Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: Staff performance

Abstract

Systematic observational measures were taken of the minute-to-minute behaviour of staff in two types of residential unit for mentally handicapped people. Houseparents in Wessex locally-based hospital units spent, on average, a greater proportion of their time contacting clients than junior nursing staff in traditional hospital villas, and the houseparents spent more of their time praising or cueing client activity. The performance of charge nurses and sisters in the villas was similar to that of junior nursing staff, but the wardens and deputies of the locally-based hospital units spent little time contacting clients. Given higher staff/client ratios, there were greater numbers of staff in the locally-based hospital units contacting clients and handling materials designed for their use, thus showing that equivalent standards of staff performance can be attained in alternatives to large mental handicap hospitals. Given the variability between units and recent research in this area, the key independent variables now open to further study are the deployment of staff and the scheduling of activities to maintain high quality care.