Disability Practice: Safeguarding Quality Service Delivery

Foreword
Contents
Notes on Contributors
List of Figures
List of Tables
Chapter 1: Introduction
	Background
	Organisation of the Book
Chapter 2: Thinking About Disability: Implications for Practice
	Describing Disability
	Counting Disability
	Disadvantage and Disability
	Value of Understanding Different Models of Disability
	Social Model of Disability
		Definition
		What Needs to Change
		Pros and Cons
		Implications for Services
	Individual Deficit Model of Disability
		Definition
		What Needs to Change
		Pros and Cons
		Implications for Services
	Critical Realist Model of Disability
		Definition
		What Needs to Change
		Pros and Cons
		Implications for Services
	Supporting Rights and Quality of Life
		Rights
		Quality of Life
	Disability Services and Practice
	References
Chapter 3: Building Strong Foundations: Listening to and Learning from People with Intellectual Disabilities and Their Families
	Insights from Individuals with Intellectual Disabilities: What the Literature Says
	Insights from Recent Interviews with People with Intellectual Disabilities in Group Homes
	Perspectives of Families of People with More Severe and Profound Intellectual Disabilities
		“You worry all the time”: The Impact of Staff Turnover and Leadership
		Communication Between Families, Staff and the People They Support
	Conclusions
	References
Chapter 4: Supporting Community Participation
	Why Support for Community Participation Is Important
	Understanding Community Participation
	Supporting Community Participation
	Program Design and Practice for Supporting Community Participation
		Emphasising Social Relationships
		Programs that Build Social Relationships
		Emphasising Pleasant Social Interactions or Convivial Encounters
		Programs that Create and Support Opportunities for Convivial Encounters
		Emphasising a Sense of Identity and Belonging
		Programs to Support Identity and Belonging
	Practice Framework for Community Participation Programs
		Principles
		Processes
		Skills and Knowledge
	Maximising Benefits of Community Participation Programs
	References
Chapter 5: The Importance of Economic Participation for Quality of Life
	Societal Benefits to Employing People with Disabilities
	Individual Benefits for People with Disabilities
	Employment Disadvantage
	Employment Barriers and Opportunities
	Key Terms and Types of Disability Employment Programmes
		Employment Preparation and Training Programmes
		Open Employment Programmes
		Supported Employment Programmes
		Sheltered Employment
	Quality Practices and Programmes
		Place-Then-Train Model
		Quality Support Personnel and Technical Assistance
	Quality Practices in Employment Preparation and Training Programmes
		Transition Programmes
		Vocational Education and Training
		University Options for People with Disabilities
		Quality Practices for Open Employment
		Personalised Client Assessment
		Individualised Job Development and Placement
		Intensive Training and Support at the Job Site
		Ongoing Support Throughout the Course of the Individual’s Employment
		Quality Practices and Supported Employment
	Linking with Related Service Systems
	Conclusion
	References
Chapter 6: Relationship-Based Practice with People with a Mild Intellectual Disability Who Have Been Socially Marginalised and Excluded
	Why Are Relationships Important to Good Quality of Life?
	What Are the Roles of Support Services in Relationship-Based Work?
