Supported accommodation
1 / 27

supported accommodation - PowerPoint PPT Presentation

  • Uploaded on

Supported Accommodation. Eric Emerson. Three Themes . Lessons from history The policy context Lessons from evaluation research Costs & benefits Lessons from epidemiology/demography Future need & demand. Royal Albert Asylum, Lancaster. Intermediate Boys Class, Royal Albert, 1903.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'supported accommodation ' - jacob

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Three themes
Three Themes

  • Lessons from history

    • The policy context

  • Lessons from evaluation research

    • Costs & benefits

  • Lessons from epidemiology/demography

    • Future need & demand

1960 s 1970 s
1960’s & 1970’s

  • Scandals & inquiries

  • Social justice - unacceptable gap between normative notions of common decency and conditions

Key messages
Key Messages

  • Weak association between building design and purpose (and life experiences of people with learning disabilities)

  • Good intentions are not enough

  • Humility

Policy driven questions
Policy-driven Questions …

  • Who succeeds? (Who fails?)

    • People with lower support needs and who do not have challenging behaviours

  • What are the ‘benefits’ of deinstitutionalisation ?


Systematic review of UK and Irish studies 1981-1995

118 publications

70 separate studies

5,800 people with learning disabilities

(Currently being updated for NDA, Ireland)

Clear benefits

community presence, engagement, support, satisfaction

Possible/probable benefits

friendships, choice

No benefits

challenging behaviour

No systematic disadvantages


Key messages1
Key Messages

  • Deinstitutionalisation was to the benefit of people with learning disabilities

  • Inequalities

    • What benefits

    • Who benefits

Policy driven questions1
Policy-driven Questions …

  • What are the determinants of quality in community-based provision?

  • Cost-effectiveness of alternative approaches to community-based provision?

  • Do community-based supports provide an acceptable ‘quality of life’?

The determinants of quality

Moderate links between outcomes and

participant ability

staff support & staff management practices

some structural characteristics (clustering, functional grouping - but only for challenging behaviour, size?, model?)

Weak (if any) links between outcomes and

structural characteristics (size?, provider, model?)

resources (costs, staffing ratios, qualifications & skills)

But what about ….


Organisational culture?

The Determinants of Quality?

Costs benefits
Costs & Benefits

  • Little relationship between cost and size (except at lower end for people with higher support needs)

  • Cluster/campus housing has marginally lower cost and significantly lower benefits

  • Grouping together people who have challenging behaviour has higher costs and possibly lower benefits

Key messages2
Key Messages

  • More dispersed (and smaller) services do tend to provide more positive life experiences (largely at no greater cost)

  • Resources are largely unrelated to outcomes

  • Inequalities

    • What benefits

    • Who benefits

An acceptable quality of life
An Acceptable Quality of Life?

  • Face-to-face interviews with 1,729 people

    • supported through the ‘Supporting People’ programme (554)

    • in registered residential care homes (913)

    • in NHS accommodation (262)

  • Themes

    • Social exclusion

    • Choice & control

    • Health & well-being

Social exclusion production employment age 60
Social Exclusion: Production (Employment, Age <60)

Social exclusion relationships
Social Exclusion: Relationships

Contact with Family

Social exclusion relationships1
Social Exclusion: Relationships

Contact with Friends

Key messages3
Key Messages

  • Significant problems remain in addressing (among other things) aspects of

    • Social exclusion

    • Choice, control & self-determination

    • Health and well-being

Changes in the need demand for supported accommodation
Changes in the Need/Demand for Supported Accommodation

  • Changes in the population of people with learning disabilities

    • Incidence

      • No reliable information

    • Prevalence

      • Increased life expectancy

        • In general

        • Children with severe and profound disabilities

        • Older adults

    • Age structure

      • Ageing of the baby boomers

Changes in the need demand for supported accommodation1
Changes in the Need/Demand for Supported Accommodation

  • Changes in expectations

    • Moving away from home

    • Suitability

  • Changes in capacity of informal care

    • Lone carers

      • 32% of children with disabilities in Britain in 2002 were being brought up by a lone parent

      • % of children in lone parent households has risen from 6% in 1971 to 22% in 2004

    • Women & work

Key messages4
Key Messages

  • Increased ‘need’, especially among older age groups

  • Reduced capacity of informal care

  • Increased expectations & demand


  • Need to invest in

    • Dispersed (smaller scale) options

    • Monitoring quality outcomes

    • Continue to addressing social exclusion, choice & health

    • Addressing systemic inequalities

    • Expanding volume of provision

  • Humility & good intentions