Personcentred reviews as a mechanism for ... - Wiley Online Library

bs_bs_banner

Journal of Intellectual Disability Research 603

doi: 10.1111/jir.12058

volume 58 part 7 pp 603–613 july 2014

Person-centred reviews as a mechanism for planning the post-school transition of young people with intellectual disability A. Kaehne1 & S. Beyer2 1 Evidence-based Practice Research Centre, Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK 2 Institute of Psychological Medicine and Clinical Neurosciences, Welsh Centre for Learning Disabilities, Cardiff, UK

Abstract Background Person-centred planning has played a key role in the transformation of intellectual disabilities services for more than a decade. The literature has identified clear advantages for service users when service delivery is planned around the individual rather than the user is made to fit into service structures. Researchers however have pointed out that there is a lack of evidence that person-centred planning positively influences outcomes for users. Method Our study examined the application of person-centred planning during transition for young people with intellectual disabilities. We investigated the nature and content of 44 person-centred reviews of transition planning for this population in a local authority in the UK. We carried out a documentary analysis of all person-centred plans and conducted telephone interviews with all families participating in the programme. We focused on the issue of attendance at review meetings and what was discussed during the meetings.

Results Analysis of the data shows an increase in the participation of young people and carers at review meetings and a significant shift in topics discussed during the transition planning process compared with previous programmes. However, some of these effects may dissipate once young people are actually leaving school as planning well is not synonymous with having an improved range of placement options. Conclusions The findings suggest that personcentred planning can impact positively on some aspects of transition planning, while it may be too optimistic to expect radical improvement in other area. Key to further improvements is to complement person-centred planning with consistent involvement of all relevant stakeholders in planning for individuals. Keywords education, intellectual disabilities, partnerships, person-centred planning, social care, transition

Background Correspondence: Dr Axel Kaehne, Evidence-based Practice Research Centre, Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk L39 4QP, UK (e-mail: [email protected]).

Person-centred planning has been part of the individualised support agenda in the UK for more than a decade. It is generally thought to be a critical mechanism to tailor service delivery to individual

© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd

Journal of Intellectual Disability Research

volume 58 part 7 july 2014

604 A. Kaehne & S. Beyer • Person-centred transition reviews

service users and ensure that services are responsive to the individual’s needs and abilities. There is however a clear consensus in the literature that positive effects of person-centred planning on service delivery has not been sufficiently evidenced to date (Cooney 2002; While et al. 2004; Cambridge & Carnaby 2005; Black et al. 2010). In particular, it is unclear whether person-centred planning has a significant impact on outcomes for people with intellectual disabilities (ID). Researchers note that, apart from small scale studies with mainly anecdotal evidence, at present, there is no evidential link between person-centred planning and outcomes for people with intellectual disabilities (Robertson et al. 2007). One of the reasons may be that person-centred planning operates in a service delivery context where clear evidential links are difficult to establish. Claes et al. (2010) argue that the components of person-centred planning are complex and hard to define. They urge researchers to provide full descriptions of person-centred processes to permit the attribution of effects to specific components of intervention (Claes et al. 2010). In the only systematic review on the subject Claes et al. (2010) warn of the dangers that personcentred planning may become a paper exercise, reflecting a paternalistic steering approach by service staff, which may fail to increase independence, choice and inclusion for service users. One critical factor in the transformation of service delivery for people with ID may be for person-centred planning to be properly accessible to service users. Claes et al. (2010) argue that there is little evidence that person-centred planning results in improved accessibility of person-centred plans for service users. This may undermine the aim to place the user at the heart of the process. Those findings echo considerable scepticism in the literature that person-centred planning at present results in more flexible support for service users. Some researchers argue that person-centred planning appears unable to tackle deep seated structural problems of service delivery (Ward et al. 2003; Cambridge & Carnaby 2005). This interpretation contrasts with some optimism among practitioners and policy makers that personcentred planning may be a key mechanism to change service delivery (Duffy & Sanderson 2005; Welsh Government 2007). Such optimism extents

