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A better life: the implementation and effect of person-centred active support in the Avenues Trust
- Authors:
- BEADLE-BROWN Julie, HUTCHINSON Aislinn, WHELTON Beckie
- Journal article citation:
- Tizard Learning Disability Review, 13(4), December 2008, pp.15-24.
- Publisher:
- Emerald
Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person-centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid to both training staff and the level of increased engagement increased significantly after the introduction of person-centred active support. In addition, people experienced decreased self-stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learned about the implementation are provided.
Implementation and evaluation of active support
- Authors:
- BRADSHAW Jill, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(3), September 2004, pp.139-148.
- Publisher:
- Wiley
Active support was implemented in three community houses (active support houses), with 11 service users with severe learning disabilities. This was evaluated with reference to changes in levels of engagement, challenging behaviour (major and minor) and staff contact, measured against three comparison services (non-active support houses). All measures increased for the active support houses. Significant increases in activity levels were found in one house. Statistically significant increases in activity and minor challenging behaviour were also found when all active support houses were compared with all non-active support houses. In the non-active support houses, all measures decreased, with the exception of mean level of staff contact in one house. Unlike previous research findings, those service users who were less able did not receive comparatively more support from staff post-training and changes appeared unrelated to staff contact.
Managers’ views of skilled support
- Authors:
- BRADSHAW Jill, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(5), 2018, pp.873-884.
- Publisher:
- Wiley
Background: Quality of life of people with intellectual and developmental disabilities has been found to primarily depend on whether staff are providing facilitative and enabling support that helps to compensate for severity of disability. Managers have a key role in facilitating staff to provide such support. Method: Qualitative interviews were conducted with 35 managers of supported accommodation services to explore service aims and the nature of, and challenges in providing, skilled support. Key themes were identified using a Thematic Networks Analysis. Results: Service aims were rarely formalised, were related to the individuals supported and not to the organisation. Managers found it difficult to define skilled support, other than by reference to individuals. Practice leadership roles were challenged as a result of austerity measures. Conclusions: Front‐line managers need more information and training in skilled support, with stronger leadership from senior management to provide the motivation and resources needed. (Edited publisher abstract)
Housing with care and support: a snapshot of the sector and its challenges and opportunities
- Author:
- SKILLS FOR CARE
- Publisher:
- Skills for Care
- Publication year:
- 2017
- Pagination:
- 36
- Place of publication:
- Leeds
Using five in-depth case studies of housing with care and support providers, this paper explores the strategic and operational issues they face, the influence these have on their workforce and what they saw as the future challenges ahead. The five case studies focused on extra care housing for older people and supported living for people with learning disabilities. The services were set up using different delivery models, some splitting the landlord function from the housing support function and some separating the housing from the care function, with some keeping all three together. Issues discussed include: the structure of the service and its effect on learning and development, workforce planning; recruitment and retention; progression and career development; and partnership, integration and changing expectations of commissioners and their influence on the workforce. Common themes identified across the sites included: challenges in recruitment and retention; lone working as a factor in poor staff retention; and an increasing number of people with high levels of need living in extra care housing, placing the model at risk. Common gaps in learning included mental health, substance dependence, anti-social behaviour, challenging behaviour and preventing loneliness. (Edited publisher abstract)
A comparison of support for two groups of young adults with mild intellectual disability
- Authors:
- SOENEN Sarah, BERCKELAER-ONNES Ina van, SCHOLTE Evert
- Journal article citation:
- British Journal of Learning Disabilities, 44(2), 2016, pp.146-158.
- Publisher:
- Wiley
Young adults with mild to borderline intellectual disability (MBID) have varying profiles of cognitive, adaptive and behavioural functioning. There is also variability in their educational and therapeutic needs. This study compares recommended and actual provision of support for two groups of young adults with MBID and looks at young adults’ satisfaction with their support. Participants’ clinical files were analysed and a satisfaction interview was administered. Descriptive statistics were used to characterise the groups, and t-tests or chi-square tests were used to explore similarities and differences between the groups. A combined, supported independent living setting, a structuring and regulating support style and psychotherapy were recommended for the young adults in group 1 (MBID with externalising behavioural problems), whilst independent living with access to community support services and a meeting house, and skills training was recommended for group 2 (MBID with internalising behavioural problems). Both groups were considered capable of standard employment with support from a job coach. The authors found mismatches between recommended and actual provision of support. The findings suggest that service providers do not focus enough on the educational support needs, but therapeutic needs are generally more often met. (Edited publisher abstract)
Don't shut me in
- Author:
- GILLEN Sally
- Journal article citation:
- Learning Disability Today, August 2011, pp.12-15.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Despite being in force for two years, recent cases have highlighted a lack of training and awareness in the Deprivation of Liberty Safeguards. This article discusses the difficulties in defining a deprivation of liberty, explores the implications of recent court rulings and identifies gaps in training provision for social work managers and staff.
Pain in people with learning disabilities in residential settings: the need for change
- Authors:
- BEACROFT Monica, DODD Karen
- Journal article citation:
- British Journal of Learning Disabilities, 38(3), September 2010, pp.201-209.
- Publisher:
- Wiley
Many people with learning disabilities find it difficult to communicate effectively that they are in pain or how they are feeling. This audit investigated residential staff beliefs around pain thresholds, and the strategies they adopt to recognise and manage pain in people with learning disabilities. A structured interview was held with 58 staff from 33 residential homes and supported living services across Surrey. The results demonstrated that pain is not being effectively recognised or managed by residential staff, and that people with learning disabilities are not getting timely and appropriate medication for their pain. Some staff still believed that people with learning disabilities have a higher pain threshold than people without a learning disability, and let this belief affect how they manage pain. The results highlighted the need for training for staff in how to recognise and manage pain, as well as the need for appropriate pain recognition tools and communication aids to be utilised to support people with learning disabilities to be able to communicate their pain to others. It also indicated the need for better communication between staff and other services that the person with learning disabilities accesses.
Making it work: strategies for success in supported employment
- Authors:
- JONES Stephanie, et al
- Publisher:
- Pavilion/Joseph Rowntree Foundation
- Publication year:
- 2002
- Pagination:
- 50p.
- Place of publication:
- Brighton
Explores the experiences and strategies for success of supported employees, employers, colleagues and job coaches. The report focuses on the experiences of people with learning difficulties themselves and was carried out in collaboration with members of the self advocacy group People First Wales.
Implementation of active support over time in Australia
- Authors:
- BIGBY Christine, BOULD Emma, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 44(2), 2019, pp.161-173.
- Publisher:
- Taylor and Francis
Background: Research indicates the value of active support in achieving good outcomes across a number of quality of life domains for people with intellectual disabilities. However, implementation is not easy, and little research has explored why. The study aimed to identify some of the factors that impact on implementation of active support in supported accommodation services. Methods: Data on the quality of active support, staff training and practice leadership were collected through staff questionnaires, observations and manager interviews, for between two and four years across six organisations. Results: Active support improved over time for more able people with intellectual disability, but not for people with higher support needs. There was a weak positive correlation between active support and (1) practice leadership scores, and (2) the percentage of staff reporting active support training. Conclusions: It is important to recognise the influence of practice leadership and staff training on the quality of support and ensure provision for these in funding schemes. (Edited publisher abstract)