Person-centred support and choice in adults with intellectual disabilities and challenging behaviour supported in the community by paid carers: Results from a cross-sectional study (Crabtree, 2019)

Ratti V. Crabtree J. Hassiotis A. 

Journal of Intellectual Disability Research 2019;63(7): 690. 

Available online at this link 

Introduction: Despite difficulties with its definition and measurement, person-centred support (PCS) is widely advocated. Measures of the construct adapted from dementia research, were explored in community home environments of adults with intellectual disabilities (ID) and challenging behaviour. Method(s): 108 paid carers of adults with ID and challenging behaviour across England, completed questionnaires on PCS and choice. A crosssectional study with multivariable regression analysis was used to investigate the relationship between these variables, residence characteristics, staff variables and service-users' challenging behaviour. Result(s): Carers reported high levels of PCS and choice. PCS was not significantly associated with either size or type of accommodation, whereas choice was associated with both size and type (higher choice in smaller supported-living arrangements). Neither PCS nor choice were associated with the carers' length of experience of working with people with ID, nor their length of acquaintance with service-users. Carers who reported higher levels of PCS, nonetheless reported lower levels of subjective burden. No association was found between PCS/choice and total challenging behaviour, however there were significant inverse associations with the stereotypy domain. Implications: Type of accommodation may not be a substantive factor in the delivery of PCS which may nonetheless be associated with staff's feelings of competence. PCS may not have a meaningful impact on challenging behaviour and carers in staffed homes may require expert specialist input.