title: Targeted support and telecare in staffed housing for people with intellectual disabilities: impact on staffing levels and objective lifestyle indicators.
abstract: BACKGROUND
  Increased provision of out-of-family residential support is required because of demographic changes within the intellectual disabilities population. Residential support now has to be provided in a climate requiring both financial constraint and high quality service outcomes. The aim was to evaluate the quality of life consequences of living with less intensive staff support, resulting from the introduction of more targeted staff allocation coupled with telecare.
  
  
  METHODS
  The study comprised 91 participants who lived in 33 settings. The targeted support/telecare intervention was implemented at staggered intervals in 25 of these settings (63 participants). Data on a range of participant and setting descriptors, quality of care, and a range of objective lifestyle indicators were collected at four points in time over 2 years. Impact of the intervention was evaluated using within-group comparisons over time.
  
  
  RESULTS
  Comparison between pre- and post-intervention showed that staffing levels were significantly reduced by 23%, whereas they were constant in the absence of intervention. One health indicator improved in the absence of intervention and another improved following intervention. There were no significant changes in any other lifestyle indicators (safety, money, social and community activity, independence or choice).
  
  
  CONCLUSIONS
  A combination of targeted support and telecare had no adverse short-term affect on participants' quality of life, but reduced staff input so it seems that they have a role to play in the strategic development of out-of-family placements for adults with intellectual disabilities. Further research is needed to explore in more detail how efficiency is achieved in practice.
authors.affiliation: Welsh Centre for Learning Disabilities, School of Medicine, Cardiff University, Cardiff, UK. perry.jonathan@gmail.com
authors.forename: Jonathan
authors.initials: J
authors.lastname: Perry
authors.forename: Caroline
authors.initials: C
authors.lastname: Firth
authors.forename: Michael
authors.initials: M
authors.lastname: Puppa
authors.forename: Rick
authors.initials: R
authors.lastname: Wilson
authors.forename: David
authors.initials: D
authors.lastname: Felce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D016352:Group Homes / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities / Q000534:rehabilitation*; D011788:Quality of Life; D017216:Telemedicine / Q000191:economics / Q000295:instrumentation / Q000458:organization & administration*; D000078329:Workforce; D055815:Young Adult