Best practice in a resource vacuum : responding to the accommodation needs of people with high, complex or changing support needs

This paper aims to identify current practice responses to the housing and support needs of people with high, complex or changing support needs. Case studies of current housing dilemmas and responses were provided by Annecto and Scope (Vic), and included data about the responses of other providers known to these agencies. The paper will first present case study data in three categories of accommodation: living independently (ie. living alone in self-rented or self-owned housing with or without formal support); living without a home (ie. living in non permanent or non secure housing); and living in the parental home and planning for change. The case studies are followed by a discussion of the key response strategies evident in each, and an analysis of significant ‘lessons’ for policy.

Individual and organisational factors associated with the use of seclusion in disability services

Background: Seclusion is a restrictive intervention that results in some form of containment and social isolation of a person from others. Little is known about the relationships between individual and organisation factors and the use of seclusion in disability services. Method: The reported use of seclusion in disability services in Victoria, Australia, was examined over a 3-year period, with a focus on the characteristics of those who were secluded (n = 146) and the characteristics of organisations that reported seclusion compared to others who were reported to be restrained but not secluded (n = 2,482). Results: Results from a logistic regression showed that the individual factors of age, the presence of autism and/or a psychiatric disorder put people at risk of being secluded. In terms of organisational factors, receiving accommodation services in institutions or in the community and the location of the organisation were risk factors. Conclusions: The findings are consistent with previous research but add to this literature by showing that certain organisational characteristics are also risk factors for seclusion. Understanding these factors is important in order to help disability support staff find other more ethical and appropriate alternatives to seclusion.

The content validity of the behaviour support plan quality evaluation tool (BSP-QEII) and its potential application in accommodation and day-support services for adults with intellectual disability

Background The quality of support provided to people with disability who show challenging behaviour could be influenced by the quality of the behaviour support plans (BSPs) on which staff rely for direction. This study investigated the content validity of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII), originally developed to guide the development of BSPs for children in school settings, and evaluated its application for use in accommodation and day-support services for adults with intellectual disability.

Method A three-round Delphi study involving a purposive sample of experienced behaviour support practitioners (n = 30) was conducted over an 8-week period. The analyses included deductive content analysis and descriptive statistics.

Results The 12 quality domains of the BSP-QEII were affirmed as valid for application in adult accommodation and day-support service settings. Two additional quality domains were suggested, relating to the provision of detailed background on the client and the need for plans to reflect contemporary service philosophy. Furthermore, the results suggest that some issues previously identified in the literature as being important for inclusion in BSPs might not currently be a priority for practitioners. These included: the importance of specifying replacement or alternative behaviours to be taught, descriptions of teaching strategies to be used, reinforcers, and the specification of objective goals against which to evaluate the success of the intervention programme.

Conclusions The BSP-QEII provides a potentially useful framework to guide and evaluate the development of BSPs in services for adults with intellectual disability. Further research is warranted to investigate why practitioners are potentially giving greater attention to some areas of intervention practice than others, even where research has demonstrated these others areas of practice could be important to achieving quality outcomes.

Reintegration services for long-term dangerous offenders : a case study and discussion

Successfully reintegrating long-term prisoners back into the community often presents significant challenges for service providers. Ex-prisoners typically experience high levels of social stigma; present with multiple needs; and can struggle to find meaningful employment, stable accommodation, and to maintain supportive relationships. There have, however, been relatively few published evaluations of the outcomes achieved by postrelease services on managing the risk of reoffending and, as such, it is difficult for service providers to meet these multiple and complex levels of need in ways that might be considered to be evidence based. In this article we describe a specialized prerelease support, reentry, and reintegration service that is offered to long-term prisoners, many of whom have been legally labelled as ‘‘dangerous.’’ The current model of service delivery is reviewed and discussed in the context of current theories of offender rehabilitation and reintegration. These are then used to discuss the way in which services for this group of offenders might best be conceptualized.

Integration of resident's energy costs in short stay accommodation billing system

This paper presents an energy management software package and the supporting energy information automation system to enable the short stay accommodation industry to determine actual residents' energy consumption. The proposed energy management system is used to develop a 'novel deal' method in short stay accommodation based on integration of the room level energy costs into the billing system. This system has the potential to increase energy efficiency in the short stay accommodation industry by actively engaging the residents in the energy saving process. The system is economically and environmentally sustainable and can achieve a high level of energy efficiency with low expenses. The proposed model is also effective for carbon mitigation, and offers a value proposition for all the parties in the short stay accommodation industry, including owners and residents. The paper presents a software system to capture room level energy consumption information and to present the detail of consumed energy information in the resident's accommodation bill. The presented information includes energy consumption profile, the greenhouse gas emission profile, and the cost associated to the energy related services.

Redeveloping secure psychiatric services for women

Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.