QUALITY AGENDA, THE

There is now no serious alternative to the principle that services should be tailored to individual urgencys circumstances and wants, and it is hard to remember a time when services for clan with intellectual disabilities were not awaited to be individualised. However, in the 1960 custodial care was the norm in Britain, Scandinavia and America, and still is the norm in many countries in Europe and beyond. The stir towards individualisation and deinstitutionalisation became individual of the main drivers associated with quality of services in the 1970 and 1980 and, as the institutions began to shut and community care became the norm, policy and research have guided services in the direction of further personalisation of services and 'an ordinary life' (O'Brien & Tyne 1981) In the UK when single thinks now about quality of life and associated quality of services for race with intellectual disability, the metes that first spring to mind are likely to be 'individualised', 'person-centred' 'choice and control' 'independence' and 'inclusion'.

However, high-quality services don't just 'happen'. above time research has shown that simply moving race out of institutions and into community-based provision is not sufficient for them to experience a profitable quality of life and highquality care. For example, Emerson and Hatton (1994) fix that outcomes following deinstitutionalisation were variable; there were clan living in small group domiciles for whom outcome was as poor as for those in institutional care. Small collection homes in the community can be as institutionalised and of as poor a quality as the large institutions in which the first scandals happened (Mansell et al, 1994; Landesman, 1988) A similar pattern has emerg with regard to day services. Following the drive for individualisation and personalisation of services, and also consultation with service users (Whittaker & McIntosh, 2000) there has been a gradual breaking up of the large day opportunity services or local authority day middles replaced by smaller community-based provision and supported occupation This process is, however, still ongoing and for many family the only day services available continue to be large congregate settings.

Central to the improvement of quality of service for these clusters of people has been the relatively novel (DoH, 2001, 2005) emphasis upon personcentred approaches such as person-centr planning, person-centr funding and personcentr action.

This issue of the Learning Disability Review focuses upon the quality agenda, and includes a range of papers looking at issues of quality in services with a particular focus upon person-centred approaches. In the first paper, I consider a certain number of of the links between person-centr approaches and the quality of life conception illustrating how person-centred planning, funding and action affect quality of life, using each of the domains and lock opener indicators outlined by Schalock et al (2002)

Liz Neil and Lynne Wilmot, in the first of sum of two units service-led features, describe a proces of activity planning used in somersault UK, to support the modernising day services agenda. This means of activity planning, which was called My Day, was adapted from serviceable practice already available, and was unfolded as a way of arranging a wide variety of individualised activities for nation with learning disabilities. A a whole of activity recording is integral to the My Day plan and allows for the collation of statistics to inform service delivery.

The paper by means of Kamisha Guthrie and Julie Beadle-Brown reports upon a pilot study exploring rapport between staff and service users with learning disability. Rapport is musing to be central to the quality of staff support for individuals. In the training materials upon person-centred active support, Mansell and colleagues (2005) say that 'style' of staff support emergencys to be positive and helpful if active support is to work; this is essentially 'rapport'. from one side a series of focus clusters Guthrie and Beadle-Brown found that there appeared to be more [i]or[/i] less core aspects of rapport (both advantageous and bad rapport) identified by the agency of service users, staff and professionals. There were also similarities in in what manner poor rapport was manifested through both service users and staff/ professionals in their relationships with other clan

In the second of the sum of two units service-led features, Junelle Rhodes and David Hamilton illustrate the approach taken to introducing person-centr active support in community residential units (staffed housing) in Australia. They report more [i]or[/i] less basic findings illustrating improvements in engagement in activity without long-term increases in challenging behaviour, on the contrary concentrate on staff accounts of in what way things have changed both for service users and for staff upon a day-to-day basis. Lessons learnt from the implementation of person-centr active support in these settings are also discussed.

Finally, Edwin Jone and Kathy Lowe have provided a commentary upon the whole issue, to draw together the main themes emerging from each of the preceding papers, as well as considering the importance of person-centr action. In particular, they consider lock opener issues such as quality of life, participation and inclusion, management involvement and attention with regard to implementation, and the importance of interaction and rapport.