‘It's pretty hard with our ones, they can't talk, the more able bodied can participate’: staff attitudes about the applicability of disability policies to people with severe and profound intellectual disabilities

TLDR

Outcomes for residents in community‑based residential services vary with their adaptive behaviour and staff facilitation, and higher support needs predict poorer outcomes, yet staff attitudes toward inclusion remain largely unexplored despite investment in values‑based training. The study employed ethnographic and action‑research methods to observe 25 residents with severe and profound intellectual disabilities in five small‑group homes and assess staff attitudes. Staff accept inclusion principles in general but consider them infeasible for residents with severe and profound intellectual disabilities, a conclusion confirmed by a questionnaire of 144 direct‑care staff and managers, indicating a need for focused attention on applying policy values to those with more severe disabilities.

Abstract

The level of resident's adaptive behaviour and staff facilitative practices are key sources of variation in outcomes for residents in community-based residential services. The higher the resident support needs the poorer their outcome. Although substantial investment has been made in values-based training for staff, their attitudes and the impact of these on practice is largely unexplored.The first study used ethnographic and action research methods to examine the daily lives of 25 residents with severe and profound intellectual disabilities (ID), who lived in five small group homes, and the attitudes of the staff supporting them. Thematic analysis of the data led to a proposition that although staff accept principles of inclusion, choice and participation for people with ID in general, they do not consider it feasible to apply these to the people with severe and profound ID to whom they provide support. The findings from a second study that used a group comparison design and administered a short questionnaire about staff attitudes to 144 direct-care staff and first-line managers working in disability services confirmed this hypothesis.The study suggests more focused attention is needed to staff understanding the values embedded in current policies and their application to people with more severe disabilities.