The 1993 report by Jim Mansell, Services for people with learning disability and challenging behaviour or mental health needs (updated and revised in 2007) is the key good practice guidance document for those with responsibility for supporting people with learning disabilities or autism and behaviour that challenges. This report emphasises:
- the responsibility of commissioners to ensure that services meet the needs of individuals, their families and carers;
- a focus on personalisation and prevention in social care;
- that commissioners should ensure services can deliver a high level ofsupport and care to people with complex needs/challenging behaviour;
- that services/support should be provided locally where possible.Evidence shows that community-based housing enables greater independence, inclusion and choice and that challenging behaviour lessens with the right support.The Association of Supported Living‘s report There is an Alternative (2011) describes how 10 people with learning disabilities and challenging behaviour moved from institutional settings to community services providing better lives and savings of around £900,000 a year in total.The CQC Count me in 2010 census showed only two learning disabled patients on Community Treatment Orders compared to over 3,000 mental health patients – suggesting a greater reliance on in-patient solutions for people with learning disabilities than for other people needing mental health support.CQC found some people were staying many years in assessment and treatment units, and estimated that in March 2010, at least 660 people were in A&T in Learning Disability wards for more than 6 months.
- The good practice case study set out in this chapter shows how the model of care set out in the Mansell reports fits with the new health and care system architecture focusing on key principles, desired outcomes for individuals, and a description of how the model should work in practice.