There are an increasing number of adults with learning disability who are now being supported to live in their community through housing support and health and social care. My own company Bettal Quality Consultancy has found a considerable uptake for our supported living policies and procedures from providers of homecare services who wish to provide supported living services.
Given that more people with learning disability are choosing to live in properties with supported living services, it is prudent to learn what do people value and rate important to the quality of their lives in the community.
Despite the large amounts of public money being spent, very little is known about how good, supported living/residential care services are, and how much they really cost.
The 200 Lives project
The 200 Lives project, which was led by Professor Chris Hatton of Public Health and Disability at Manchester Metropolitan University’s Centre for Disability Research, examined the quality and costs of supported living and residential care for 200 adults with learning disabilities aged 18-64 years.
The aim of the study was to use this information to get good, up-to-date evidence on the quality and costs of supported living and residential care services to people who can make good use of it.
This study was designed to seek the perspective of people with learning disabilities and to include people who did not have capacity to consent to take part in the research to ensure participants with a wide range of support needs.
The project was funded by the National Institute for Health Research and run by Manchester Metropolitan University in partnership with National Development Team for Inclusion, London School of Economics and Changing Our Lives.
Importance of the local community
The study found who people live with is more important to them than the property itself. For many people, the company of their housemates and staff was one of their favourite things about where they lived. Equally, some people may prefer to live alone or with a partner.
When people did not get along with their housemates or staff, this could be a reason for them to want to move. Those who were in supported living felt more connected to their local community.
These households appeared to be more integrated into their surrounding communities. This can have positives and negatives; people in supported living were more likely to know their neighbours and be more involved in their communities. However, they could be more affected by local crime, antisocial behaviour and deprivation.
In addition, living somewhere for a long time could help people to feel a sense of belonging, as they knew people in the area. People were proud of their roles within their families, friendship groups, local communities and/or romantic partnerships. For example, being part of a local church or supporting their local football team helped them to feel a sense of belonging.
No differences were found in terms of people’s social networks across supported living and residential care, and the average size of people’s social networks was quite small.
Supported living can work well for people with higher support needs
The research found that supported living can work well for people with higher support needs. On average, people living in residential care had significantly higher levels of support needs than people living in supported living.
People in residential care homes were also much more likely to be under Deprivation of Liberty Safeguards (DoLS) than people in supported living, although services across the board rarely prohibited any activities.
The 200 Lives project has shed light on the preferences of adults with learning disability on where they wish to live. There is growing evidence that many would opt for supported living services as opposed to residential care.
Interestingly, the new report from the 200 Lives project found that most just want to feel part of their local community along with who they live with as more important to them than the property itself. In addition, costs need to be considered. Residential care is considerably more expensive than supported living placements, due to the high accommodation costs.
However, there is some evidence people could be more affected by local crime, antisocial behaviour and deprivation; but this could be put down to more integration with the community.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy