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Improv comedy is a small subset of improvisation, which has been under-researched. This study aims to investigate if the benefits agents experience match previous research. Literature discusses positivity, community, social and communication skills, and relaxation. The survey gained 128 global respondents answering a series of questions related to their improv experiences (as per stated literature topics), including in-depth demographic information. Improv has added value to most people’s lives, provided improvements to their socialization, and improved their communication. The respondents felt that they enjoyed the company of others, and they wanted the same. Most people trust their scene partner more often than not and felt that they were relaxed in their own group and as a guest. Variations within the global population are examined. The survey functions both reliably and validly, finding that past research fits the global population of those engaged in improv. Most respondents agree to the domains presented and trust their scene partner. Performing improv breeds trust and trust can lead to increased benefits in the domains. Nonetheless, there are no differences in represented groups of respondents on their experience of the benefits of improv.

Background Studies incorporating staff-rated or observational measures of practice leadership have\ud shown that where practice leadership is stronger, active support is better implemented. The study\ud aim was to compare measures of practice leadership used in previous research to determine the\ud extent of their correspondence.\ud Method A subset of data from a longitudinal study regarding 29 front-line managers working across\ud 36 supported accommodation services in Australia was used. An observed measure of practice\ud leadership, based on an interview and observation of a front-line manager, was compared with\ud ratings of practice leadership completed by staff. The quality of active support was rated after a\ud 2-hour structured observation.\ud Results Correlations between staff-rated and observed measures were non-significant. Only the\ud observed measure was correlated with the quality of active support.\ud Conclusions This study provides evidence to support using an observational measure of practice\ud leadership rather than reliance on staff ratings.

Purpose The purpose of this paper is to provide a commentary on Banks et al. and sets the wider context. Design/methodology/approach It provides a brief narrative review of the literature on the factors that determine the quality of life of people with intellectual disabilities, including the impact of culture. Findings Key to ensuring good quality of life outcomes is support that is facilitative, enabling and empowering which can compensate for severity of disability and improve people’s experiences. This approach is called Active Support. Improving quality of life is a key part of preventing and responding to behaviours that challenge. Culture is an important factor in ensuring staff are motivated to work in such ways but is likely to be intertwined with many other factors. Originality/value This paper summarises the key literature on what is needed to improve outcomes for people with intellectual disabilities. It introduces the importance of exploring how the different dimensions of culture interact and how culture, practice, processes and structures might work in a much more complex and intertwined fashion than previously conceptualised.

Účel: Naším cílem bylo vyvinout a ověřit nástroj pro měření vnímané důležitosti indikátorů kvality služeb sociální péče u různých skupin aktérů. Metoda: 671 respondentů (249 zástupců veřejné správy, 217 poskytovatelů sociálních služeb a 205 uživatelů služeb) vyplnilo 40položkový dotazník zpracovaný na základě relevantních modelů hodnocení kvality. Výsledky: Byla provedena analýza položek a bylo zjištěno, že data jsou vhodná pro další analýzu a není potřeba položky odebírat. Explorativní faktorová analýza (EFA) odhalila 5-faktorové řešení, které byl následně potvrzeno konfirmační faktorovou analýzou. Škály odvozené od EFA vykazovaly vysokou vnitřní konzistenci s Cronbachovým alfa v rozmezí od 0,83 do 0,95. Diskuze a závěr: Studie nabízí nový přístup k vývoji měřítka kvality služeb sociální péče na základě samostatného šetření vnímané důležitosti a spokojenosti se službami. Má tedy význam pro pokračující vědeckou debatu o zohlednění důležitosti ve výzkumu spokojenosti se službami. Purpose: We aimed to develop and validate an instrument measuring perceived importance of indicators of the quality of social care services in different groups of stakeholders. Method: 671 respondents (249 representatives of public administration, 217 social service providers and 205 service users) completed a 40-item questionnaire developed on the basis of relevant quality assessment models. Results: Item analysis was carried out and it was found that data were suitable for further analysis and no item removal was needed. Exploratory factor analysis (EFA) revealed 5-factor solution which was subsequently affirmed by confirmatory factor analysis. Scales derived from EFA exhibited high internal consistency with Cronbach's alpha ranging from 0.83 to 0.95. Discussion and Conclusion: The study offers a novel approach to the development of a measure of the quality of social care service based on separate investigation of perceived importance and service satisfaction. Hence, it has relevance for ongoing scientific debate on importance weighting in service satisfaction research.

© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd Background: Active Support, now widely adopted by disability support organizations, is difficult to implement. The study aim was to identify the factors associated with good Active Support. Methods: Data on service user and staff characteristics, quality of Active Support and practice leadership were collected from a sample of services from 14 organizations annually for between 2 and 7 years, using questionnaires, structured observations and interviews. Data were analysed using multilevel modelling (MLM). Results: Predictors of good Active Support were adaptive behaviour, practice leadership, Active Support training, and time since its implementation. Heterogeneity, having more than six people in a service and larger organizations were associated with lower quality of Active Support. Conclusions: In order to ensure that Active Support is consistently implemented, and thus, quality of life outcomes improved, organizations need to pay attention to both service design and support for staff through training and practice leadership.

Choice and control are pivotal in UK Government policy for achieving personalisation of social care for people with learning disabilities; however, little is known about the role care management plays in supporting people with learning disabilities finding social care services. This article explores that the support care managers provide people with learning disabilities, how care managers source and use information to offer choice in relation to accommodation and support, with a focus on people receiving managed budgets. Qualitative interviews with eight care managers from two local authorities in the South East of England were analysed using thematic network analysis, producing three global themes. The first ‘shaping choice’ describes the role of the care management process and assessments have in determining opportunities for choice. The gathering and interpretation of quality information is explored in the second global theme, highlighting the role of visiting settings to understand their quality. ‘Choice in principle’ is the third global theme, whereby the factors shaping choice come to be seen as choice akin to that anyone else has. These findings have implications for future policy and practice in relation to care management for people with learning disabilities.

Research around transition to adulthood for people on the autism spectrum is limited. Transition to adulthood has long been known to bring many difficulties and obstacles and generally poor outcome...

© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time, and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality.

Kvalita veřejných služeb, včetně sociálních služeb je tématem často diskutovaným mezi tvůrci sociálních politik, poskytovateli sociálních služeb a těmi, kteří zastupují uživatele služeb. Cílem této studie bylo zjistit, jak respondenti – zástupci veřejné správy, poskytovatelé sociálních služeb a uživatelé vnímají kvalitu sociálních služeb, se zvláštním zaměřením na to: (1) co hodnotí respondenti jako důležité; (2) jaká je relativní vnímaná důležitost každé domény a jak se tato vnímaná důležitost liší mezi kategoriemi respondentů a (3) jak se tato důležitost liší v závislosti na charakteristikách respondentů. Speciálně navržený dotazník vyplnilo 217 poskytovatelů služeb, 249 zástupců veřejné správy a 205 uživatelů sociálních služeb. Subjektivní kvalita života uživatelů služeb byla všemi třemi kategoriemi respondentů hodnocena jako nejdůležitější ukazatel kvality služeb. Obzvláště důležité pak byly položky, které se týkaly povahy vztahů a interakcí mezi zaměstnanci a uživateli služeb. Existovaly určité rozdíly mezi kategoriemi respondentů a také podle jejich charakteristik. Respondenti veřejné správy, starší uživatelé služeb a poskytovatelé rezidenční péče hodnotili zdravotní péči mnohem důležitěji než ostatní respondenti. V článku jsou diskutovány také některé přístupy k hodnocení kvality. Quality of public services including social services is an issue frequently discussed by policy makers, service providers, and by those who represent service users. The aim of this study was to explore how stakeholders perceive quality of social services, with a particular focus on (1) what did participants rate as important; (2) what is the relative importance of each domain and how does that differ across stakeholder groups and (3) does importance vary by participant characteristics. A specially designed questionnaire was completed by 217 service providers, by 249 public administration representatives and 205 service users of residential care and in-home support. The subjective quality of life of service users was rated as the most important indicator of service quality by all three stakeholder groups. Particularly important were items that related to the nature of the relationships and interactions between staff and service users. There were some differences between stakeholder groups and also by respondent characteristics – public administration respondents, older service users and providers of residential care were more likely to rate health care as more important than other respondents. Implications for how quality is measured are discussed.