well beyond the transformative role person-centred planning is supposed to play in the personalisation and individualisation agenda to strategic planning. Others however argue that hopes are misplaced that person-centred planning can fulfil a strategic planning role (Felce 2004). Felce points out that there is currently no widespread collation of data contained in person-centred plans for the purpose of service planning and/or commissioning. Person-centred plans, he maintains, are unlikely to function as baseline for the calculation of future resource requirements of services. This leaves person-centred planning in a much more diminished role in the context of individualised and personalised services. In effect, researchers may have come to re-appraise the potential and capacity of person-centred planning for improvements of service delivery and conclude that personcentred planning approaches may, above all, lead to temporary improvements in planning pathways for users into conventional service structures (Claes et al. 2010). Our study investigated the use of person-centred planning in one particular context, transition planning. Transition for young people with ID has received much attention from policy makers and researchers in the last two decades, but transition outcomes for this population remain poor (While et al. 2004; Grant & Ramcharan 2007; Grigal et al. 2011). Transition planning is often marked by low levels of inclusion of relevant stakeholders (Kaehne 2010), little choice for young people and their families (Raghavan & Pawson 2008; Kaehne 2009), and a predominance of pathways that suit services rather than users and carers (Wagner et al. 2006; Heslop & Abbott 2007). While person-centred planning is unlikely to be a panacea for tackling transition problems (Flexer et al. 2011; Grigal et al. 2011), improved personcentred planning may open up opportunities to users for increased participation in the transition process itself, formulate more adequate post-school destinations based on needs and abilities of the young person and articulate clear goals for support and intervention. Our study hence followed the recommendations of Claes et al. (2010) to examine more closely what person-centred planning may be able to deliver in individual service contexts and to investigate in





detail potential links between person-centred planning and outcomes for users. Transition as well as person-centred planning are complex service interventions set in a multiple effects context. Focusing on specific, clearly defined elements of a given intervention may reduce complexity and identify potential impact of intervention components on outcomes. The present paper thus concentrates on two issues that are well documented in the data set available for our analysis: attendance at transition review meetings and issues discussed during those meetings. We recognise that there are many other aspects of transition planning that may warrant investigation. Research has shown however that attendance at meetings and issues discussed at meetings are critical to improve transition planning (Beyer et al. 2008). The paper first outlines the method of investigation and then presents the research findings. We conclude the paper with a discussion about the implications of our study for person-centred planning practice and with recommendations for further research.

Method Our study formed part of an evaluation of a larger transition support intervention funded by the Department of Health (England). The Getting a Life project (http://www.gettingalife.org.uk/) was supposed to deliver individualised transition support to a self-selecting group of families and young people with ID in nine local authorities. The evaluation report has been published elsewhere (Beyer & Kaehne 2010). This larger study contained a group of sub-studies investigating transition planning. In one local authority in the North of England, staff from local social services and a local special school with adjacent sixth form designed a dedicated transition planning system, which was to be delivered in a person-centred way to all participants. Transition planning included a transition review meeting inviting young people and their families, the production of accessible transition plans, and setting clear goals for service staff. Our study focused on two aspects of transition support: the content and quality of the transition plans, which also contained a record of the transi-

tion review meeting, and the perception of families of the annual transition meeting. All participants who received additional transition support services through the school were approached by school staff on our behalf and asked for their consent to be part of the evaluation. All participants provided written consent and were contacted by the research team to arrange a brief telephone interview. Interviews lasted about 20 min and respondents were asked to recall who attended the review meetings and which issues were discussed. Interviewers prompted for a particular set of issues but also allowed respondents to make additional comments. In addition, we obtained all transition plans for the young people in the programme and submitted them to a documentary analysis. The documentary analysis sought to establish who attended person-centred review (PCR) meetings, whether plans conformed to accessibility requirements for people with ID, whether plans recorded previously identified goals and therefore established continuity of service delivery, whether or not strengths and abilities of the young person were recorded and which issues were discussed at the review meeting. Transition review meeting records were coded according to a coding template, identifying participants, the time and place of the meeting, the overall appearance and accessibility of the plan, and the goals identified for future service delivery. Besides this, the coding frame contained 36 items offering binary options. Raters only coded whether a criterion was met or not met. They did not differentiate between the different quality of content for any particular item. Beyond the documentary evidence, raters have had no additional information on the format or content of the actual review meetings as no member of the research team attended any of the meetings. The coding frame is available for inspection from the corresponding author. Prior to commencing interviews, respondents were asked to place their consent for interview on the record again and whether or not they are happy to proceed. During phone interviews families were asked whether their and their son or daughter’s views were properly taken into account, which topics they recalled were discussed at the meeting, whether they felt they had a say in choosing the place and time of the meeting, and whether topics such as welfare benefits, employment, and



