Background: Studies of engagement in meaningful activity often focus on a short period during the afternoon. The question arises whether this produces different results from studies covering the whole day. Methods: Data collected for 18 individuals using a 20-s momentary time-sample from 08:00 to 19:00 over a number of days for each person were…

Background: Adult protection monitoring data held by local authorities in England provide opportunities to examine referrals for alleged sexual abuse for people with intellectual disability to identify patterns of risk. Methods: Adult protection monitoring data collected by two local authorities was analysed, with referrals for alleged sexual…

Background: There has been increasing recognition of the importance and extent of abuse of vulnerable adults, including people with intellectual disabilities, leading to the development of monitoring systems. This paper reports findings from one of the largest databases in the UK collected between 1998 and 2005. Method: Analysis of the 1926…

Background: As institutions for people with intellectual disabilities have been replaced with community services, health care provision has developed to provide assessment and treatment, low and medium secure units for people with challenging behaviour or mental health problems. These include both public and private sector provision. Little is…

Background: National minimum standards for residential care homes were introduced following the Care Standards Act 2000 in response to concern about the lack of consistency and poor quality services. These standards are intended to reflect outcomes for service users and to be comprehensive in scope. Method: This study compared ratings made by care…

Background: An important question in community living is what factors influence the extent to which staff provide "active support". Methods: Engagement, care practices and a range of staff and organizational characteristics were studied in 72 residential homes serving 359 adults with intellectual disabilities. Managers in 36 settings were trained…

Background: This critical review considers the nature and importance of person-centred planning in the context of current British policy and service development in intellectual disability. The difference between person-centred planning and other kinds of individual planning is discussed. Materials and method: The scale of the task of implementing…

This paper responds to four commentaries on our original paper in this issue. We respond to issues raised under three headings addressing the scale of the task envisaged in the 2001 White Paper "Valuing People," the feasibility and effectiveness of individual planning and how to achieve person-centred action. We conclude that there is substantial…