Purpose -Service user involvement in evaluating provided services is a core NHS concept. However individuals with intellectual disabilities have traditionally often had their voices ignored. There have been attempts to redress this, though much work has been quantitative, and qualitative study has more often explored populations transitioning to more mainstream care and those with milder disabilities. The authors set out to explore the views of individuals with more severe intellectual disabilities who were resident inpatients on what helped or hindered their care. Design/methodology/approach -The paper uses qualitative analysis through semi-structured interviews of eight (three male, five female, mean age 33) resident service users with severe intellectual disabilities. Findings -Sub-categories of staff personality, helpful relationships, and the concept of balanced care emerged under a core category of needing a secure base. Clients were very clearly able to identify and delineate: personal attributes of staff; clinical means of working; and the need to balance support with affording independence and growth. They further noted factors that could help or hinder all of these, and gave nuanced answers on how different personality factors could be utilized in different settings. Originality/value -Little work has qualitatively explored the needs of residential clients with severe intellectual disabilities. The authors' data show that exploring the views of more profoundly disabled and vulnerable individuals is both viable and of significant clinical value. It should aid staff in contemplating the needs of their clients; in seeking their opinions and feedback; and considering that most "styles" of personality and work have attributes that clients can value and appreciate.
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