Journal of Intellectual Disability Research 606 A. Kaehne & S. Beyer • Person-centred transition reviews

education were discussed. Generally, the interview schedule offered closed response options to families with some open questions at the end for further comments. The documentary analysis was carried out by two independent researchers. We conducted a simple reliability exercise comparing the selection of codes by both researchers. Eighty-six per cent of all coding across 36 items had been assigned to the same code by the researchers. Asking families about what was discussed at review meetings allowed us to triangulate data from our analysis of the transition meeting records (which were part of the transition plans). We clearly indicate below in which data set findings originate. The study took place over a period of 8 months in 2009/2010 and received ethical approval from the NHS Research Ethics Committee for Wales (10/MRE09/38). The study was funded by the Department of Health (England).

Results Participant characteristics In our study, 44 young people received transition planning meetings and all took part in our study. The school decided which students would receive transition support. The research team had no influence on who would or would not participate in the programme. Twenty-two young people were recruited into the larger transition support programme Getting a Life. The school decided that an additional 22 should receive the same intervention even though they were not part of the Getting a Life programme. This meant that all participants in our study received the same intervention. All young people were leavers of the local special school. Transition review meetings took place from November 2009 to March 2010. The school appointed a transition co-ordinator to organise review meetings and to deliver them in a person-centred way. The co-ordinator was briefed and trained in personcentred planning by a consultancy, which had been commissioned by the programme managers to deliver training to all local authorities. Transition co-ordinators also received person-centred transition plan templates, which outlined relevant information to be contained in transition plans. Two

issues took centre stage in our analysis: transition review attendance and issues discussed by attendees during the meeting.

Attendance We obtained data about attendance of transition review meetings from transition plans, which contained records of transition meetings. Attendance is not synonymous with invitation to attend. We know from previous studies that some staff find it difficult to attend review meetings although being invited (Kaehne 2010). Our study was not provided with any data on invitations. The average attendance was 8.8 persons, which is a significant number compared with conventional transition review meetings. Almost half of all meetings (43%) were attended by either eight or nine stakeholders. The highest number of attendees was 15 (4.5%) and the lowest was four stakeholders (4.5%). Comparing this figure with a previous transition intervention project (Beyer et al. 2008), transition co-ordinators seem to have managed to involve a significantly higher number of participants in our study (Table 1). One important aspect of transition support for young people leaving school is whether or not a sufficiently broad range of professionals and significant others participate in transition review meetings. A breakdown of attendee categories reveals that the transition project in the school achieved a higher than usual attendance rate from young people (83%), parents (68%) and Connexions advisors (82%). This represents a significant improvement compared with conventional transition reviews in schools. Involving young people is important to increase the chances of person-centred quality of planning. Without being present young people and families find it difficult to place their wishes on record and to influence the planning process (Beyer & Kaehne 2008; Kaehne 2009). Attendance does not guarantee shared decision-making in transition planning of all stakeholders but it is a sine qua non of more effective involvement of users and families in the process (Fig. 1). The low attendance rates of social workers may reflect a low rate of involvement of families with their service. For reasons of confidentiality we did not obtain data on which families received social




Table 1 Attendance at person-centred reviews (PCRs) in category

Attendee category

Number of PCRs attended (%)

Number of PCRs not attended (%)

Number of PCRs offering no data (%)

Young person Carer Speech and language therapist Employment agency School health worker Transition worker Social worker Connexions School support School manager

36 (83) 30 (68) 4 (9) 3 (7) 8 (18) 20 (45) 13 (29) 36 (82) 26 (59) 29 (66)

2 (4) 4 (9) 31 (70) 41 (93) 30 (68) 18 (41) 25 (57) 2 (4) 12 (27) 9 (20)

10 (23) 6 (14) 6 (14) 0 (0) 6 (14) 6 (14) 6 (14) 6 (14) 6 (14) 6 (14)

Young person

Carer

Speech and language therapist

Employment agency

School health worker

Transition worker

Social worker

Connexions

School support

School manager

40

36

36

35

30

29

30

26

25

20 20

13

15

8

10 5

4

3

0

Figure 1 Attendance of person-centred reviews (PCRs) by category.

