La vida de holms

Journal of Intellectual Disability Research 933 volume 55 part 9 pp 933–944 september 2011

doi: 10.1111/j.1365-2788.2011.01461.x

Invited review

jir_1461

933..944

Challenges of residential and community care: ‘the times they are a-changin’
R. Jackson
Karl Koenig Institute, Aberdeen, UK

Abstract This paper seeks to examine a number of issues which relate to the provision ofappropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the Journal of Intellectual Disability Research are identified and explored: (1) normalisation; (2) inclusion; (3) choice; and (4) regulation. It is concluded that the research community has an obligation to assume a higher profile at a timewhen the quality of life of people with an intellectual disability and their families is under threat. This can be done in a number of ways through: (1) the establishment of demonstration projects, either independently or in association with the voluntary and statutory sector,
Correspondence: Dr Robin Jackson, 4 Deeview Gardens, Drumoak, Banchory, Aberdeenshire, Scotland AB31 5AF, UK (e-mail:robin@dalmaik.demon.co.uk). Robin Jackson PhD is an Honorary Fellow, Karl Koenig Institute, Aberdeen. He has written extensively on the themes of intellectual disability and special education: Advocacy and Learning Disability (2002), Holistic Special Education (2006), Discovering Camphill: New Perspectives, Research and Developments (2011). He was invited by the editors to provide a final article forthe two Guest Issues on Residential and Community Support by commenting and evaluating the current situation in this field of endeavour. The article has received an internal review and the comments are those of the author alone.

to explore innovative and practical approaches of enhancing the quality of services offered to people with an intellectual disability; (2) looking at ways of improvingthe quality of training programmes for care staff by moving away from current approaches that emphasise narrow instrumental competencies to strategies that develop essential expressive and relational aspects of care practice; and (3) offering a more considered and rigorous critique of current professional practice and assuming a leadership role at a time when leadership in this field is lacking.Keywords choice, inclusion, intellectual disability, marketisation, normalisation, regulation

Introduction
‘The times they are a-changin!’, this title of one of Bob Dylan’s best-known songs is singularly apposite at this point in time. As I write this paper, one of the largest private companies providing health care for the elderly and people with intellectual disability (ID) in the UK is on thepoint of financial collapse and at the same time an undercover investigation undertaken by the BBC Panorama programme has revealed appalling incidents of abuse in a home run by one of the other leading companies providing

© 2011 The Author. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd

Journal of Intellectual Disability Research 934 R. Jackson • Challenges ofresidential and community care

volume 55 part 9 september 2011

residential care for people with ID. To compound matters it later emerged that the national regulatory body – the Care Quality Commission – had ceased inspecting all privately run units for people with ID for a period of 4 months (October 2010 to January 2011), notwithstanding the fact that a year earlier it had published a reporthighlighting poor practice in specialist health services for people with ID! These two damaging developments are perhaps not quite so surprising when one notes the strongly voiced concerns about the ability, capacity and willingness of the newly created social care regulator – the Care Quality Commission – to monitor effectively developments in the health and social care sector (Samuel 2010). My...