury
These country reports form the third volume of the final report from the European Union Project Deinstitutionalisation and community living – outcomes and costs: report of a European Study. There are 28 country reports included. The aim of each report is three-fold: to summarise the data collated for the template for each of the service types identified for that country; to comment on the completeness and adequacy of the data collated; to provide a commentary on the context and current situation for people with disabilities in each country. In order to analyse, summarise and compare data across countries, information received on each template was recorded into categories. It is these categories which are included in the data summaries at the beginning of each of the country reports.
Care standards in homes for people with intellectual disabilities
- Authors:
- BEADLE-BROWN Julie, HUTCHINSON Aislinn, MANSELL Jim
- Publisher:
- Tizard Centre
- Publication year:
- 2005
- Pagination:
- 13p.
- Place of publication:
- Canterbury
National minimum standards for residential care homes were introduced following the Care Standards Act 2000 in response to concern about lack of consistency and poor quality services. These standards are intended to reflect outcomes for service users and to be comprehensive in scope. This study compared ratings made by care standards inspectors with research measures for 52 homes for people with intellectual disabilities serving 299 people. The research measures focused on the lived experience of residential care, including engagement in meaningful activity, choice and participation in activities of daily living. They also included measures of related care practices and organisational arrangements. The research measures were in general significantly correlated with each other. Most of the care standards ratings were also correlated with each other.
Comparing costs and outcomes of supported living with group homes in Australia
- Authors:
- BIGBY Christine, BOULD Emma, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 43(3), 2018, pp.295-307.
- Publisher:
- Taylor and Francis
Background: Supported living is perceived as more flexible than group homes for people with intellectual disability. This study identified costs and factors associated with quality of life (QOL) in supported living and compared this with group homes. Method: Thirty-one residents in supported living participated in a survey incorporating measures of service user characteristics and QOL. Participants in supported living were compared to a sample of 397 people in 96 group homes, and QOL outcomes compared for a matched sample of 29 people in supported living and group homes. Results: QOL differed little, supported living was cheaper, and 30–35% of both groups had similar support needs. Being younger, having autism, better health, family support, and participation in structured activities were associated with better outcomes in supported living. Conclusions: Supported living holds potential for group home residents, but greater support is required in domains such as health and interpersonal relationships. (Edited publisher abstract)
Evaluating service users’ experiences using Talking Mats®
- Authors:
- STEWART Kitty, BRADSHAW Jill, BEADLE-BROWN Julie
- Journal article citation:
- Tizard Learning Disability Review, 23(2), 2018, pp.78-86.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to establish the effectiveness of Talking Mats® (TM) in evaluating service users’ experiences, and explore their views of the implementation of person-centred active support (PCAS). Design/methodology/approach: This is a mixed-methods study, employing qualitative interviewing and observational measures. Findings: Both qualitative and quantitative measures indicated inconsistent implementation of PCAS. It was possible to effectively gain participants’ views on positive and negative aspects of quality of support and quality of life, using TM, across three themes, My life, My support and Self-determination. Research limitations/implications: Generalisability of the research may be limited due to the sample, and the potential for researcher and interviewer bias is acknowledged. Practical implications: TM provides a mechanism that may facilitate the inclusion of the views and experiences of people with intellectual and developmental disability (PWIDD) who have limited verbal skills. Their views need to be reflected in adaptions made to PCAS. Originality/value: This study included a population who are often left out of qualitative research because of the methodologies adopted. It also included older PWIDD, where there has been less research about the effectiveness of TM. (Edited publisher abstract)