	Relationship-Based Practice at the Personal Level
		Working with Individuals
		Groupwork
	Relationship-Based Practice at the Organisational Level
	Relationship-Based Practice at the Service Systems Level
	Conclusion
	References
Chapter 7: Supporting Engagement in Everyday Life at Home and in the Community: Active Support
	Why Engagement Is Important
	Significance and Essential Components of Active Support
		Every Moment Has Potential
		Graded Assistance to Ensure Success
		Maximising Choice and Control
		Little and Often
	Embedding Active Support in Organisations
		Frontline Practice Leadership
			Focussing Staff Attention on the Quality of Life of the People Supported
			Supervising the Practice of Each Staff Member Individually
			Allocating and Organising Staff to Provide Support
			Observing Staff, Giving Feedback, Coaching Staff and Modelling Good Practice
			Facilitating Teamwork and Team Meetings
		Senior Organisational Leadership That Values Practice
	Dangers of Being Oversupported
	Active Support and Other Person-Centred Practices
	References
Chapter 8: Healthy Lifestyles and Primary Healthcare
	Implications of Poor Health
	Disadvantages Experienced by People with Intellectual Disabilities
		Intrinsic Contributors to Poor Health
		Extrinsic Contributors to Poor Health
	The Role of Disability Support Workers
		Support in Making Day-to-Day Decisions that Promote Health and Wellbeing
		Responding to Possible Signs of Ill Health
		Accessing Healthcare
		Supporting Communication During Healthcare Consultations
	Healthcare Systems
		Designed as Mainstream Systems
		Working Across the Disability and Healthcare Systems
	References
Chapter 9: Supporting People with Complex and Challenging Behaviour
	The Impact of Challenging Behaviour on Quality of Life
		Denial of Human Rights
		Stereotyping
		Disruption to Staff Relationships
	Reasons for Challenging Behaviour
	Supporting People with Challenging Behaviour
	Behavioural Strategies
		Assessing Behaviour and Developing a Behaviour Support Plan
	Psychodynamic Approaches
	Examples of Supporting People with Challenging Behaviour
		Joe
		Services and Evidence-Based Practice
		Relationships
		Staff Training and Supervision
		Teamwork
		Sylvie
		Service Delivery
		Relationships
		Training and Supervision
		Teamwork
	Reflecting on the Use of Positive Behavioural Support
	References
Chapter 10: Support Planning with People with Disabilities
	Support Needs and Support Planning
	Purpose and Key Principles of Support Planning
	Support Planning Processes
		Goal Setting: What Will the Plan Achieve?
		Identifying Strategies: How Goals Are Going to Be Met
		Monitoring and Review Processes
	Conclusion
	References
Chapter 11: The Right to Participate in Decision Making: Supported Decision Making in Practice
	Why Decision Making Is Significant
	Taking Away Rights to Decision Making
	The Right to Support with Decision Making
	Evidence Informed Supported Decision Making
	The La Trobe Support for Decision Making Practice Framework
		Step 1. Knowing the Person
		Step 2. Identifying and Describing the Decision
		Step 3. Understanding the Person’s Will and Preferences for the Decision
		Step 4. Refining the Decision and Taking Account of Constraints
		Step 5. Consider if a Formal Process Is Needed
		Step 6. Reaching the Decision and Associated Decisions
		Step 7. Implementing the Decision and Seeking Advocates if Necessary
		Principles of Decision Support Practice
		Strategies
	The Broader Context of Supported Decision Making
		Skills and Expectations About Decision Making
		The Importance of Culture
		Mainstream Service and Public and Private Institutions
	Conclusion
	References
Chapter 12: ‘Nothing about us without us’. Including Lived Experiences of People with Intellectual Disabilities in Policy and Service Design
	Introduction
	Working Together on Policy and Service System Issues
	Why Involving People with Disabilities in Policy and Service Development Matters
	Structures for Involvement in Policy and Service Design
		Advisory Bodies, Representative Groups and Governing Boards
		Disabled People’s Organisations and Self-advocacy Groups
	Inclusive Ways of Working and Supporting Effective Participation
		The Right Conditions
		Building Capacity of Individuals and Organisations
		Significance of Attitudes and Supporters
		Inclusive Ways of Working
		Individual Support
		Attending to Practicalities
	Avoiding Tokenism and Other Unresolved Issues to Consider
		Beyond Representation
		Blending Different Types of Expertise
	Conclusions
	References
Chapter 13: Organisational Culture in Disability Accommodation Services
	Introduction
	What Is Organisational Culture?
	How Culture Influences Staff Behaviour
	Characteristics of Culture in Good and Poor Quality Services
		Culture in Poor Quality Services
		Culture in Better Services
	Culture and Quality of Life
	Understanding an Organisation’s Culture
	Integrated and Differentiated Culture
	Generating and Reinforcing Positive Culture or Changing Poor Culture
		Learning from Cultural Characteristics and Practice
		Organisational Structures and Processes that Influence Culture
		Value of a Practice Framework
		Human Resource Practices: Hiring, Firing and Training
		Structures that Support Effective Leadership
		Service-Level Change
	References
Chapter 14: Building Quality and Safeguarding into Disability Service Provision
	Understanding the Key Terms
	Core Concepts in Building Quality and Safeguarding
	Levels for Action in Building Good Quality and Safeguarding
	The Varied Needs of Stakeholders
	Key Strategies for Providers
	Going Deeper: What Can Providers Do to Provide Quality and Safe Services?
		Proactive Strategies
		Reactive Strategies
	Conclusion
	References
Index