The theory and practice of adult placements

Adult placement schemes are similar to foster schemes, but are for adults rather than children. They offer alternative and flexible forms of accommodation and person-centred support provided by adult placement carers – ordinary individuals or families in the local community.

These schemes are run or commissioned by local authorities and offer a range of services including long-term, short-term, respite or day care accommodation with an adult placement carer and their family. Adult placement carers are generally recruited through word-of-mouth and are approved, paid and regularly checked by adult placement schemes.

Most users of adult placements are people with learning disabilities, but older people, people with mental health problems, disabled people, and those with complex and multiple needs can also be supported through this service.

Despite the growing popularity of adult placements, there is very little formal research about it. However, evidence from practice surveys point to several key areas that practitioners and commissioners should consider.

The benefits of adult placements include reduced costs. A cost analysis by the National Association for Adult Placements (NAAPS) carried out for the Department of Health (unpublished study) looked at six schemes providing a range of residential and day services to different client groups. It showed that despite wide variations depending on the support needs of service users, the cost of adult placements schemes is generally significantly lower than other forms of social care provision. Adult placements are also ideal in helping local authority commissioners to meet the choice, dignity and control aims of the white paper Our Health, Our Care, Our Say by developing small-scale local services for the needs of their community.

Assessment and referral is one of the most important parts of the adult placement process. The Department of Health (2003) national minimum standards for adult placements state that a scheme can only accept a referral on the basis of a full assessment of the individual, undertaken by trained staff, involving appropriate communication methods, and with an independent advocate as appropriate. Scie’s (2004) practice survey found that a comprehensive needs assessment, informed by a person-centred plan, is essential to ensure that the adult placement is tailored to the individual.

Matching and introductions are also key aspects of ensuring a successful placement. The adult placement scheme should make sure that the placements will suit the users and that the carers are able to meet the person’s needs and feel comfortable themselves. Meeting all a person’s preferences and needs to achieve a perfect match is almost impossible and schemes will usually select the best match available. However, schemes stress that a placement should not be made if no appropriate match is available. They also emphasise the importance of taking at least six months to a year to develop and test the match between the user and carer. Flexibility is essential.

Despite all of the obvious benefits of adult placement, raising its profile among social care staff was a major issue identified in the practice survey. There was an acknowledgement of the need for better partnership and communication between strategic commissioners supporting schemes, care managers, the adult placement schemes and the adult placement carers. This is likely to lead to better outcomes for the service user.


● Find out more about adult placements and how they could be used and promoted in your area.

● Make sure that an assessment covers: requirements for accommodation and personal support, meaningful education, training and occupation, family and social contact, cultural and faith needs and the provision of disability equipment, including arrangements for payment and supply.

● Spend time with the individuals and involve the people who know them best in explaining adult placement and the way it works. People may need to experience the range of options open to them before being able to make a meaningful choice.

● Make sure you give the adult placement scheme, carer and user as much information as you have. Adult placement carers need to prepare for the placement – they are providing a lot more than just shelter.

● It is important that the person’s family feels fully involved in the matching and introductory process. Schemes stress that placements are much more likely to succeed if they have the support of the family.

Further information

● Practice guide 4: Adult placements and person-centred approaches 

● Practice guide 8: Improving outcomes for service users in adult placement – Commissioning and care management

Having a good day? A study of community-based day activities for people with learning disabilities

Department of Health (2003) National minimum standards for adult placements

DH (2001) Valuing People: a new strategy for learning disability for the 21st century


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