The development of a method for monitoring local authority block contracts for residential care for people with learning disabilities: Marilyn Barbara Miles

Abstract

This research study began in 1993 and continued until 1996. The formal data collection period was between April 1993 and July 1994 which was during the first period after the implementation of those sections of the NHS and Community Care Act 1990 which relate to the contracting of social care by local authority social services departments. The research methodology adopted was one of action research within a case study.

The study is set in the context of the changes in community care initiated by this Act in the UK and in the particular circumstances of Berkshire Social Services which was re-structured in 1991 in anticipation of these changes.
The development of a method for monitoring block contracts for residential care for people with learning disabilities is described. Although the contracts were in place before April 1993 (the time varied from a few weeks to 11 months), little thought had been given during the development of the contracts to monitoring and review issues e.g. procedures. The method described evolved during the course of the study as the author responded to events and results from the task of monitoring.

Keyworkers to residents in the residential homes are one stakeholder group in the contracts. Their perspective was explored in greater detail through a postal questionnaire carried out in November 1994. Results show areas where providers could improve to meet the standards of the contract specification and improve the quality monitoring and the quality of life of the residents. Specific areas were in induction and training of staff, individual and care planning, meeting health needs, and promoting choice/autonomy. The survey also shows the limitations of the contract documentation in terms of measuring and improving quality outcomes for residents. Recommendations from the survey for future contract monitoring in Berkshire are discussed as is the way that the author's subsequent practice was affected. This formed the second part of the study. Good practice guidelines in monitoring are postulated and the wider implications from the study as a whole are also explored.

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