| Abstract: | Objective data on the quality of 15 residential homes and 17 day centres were collected as part of a Social Services Inspecorate inspection of services for adults with learning disabilities in eight local authorities in England. A sample of 56 residents was drawn from the former and information collected on their behavioural characteristics, social and community integration, autonomy, receipt of attention and assistance from staff, and participation in activity. The activity timetables of the latter were analysed to determine their emphases. Representative group activities taking place within the centres were observed and user:staff ratios, user receipt of attention from staff and user engagement in activity recorded. Findings from the residential settings demonstrated that the frequency of community integration, the extent of autonomy and the level of activity were associated with resident ability. However, there was a lack of association between staff:resident interaction and resident needs for support. Given the ranges on the quality of life indicators investigated, people with more severe disabilities were found to lead segregated and under occupied existences. These findings add weight to the need to be more precise about the determinants of quality and, in particular, the role and performance of staff. A cluster analysis of day centres based on their activity distributions produced two clusters in common with an earlier Welsh survey; centres with an emphasis on ‘recreation and personal development’ or ‘recreation’. The English sample, however, had a lesser emphasis on both contract work and open employment and contained centres which had a greater representation of personal development and education. Developing consensus on the functions and goals of day services is required if day service reform is to lead to the most effective organisational and operational arrangements. |