© 2020 The Authors. Journal of Policy and Practice in Intellectual Disabilities published by International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals LLC. The disabled people's movements have successfully influenced public policies and laws. Self-advocates who are autistic or have an intellectual disability have been working alongside other advocates for recent decades. Practice theory has rarely been used in disability research. This study explores “practice theory” through the analysis of interviews with advocates and self-advocates within the autism and intellectual disability advocacy movements. This is a qualitative, empirical study based on interviews and focus groups with 43 participants in two countries. The data were collected in 2016–17. Content analysis was used to identify themes. Data indicate that everyday practices of self-advocates and advocates such as parent advocates and professional advocates largely overlap. There are five major types of practices that are done by nearly all advocates: “informing and being informed,” “using media,” “supporting each other,” “speaking up,” and “bureaucratic duties.” Contrary to several previous studies on self-advocacy that emphasized “speaking up” as the main activity in advocacy, this study found that most practices of advocates and self-advocates are “para-advocacy” practices that may or may not lead directly to “speaking up.” Practices of self-advocates are often embedded in other everyday activities people do. The line between practices that belong to self-advocacy and practices outside self-advocacy may not always be clear even to self-advocates. Findings also indicate that hierarchies in the disability movement influence strongly the position of self-advocates.

Background: Quality of life of people with intellectual and developmental disabilities has been found to primarily depend on whether staff are providing facilitative and enabling support that helps to compensate for severity of disability. Managers have a key role in facilitating staff to provide such support.\ud \ud Method: Qualitative interviews were conducted with 35 managers of supported accommodation services to explore service aims and the nature of, and challenges in providing, skilled support. Key themes were identified using a Thematic Networks Analysis.\ud \ud Results: Service aims were rarely formalised, were related to the individuals supported and not to the organisation. Managers found it difficult to define skilled support, other than by reference to individuals. Practice leadership roles were challenged as a result of austerity measures.\ud \ud Conclusions: Front?line managers need more information and training in skilled support, with stronger leadership from senior management to provide the motivation and resources needed.

We report the feasibility of a novel, school-based intervention, coined ‘Imagining Autism’, in which children with autism engage with drama practitioners though participatory play and improvisation in a themed multi-sensory ‘pod’ resembling a portable, tent-like structure. A total of 22 children, aged 7–12 years, from three UK schools engaged in the 10-week programme. Measures of social interaction, communication and emotion recognition, along with parent and teacher ratings, were collected before and up to 12 months after the intervention. Feasibility was evaluated through four domains: (1) process (recruitment, retention, blinding, inter-rater reliability, willingness of children to engage), (2) resources (space, logistics), (3) management (dealing with unexpected changes, ease of assessment) and (4) scientific (data outcomes, statistical analyses). Overall, the children, parents and teachers showed high satisfaction with the intervention, the amount of missing data was relatively low, key assessments were implemented as planned and evidence of potential effect was demonstrated on several key outcome measures. Some difficulties were encountered with recruitment, test administration, parental response and the logistics of setting up the pod. Following several protocol revisions and the inclusion of a control group, future investigation would be justified to more thoroughly examine treatment effects.

© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Supported living is perceived as more flexible than group homes for people with intellectual disability. This study identified costs and factors associated with quality of life (QOL) in supported living and compared this with group homes. Method: Thirty-one residents in supported living participated in a survey incorporating measures of service user characteristics and QOL. Participants in supported living were compared to a sample of 397 people in 96 group homes, and QOL outcomes compared for a matched sample of 29 people in supported living and group homes. Results: QOL differed little, supported living was cheaper, and 30–35% of both groups had similar support needs. Being younger, having autism, better health, family support, and participation in structured activities were associated with better outcomes in supported living. Conclusions: Supported living holds potential for group home residents, but greater support is required in domains such as health and interpersonal relationships.

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Organisational and service level factors are identified as influencing the implementation of Active Support. The aim was to explore differences in organisational leadership and structures to identify potential relationships between these factors and the quality of Active Support in supported accommodation services. Method: Fourteen organisations participated in this mixed methods study, which generated data from interviews with senior leaders, document reviews and observations of the quality of Active Support. Results: Qualitative analyses revealed three conceptual categories: senior leaders in organisations where at least 71% of services delivered good Active Support prioritised practice; understood Active Support; and strongly supported practice leadership. In these organisations practice leadership was structured close to everyday service delivery, and as part of frontline management. Conclusions: Patterns of coherent values, priorities and actions about practice demonstrated by senior leaders were associated with successful implementation of Active Support, rather than documented values in organisational policy or procedures.

© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background Dissatisfaction with the inflexibility of the group home model has led to the growth of supported living that separates housing from support and is thought to have greater potential for better quality of life outcomes. Comparative studies have had mixed findings with some showing few differences, other than greater choice in supported living. By investigating service user experiences of supported living this study aimed to identify how the potential of supported living might be better realised. Method Thirty-four people with intellectual disability participated in 7 focus group interviews and 6 people in an individual interview. Data were analysed using grounded theory methods. Results Although participants experienced greater choice and control over their everyday lives, they did not feel they controlled the way support was provided and experienced restrictions on lifestyle associated with low income. Despite their use of community places and varied social connections to family, friends, and acquaintances, most experienced loneliness. Conclusions If the potential of supported living is to be realised, shortcomings of support arrangements must be addressed by, for example, greater consistency of support worker skills, consumer control over recruitment and rostering, and more skilled support to build friendships and manage difficult relationships.

© 2020 The Authors. British Journal of Learning Disabilities published by John Wiley & Sons Ltd Direct payments can help people with learning disabilities or autism to have good support. Often, family carers manage the direct payments for people who would find this very difficult. We asked family carers who managed direct payments to tell us why they decided to do this and what their experiences were. Family carers told us they found managing direct payments difficult and stressful at first, but this got easier over time. They also said that direct payments helped their family members to have more person-centred support. Abstract: Background There are a growing number of people with learning disabilities and autism who access personal budgets in the form of direct payments in England. Although they are often involved in decisions about their support, personal budgets are usually managed by someone else, typically a parent. This study examined the experiences of carers who manage personal budgets for adults with learning disabilities or autism with a particular focus on the challenges of securing suitable support and implications for their own well-being. Methods This was a qualitative study using a descriptive phenomenological approach to investigate the lived experiences of family carers who manage personal budgets. We conducted semi-structured interviews with 13 family carers. Interview transcripts were thematically analysed using the framework approach. Results Our analysis identified five main themes. The first theme relates to why carers decide to take up a personal budget in the first place and their initial expectations. The second theme, restricted choice, highlights the difficulties in securing adequate support and services in the context of what are often described as “complex needs.” The third and fourth themes relate to the tasks involved in managing a personal budget and the challenges associated with the dual role of the carer as a parent and a “professional.” The fifth and final theme, mixed emotions, describes the impact on the subjective well-being of carers. Conclusions Family carers indicated that the benefits of personal budgets outweighed the difficulties and stress inherent in managing them. They need adequate support to ensure that personal budgets deliver personalised and self-directed support and greater well-being, and are sustainable arrangements.

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: There is strong evidence about the effectiveness of Active Support. Recent research has established predictors of good Active Support as staff training, practice leadership, and service setting size. This paper explores features of organisational leadership and structures predictive of Active Support. Methods: Multilevel modelling with data from surveys, observations and interviews was used to identify predictors of Active Support at the levels of service users (n = 253), services (n = 71) and organisations (n = 14). Results: Good Active Support was predicted by: (1) positive staff perceptions of management, (2) prioritisation of practice and Active Support by senior managers, (3) strong management support for practice leadership, (4) organisation of practice leadership close to everyday service delivery, and (5) concentration of practice leadership with frontline management. Conclusion: These findings extend understanding of predictors of Active Support and provide indicators of service quality, with important implications for service providers, service users and those monitoring the quality of services.

Purpose The purpose of this paper is to reflect on the difficulties highlighted by Ntinas around supporting change in services for people with intellectual and developmental disabilities. Design/methodology/approach This commentary examines what is needed for change and reflects on staff culture. Findings The authors propose that it is not sensible to separate the culture of a service from the implementation of person-centred approaches and attempt to map how the concepts overlap and are interconnected. Originality/value Whilst some elements of culture are clearly important in order to start the process of change, other elements will change as an intervention is introduced and embedded.

Background This study reports the experiences of developing and pre-testing an Easy Read version of the Adult Social Care Outcomes Toolkit (ASCOT) for self-report by people with intellectual disabilities. Methods The study has combined survey development and pre-testing methods with approaches to create accessible information for people with intellectual disabilities. A working group assisted researchers in identifying appropriate question formats, pictures and wording. Focus groups and cognitive interviews were conducted to test various iterations of the instrument. Results Substantial changes were made to the questionnaire, which included changes to illustrations, the wording of question stems and response options. Conclusions The process demonstrated the benefits of involving people with intellectual disabilities in the design and testing of data collection instruments. Adequately adapted questionnaires can be useful tools to collect information from people with intellectual disabilities in survey research; however, its limitations must be recognized.

