Edited by Barbara McIntosh and Andrea Whittaker.
ISBN 1 85717 400 3
People with learning difficulties who have complex needs are
often poorly served by day services. While local day centres may
provide good opportunities for people with mild or moderate
learning difficulties to make friends, enjoy leisure and learn new
skills, they are often less successful in meeting the needs of more
disabled people who have profound and complex disabilities.
Hopefully this situation is beginning to change, in part
stimulated by the Changing Days project led by the King’s Fund and
the National Development Team. This book is the final output of
Although the main text is designed to be read by managers and
commissioners there is also a plain language version intended to be
accessible to service users. A personal planning book is included
as an appendix.
The book is based on the experience of working with 45 people
from three sites, but also includes material from other projects.
There are chapters on communication, health, education, transition,
supported employment, leisure, involving service users, managing
change, care management, finance and person-centred planning.
(Their approach to person-centred planning is an adaptation of
personal futures planning and essential lifestyle plans together
with ideas gained from working with circles of support.)
To test whether the project had been useful I turned to the
chapter where managers reflect on their experiences. In Knowsley
important lessons were learned. There were two distinct strands to
their work. The first was to identify 16 people with complex need
and work with each of them to create an essential lifestyle plan
and set up a planning circle.
The second strand was working with a group of more able people
and training them to be advocates for those with more complex needs
and take a lead role in evaluating and shaping services. There was
very positive feedback. This practical manual will be a valuable
resource to those who commission and manage day services.
Oliver Russell is a consultant psychiatrist and, until
recently, was director of Norah Fry Research Centre, University of