A conceptual model of quality service provision for people with intellectual disability and challenging behaviours: Enhancement and enrichment through service user and other stakeholder consultation

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People with intellectual disability and challenging behaviour are one of the most disenfranchised groups in society. How they are supported through services has a primary role in changing this outcome. While legislation provides frameworks for quality service provision for people with disabilities, they do not identify the mechanisms specific to the cohort that can address this disenfranchisement. As such, it is paramount to develop an understanding of quality service provision specific to those with intellectual disability and challenging behaviour. To identify the factors required for quality service provision for people with ID and CB, a three-stage design incorporating participants from various stakeholder groups (n=7) was undertaken. Study one involved data collection from CEOs and managers (n=55) of service provider agencies using a Delphi study, and clinicians and senior practitioners (n=85) using survey methods. Study two incorporated interviews conducted with families/carers of service users (n=11), advocates (n=10), support workers (n=13) and supervisors (n=11) who had provided services to the cohort, complemented by survey data (n=102). Study three involved data collection with service users with intellectual disability and challenging behaviour (n=14) through focus groups. The results of this research led to the identification of processes and practices associated with and impacting on quality service provision that were not identified through the literature review. Further, it identified agents that are formative to the production of quality services. The outcome of this research is a model of quality service provision for the cohort that conceptualises quality as a continuous process and includes factors across socio- political systems that are formative to, and impacting on, quality service provision. The developed model has significant implications for service provider agencies, service user consultation, government, substitute decision making, and the National Disability Insurance Scheme.