Clinical

Out of area and bottom of agenda

The recommendations in the Mansell reports published first in 1993 and updated in 2007 have not been implemented, despite the scandal at Winterbourne View and its aftermath. There is now nationwide awareness of the plight of people with learning disabilities placed in out-of-area specialist inpatient hospitals, yet only about 5% of them have been moved to independent accommodation over the past year. This article studies why Mansell’s recommendations have not been put into practice and explains why challenging behaviour should be seen as a symptom of underlying problems, not as the focus of community learning disability team attention. It concludes that strategies, such as positive behaviour support and person-centred active support, may enable clients to achieve maximum levels of independence and participation.

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