Challenging behaviour services review finds specialist congregate services use more restrictive approaches with limited effect.

by John Northfield

This literature review looked at evaluations of service provision in the UK for people with challenging behaviours, reviewing the literature from 1990 to 2010 looking at studies that evaluated a range of UK service provision in terms of impact on … Continue reading →

NHS Evidence QIPP, case study: Care Funding Calculator

The London boroughs of Barnet and Islington, Southwark, Havering and Harrow have delivered substantial savings in residential care for people with learning disabilities by using a fair pricing tool. By implementing the Care Funding Calculator (CFC) – a tool developed to prevent councils paying different amounts for similar care packages – local purchasers can better understand the costs for accommodation‐based care. This has allowed them to assess the level of staff support required to meet an individual's needs and agree a price based on relevant market knowledge. By moving towards different types of accommodation - such as supportive living under a tenancy or enabling users to invest in shared ownership schemes - more individuals have been able to live in their home area rather than being restricted to 'out of borough' residential options. The average saving per PCT area in each London borough was £500,000 mainly achieved through a reduction in the number of high cost residential placements. This equates to almost £200,000 per 100,000 population. Sarah Hollingworth, Department of Health lead on the initiative, said: "In some councils it is the social worker's responsibility to negotiate costs and terms with care providers – understandably their primary concern is sourcing and arranging the care needed as quickly as possible. By making a strategic shift towards to commissioning other types of living options we have delivered real cash savings, whilst still meeting the needs of individuals." For more details see the NHS Evidence QIPP collection.

People with Intellectual Disabilities: Towards a Good Life? Kelly Johnson and Jan Walmsley with Marie Wolfe Policy Press, University of Bristol, Bristol. 2010. 204 pp., £24.99. ISBN 978-1-84742-068-8.

Born of justifiable frustration with current policy and a desire to initiate a wave of new thinking, Kelly Johnson and JanWalmsley consider the ‘good life’ and what it might be for men and women with an intellectual disability (ID). This book, divided into three parts, each comprising three chapters, begins with MarieWolfe, a woman with a learning disability, reflecting on her life (Chapter 1). Her reflections that encompass her involvement in the advocacy movement, living both independently and in group homes, and her hopes and aspirations for the future are followed (Chapter 2) by a discussion of the ‘good life’. Here the authors, through a wide ranging collection ofWestern minds, search for new ideas and report upon their attempts to ascertain what the ‘good life’ might comprise. Their findings, although far from definitive, point to the enduring significance of reason, along with the importance of both freedoms and duties.While clearly uncomfortable with defining the ‘good life’, the authors reel off the usual obstacles to achieving it: oppression, absence of physical safety, a failure of recognition and, tellingly for our society, narrowly defined and imposed definitions of happiness that rely upon the accumulation of positional goods. Armed with this and Marie’s description of her life, Johnson and Walmsley reflect directly on the ‘good life’ for men and women with IDs (Chapter 3)…..

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