Building on cultural dimensions of underperforming group homes this study analyses culture in better performing services. In depth qualitative case studies were conducted in 3 better group homes using participant observation and interviews. The culture in these homes, reflected in patterns of staff practice and talk, as well as artefacts differed from that found in underperforming services. Formal power holders were undisputed leaders, their values aligned with those of other staff and the organization, responsibility for practice quality was shared enabling teamwork, staff perceived their purpose as “making the life each person wants it to be,” working practices were person centered, and new ideas and outsiders were embraced. The culture was characterized as coherent, respectful, “enabling” for residents, and “motivating” for staff. Though it is unclear whether good group homes have a similar culture to better ones the insights from this study provide knowledge to guide service development and evaluation.

Objectives: Research shows practice leadership to be a factor in the successful implementation of active support. The aim of the study was to explore differences in staff practice, associated with the presence of a practice leader in a shared supported accommodation service.\ud \ud Methods: Quality of support and engagement for 189 service users with intellectual disability from 58 services were collected during a 2 h observation using the EMAC-R and ASM. The practice leader was present in 19 services (n = 59) and absent in 39 (n = 111). An Observed Measure of Practice Leadership was administered during a second visit to each service.\ud \ud Results: When the practice leader was present, levels of engagement and active support were statistically higher (p

Purpose – The purpose of this paper is to summarise key findings and recommendations from the “Living in Fear” research project focusing on the experiences of people with learning disabilities and autism related to disability hate crime and the experience of the police in dealing with such incidents. Design/methodology/approach – Methods included: first, a postal survey with 255 people with learning disabilities or autism (or their carers for people with more severe disabilities), of whom 24 also took part in semi-structured interviews; and second, an electronic survey of the knowledge and experience of 459 police officers or support staff. Findings – Just under half of participants had experienced some form of victimisation. The Police reported problems with the definition of disability hate crime and challenges to responding effectively. Social implications – A case study from the research highlights some of the key findings and is linked to implications for people with learning disabilities and autism, carers, police and other agencies. Originality/value – Previous research has highlighted that victimisation is an issue for this group of people, but has never explored the prevalence and nature of such experiences in a representative sample. Neither has previous research brought together the perspectives of so many different agencies to offer recommendations that go across many sectors. The paper will be of interest to people with disabilities and their carers, professionals in health, social care and the Criminal Justice system.

Background: This protocol outlines research to explore the impact of coronavirus disease 2019 (COVID-19) on individuals who have intellectual and developmental disabilities and their caregivers. Evidence suggests that people with intellectual and developmental disabilities experience disparities in healthcare access and utilisation. This disparity was evident early in the pandemic when discussions arose regarding the potential exclusion of this population to critical care. Methods: An anonymous online survey will be conducted with caregivers, both family members and paid staff, to explore the impact of COVID-19 on this population in terms of demographics, living arrangements, access to services, the impact of social distancing, and also carer wellbeing. The survey will be developed by the research team, many of whom are experts in intellectual disability within their own jurisdictions. Using back-translation our team will translate the survey for distribution in 16 countries worldwide for international comparison. The survey team have extensive personal and professional networks in intellectual disability and will promote the survey widely on social media with the support of local disability and advocacy agencies. Statistical descriptive and comparative analyses will be conducted. Ethical approval has been obtained for this study from University College Dublin’s Human Research Ethics Committee (HS-20-28-Linehan). Dissemination: Study findings will be prepared in a number of formats in order to meet the needs of different audiences. Outputs will include academic papers, lessons learned paper, practice guidelines, reports, infographics and video content. These outputs will be directed to families, frontline and management delivering disability services, national-level policy makers, healthcare quality and delivery authorities, national pandemic organisations and international bodies.

This article focuses on access of students with disabilities to education in Ethiopia and, in particular, on the role of inclusive education resource centres (IERCs). A mixed-methods approach was used to collect both quantitative and qualitative data. The participants were school administrators, itinerant teachers, special educators, regular classroom teachers, and school directors. It was identified that a large number of students and teachers benefitted from the support provided by IERCs. The target schools are equipped with materials that support inclusive pedagogy. The awareness of parents and communities is gradually changing, except in some unreached communities. As a result, the number of students with disabilities enrolled is increasing. There were some barriers observed, such as assignment of itinerant teachers to a large number of satellite schools, high turnover of local government officials, and whether there was investment in the sustainability of IERCs and the positive outcomes observed.

