Abstract

Despite changes in the nature of supported accommodation services for people with learning disabilities, little progress was made during the '70s, '80s and '90s in addressing the extent of unmet need. While the advent of Supporting People has more recently led to an increase in the volume of provision, unmet need continues to be a major concern to people with learning disabilities and their families. There is good reason to believe that, as a result of changes in the demographic profile of people with learning disabilities, changes in expectations and changes in the pattern of informal care, this issue will become substantially more pressing over the coming two decades. This paper attempts to estimate the nature and extent of increased need.

Introduction

The last four decades have witnessed dramatic changes in the way we have provided supported accommodation for people with learning disabilities. In 1976, more than 50,000 people with learning disabilities were living in large-scale NHS long-term institutional provision. In effect, institutionalisation was the only option for people with learning disabilities who could not live relatively independently and who, for whatever reason, no longer lived with their family. In 2006 the last of these NHS institutions will close. In their place we now have an array of smaller, more community-orientated provision (Emerson, 2004).

There is little doubt that these changes have, overall, been to the benefit of people with learning disabilities and informal carers (Emerson & Hatton, 1994; Hatton & Emerson, 1996). There is also little doubt that the gains made are still far from sufficient to afford many people with learning disabilities an acceptable quality of life (Emerson et al, 2005).

Improving the quality of supported accommodation is, however, only part of the problem we are currently facing. The other key part relates to increasing the supply of supported accommodation services in order to meet current and future need and demand. The 1971 White Paper Better Services identified a significant shortfall in the volume of provision, and set specific targets for increasing volume by 1991. The best estimate is that no progress at all was made towards these targets over the following three decades (Emerson & Hatton, 1998), and that unmet need for supported accommodation for people with learning disabilities continued to constitute a major problem