Promoting choice and control in residential services for people with learning disabilities

W.M.L. Finlay, C. Walton, C. Antaki
2008 Disability & Society  
This paper discusses the gap between policy goals and practice in residential services for people with learning disabilities. Drawing on a nine-month ethnographic study of three residential services, it outlines a range of obstacles to the promotion of choice and control that were routinely observed in the culture and working practices of the services. Issues discussed include conflicting service values and agendas, inspection regimes, an attention to the bigger decisions in a person's life
more » ... a person's life when empowerment could more quickly and effectively be promoted at the level of everyday practice, problems of communication and interpretation, and the pervasiveness of teaching. We offer a range of suggestions as to how these obstacles might be tackled. Promoting choice and control.. 2 Promoting choice and control in residential services for people with learning disabilities In the UK, recent government policy places the promotion of choice, control and empowerment as a central value for social care services (eg Department of Health, 2005; HM Government, 2005; Prime Minister's Strategy Unit, 2005; Social Exclusion Unit, 2005). In services for people with learning disabilities, for example, policies have been put in place to encourage empowerment through person-centred planning, direct payments and individual budgets, including service-users in Partnership Boards, increases in the number of advocates, and making sure information is presented in a variety of formats. However, there are still barriers to the promotion of empowerment in services. The recent report Improving the Life Chances of Disabled People (Prime Minister's Strategy Unit, 2005) discusses two main barriers: supports are often not fitted to the individual, rather disabled people are expected to fit into existing services; and services tend to focus on incapacity, inability and risk, with the result that dependency is created. Indeed, this report identifies a 'culture of care and dependency' (p73) in health and social care services, in which those with 'significant cognitive and/or communication impairments are particularly at risk of being denied choice and control in their lives' (p78). The difficulties of translating policy goals of choice and autonomy into practice for people with learning disabilities have been examined by many writers in the field (eg
doi:10.1080/09687590802038860 fatcat:gnp257sk2vag3k6nfppffsfcua