Purpose The purpose of this paper is to establish the effectiveness of Talking Mats® (TM) in evaluating service users’ experiences, and explore their views of the implementation of person-centred active support (PCAS). Design/methodology/approach This is a mixed-methods study, employing qualitative interviewing and observational measures. Findings Both qualitative and quantitative measures indicated inconsistent implementation of PCAS. It was possible to effectively gain participants’ views on positive and negative aspects of quality of support and quality of life, using TM, across three themes, My life, My support and Self-determination. Research limitations/implications Generalisability of the research may be limited due to the sample, and the potential for researcher and interviewer bias is acknowledged. Practical implications TM provides a mechanism that may facilitate the inclusion of the views and experiences of people with intellectual and developmental disability (PWIDD) who have limited verbal skills. Their views need to be reflected in adaptions made to PCAS. Originality/value This study included a population who are often left out of qualitative research because of the methodologies adopted. It also included older PWIDD, where there has been less research about the effectiveness of TM.

Background Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures. Methods This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia. Results The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support. Conclusions The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management.

This article summarises key aspects of the Mental Capacity Act (2005) in England and Wales. In particular, it focuses on the implementation of this Act and the lessons that can be drawn from the situation in the United Kingdom by those currently developing legislation around supported decision-making. The Mental Capacity Act (2005) has five core principles: (i) a presumption of capacity; (ii) individuals being supported to make their own decisions; (iii) unwise decisions; (iv) best interests; and (v) the least restrictive option. Although some good practice of supported decision-making is available, the House of Lords Select Committee Report (2014) identified that the Mental Capacity Act was currently very poorly implemented, with core issues including: a lack of understanding of the Act's principles, in particular, by health and social care professionals; a continuing prevalence of paternalistic substitute decision-making rather than the intended supported decision-making; and a general lack of change in...

This chapter presents the findings from interviews with 200 people with disabilities across 9 European countries focused on their living situation, the support they receive and the barriers and facilitators to active citizenship through community living.

Background: Since the adoption of the UN Convention on the Rights of Persons with Disabilities (CRPD), human rights have become central for disability advocacy. The CRPD requires that disabled people and their representative organisations (DPOs) have a prominent role in the implementation and monitoring of the Convention. However, the representation of people with intellectual disabilities or autistic people is still often indirect, carried out by parents or professionals. \ud \ud Methods: This is a qualitative research which looks at how self-advocates (SAs) with intellectual disabilities or autism participate in DPOs and how they see the role of human rights and laws such as the CRPD in their advocacy. Data was collected in the UK and in Hungary between October 2016 and May 2017. A total of 43 advocates (SAs and other advocates) were interviewed. For the analysis, thematic analysis was used. \ud \ud Results: findings indicate that most participants have limited knowledge of the CRPD and human rights. Human rights are usually seen as vague and distant ideas, less relevant to everyday lives. SAs may not feel competent to talk about the CRPD. The inclusion of SAs in DPOs is mostly tokenistic, lacking real participation. \ud \ud Conclusions: The CRPD can only bring meaningful change to SAs if they get full membership in DPOs.

© 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd Background: The aim was to explore the relationship between quality of active support and communication support for people in group homes with high and low support needs. Methods: Data from 182 service users, 20–81 years (mean = 40), 89 with high support needs, were observed to have either good (n = 142) or poor (n = 40) communication support. Measures were of quality of active support, engagement and staff contact; field notes provided examples of good and poor communication supports. Results: We found a relationship between the quality of communication support and active support. Receiving good communication was associated with higher levels of engagement. Field notes included some examples of appropriate communication supports, but limited use of augmentative and alternative communication (AAC). Conclusions: Staff show limited use of appropriate communication with people having high support needs who require AAC. Strategies to improve quality of practice are discussed.

© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Research indicates the value of active support in achieving good outcomes across a number of quality of life domains for people with intellectual disabilities. However, implementation is not easy, and little research has explored why. We aimed to identify some of the factors that impact on implementation of active support in supported accommodation services. Methods: Data on the quality of active support, staff training and practice leadership were collected through staff questionnaires, observations and manager interviews, for between two and four years across six organisations. Results: Active support improved over time for more able people with intellectual disability, but not for people with higher support needs. There was a weak positive correlation between active support and (1) practice leadership scores, and (2) the percentage of staff reporting active support training. Conclusions: It is important to recognise the influence of practice leadership and staff training on the quality of support and ensure provision for these in funding schemes.