Reflections on change: supporting people with learning disabilities in residential services

Accessible summary We looked at how staff think about the changes from working in a long-stay hospital setting to working in a home for people with learning disabilities. In homes, staff said that they were more relaxed and could spend more time and offer more choices to residents than they could when they worked in hospital settings. With the changes, staff often had to make their own decisions about the care they provide and were worried about getting it right. Staff felt that their managers were looking more closely at what they were doing. Staff said that team meetings, supervision and training helped them to cope with the changes. This study describes research that was designed to explore the reflections and perspectives of staff who had experienced the change from institutional care to person-centred care and learn what factors had supported the change to, and continued adoption of, person-centred care. In-depth, semistructured interviews were conducted with seven participants working in residential homes for people with learning disabilities. The interviews were analysed using interpretative phenomenological analysis. Participants described positive changes, for example they were able to offer choice and spend time with residents. They perceived the work as less pressured and more relaxed. For some, this had the impact of encouraging them to work harder and freeing up their time to facilitate forming relationships with residents in the homes. Participants discussed an increased autonomy, responsibility and accountability in their work and a sense of being constantly monitored. There appeared to be reluctance amongst participants to own difficulties and anxieties associated with changes. Participants identified a number of strategies and issues that they felt had supported these changes. The research suggests some areas of consideration for implications regarding future practice in staff support and training within services for people with learning disabilities.