The Costs And Benefits Of Community Care: A Case Study Of people with learning difficulties

By Alan Haycox.



ISBN 1 85628 433 6

A revealing and significant quote appears in this book during a
description of what life was like for residents of a long stay
hospital. ‘The residents,’ the author states, ‘were merely being
stored prior to their transfer to community care’.

This simple statement reflects his discovery that not only did
most hospital residents spend most of their time doing nothing and
interacting with no-one, but also that the opportunity to prepare
them for their new lives in the community had been wasted.

This evaluation of a community care project for people with
learning difficulties, juxtaposed as it is with a comparison of
their hospital lifestyles, is frequently enlivened by personal
observations of this nature. These flashes of feeling help make the
book more interesting and readable for those less fascinated by
statistical data.

It tries to provide an objective and statistically valid
assessment of the achievements of community care as opposed to
hospital care, and of the costs involved in their provision in
terms of resources and outcomes. Although the community care
project was based on values enshrined in normalisation theory, the
research subjects do not appear to be real people. The book gives
little insight into their desires and hopes and provides almost no
information on the lives they led when they moved into the

It does succeed in emphasising the individual nature of cost and
quality concerns. It underlines the contention that cost and
quality of life differ between people because of individual
differences: good community care may cost more for one person, less
for another; and will take a different form for both. The book also
provides evidence of the need to address issues around staff
training, support and attitudes if people with learning
difficulties are going to experience good quality outcomes.

Destined chiefly for an academic market due to its
scientific-based content and high price, it represents a useful
addition to the literature on resettlement. It has valuable
contributions to make on various issues, including the treatment of
staff, the preparation of residents for community life, and the
need to focus planning and assessments on individuals rather than
on groups.

Jean Collins is director, Values Into Action and author of
When The Eagles Fly, The Resettlement Game and Still
To Be Settled

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