Summary
Supporting and developing choice has often been seen as an aim for community services, but is difficult to achieve for individuals with severe learning and communication difficulties. Measures of service quality have tended to look more at the activities which individuals engage in, although there is now an increasing emphasis on trying to access user views. The aims of the present study were to examine staff judgements about clients' responses to the daily routines organized for them and to examine the extent to which it appeared that service users were engaging in activities which they preferred. The results suggest that staff are able to ascribe meaning to the different behaviours of clients, but that they do not always agree amongst themselves as to what the behaviour means. They are also aware that service users do not enjoy all the activities in their daily routine. Service providers and commissioners need to make the development of choice and preferences for service users as much of a priority as engagement in activities.
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