Categories of attendees of PCRs

service input. However, transition for young people with ID is not only a transition from school to postschool options but often also a transfer from children to adult social services. The low attendance rate of adult social services in transition meetings is well documented in research and contributes to difficult service transitions for families and young people (Kaehne 2010). Families were clearly thinking of this when asked who they would have liked to see at transition review meetings. A third of

family respondents (33%) mentioned adult social care as the main missing participant.

Topics discussed We also obtained data about the topics of discussions of all transition review meetings from two sources, the transition meeting records, which were part of the transition plans, and from our family interviews. While recollection of meetings by par-




ticipants may not always be accurate, transition meeting records were drawn up after the meeting and may equally contain some errors. The fact that we had two sources for this type of information potentially increased the accuracy of the overall picture. Eventually, it turned out that data from both sources were remarkably similar. We report below the results from the PCR meeting records. As Fig. 2 shows discussions about school education and college dominated the transition review meetings. Debates on the health needs of the young people featured prominently as well. This is surprising given that health professionals rarely attend transition review meetings and transition planning is traditionally dominated by issues around educational, vocational and social support pathways. Also surprising to a certain degree is that individual budgets (IB) and direct payments (DP) featured comparatively low on the list of topics. This may be one reason why there is still a low uptake of IB/DP in the ID population across England and Wales (Cowen et al. 2011) despite there being research evidence that some benefits accrue to users through the use of DP (Stainton & Boyce 2004). As IB/DP may not be often discussed during transition review meetings, service users may lack reliable

40

information about the advantages and disadvantages of these mechanisms to provide individually tailored support. The absence of discussion around IB and DP may also complicate subsequent planning for individual support through the adult sector. There may be an association with the low level of involvement of adult social care staff in transition meetings, something future research will have to explore in more detail. We do know already however that the strong focus of transition review meetings on school and college education predetermines the context of discussions for post-school placements (Kaehne & Beyer 2008; Kaehne 2012). Discussions about post-school options for young people are naturally one of the most important themes for transition review meetings. Our analysis shows that transition review meetings placed some emphasis on discussing skills and work experience for the young people. While work experiences do not necessarily lead to better post-school options, research shows that weekend and evening jobs are an important part of the normalisation agenda with young people with ID following similar employment pathways as the general population (Kaehne 2009). Employment pathways in the general population

School education

College

Housing

Health

Welfare benefits

IB/DP

Paid job

Evening/weekend job

Work experience

Skills/competencies

Relationships

Community activities

36

35 30

29

28

26

25

21

20

18

20 15 10 5

6

6

7

7 2

0 Issues discussed at PCRs

Figure 2 Issues discussed at person-centred review (PCR) meetings according to meeting records. IB, individual budgets; DP, direct payments.




feature casual work placements as an integral part of improving employment chances for young people, and developing similar opportunities for young people with ID appears critical in increasing their employment opportunities in the long term. However, the number of PCRs where work placements and casual employment were discussed was surprisingly low compared with instances were further education opportunities or even health was discussed. This may indicate a lack of employment opportunities in the area or simply a lack of awareness of staff and carers about the need for early development of employment skills. In our study, the local authority benefitted from additional employment support for young people with ID still at school, and the less prominent role of discussions about work placements at transition meetings despite this additional input is concerning. More importantly, PCR records also indicated that goals with regard to employment were often vague, which makes follow-up monitoring of transition support difficult. We examined in more detail which of the issues discussed at the meetings had concrete goals attached that outlined specific activities or tasks for support agencies. Only in a minority of cases were goals associated with concrete tasks for individual support workers. Goals in the field of health did not gain any allocation of tasks in any cases. Educationally defined skills and competencies (n = 16) was the category that elicited concrete tasks in the PCRs most often. This may be the case because deficiencies in competencies can often be addressed in the school environment. Allocating tasks to school staff is hence more easily done as they attend the PCR meetings, whereas task setting for agencies staff that may not consistently attend is more difficult. It may also prove very difficult for staff to formulate concrete goals in terms of relationship development for young people in transition. Relationships, community activities and paid jobs attracted surprisingly low numbers of concrete tasks (n = 3, 2 and 2 respectively) allocated to specific support workers in the plans. This finding resonates with the discussion in the literature about the nature of relationships for people with ID, the quality of professional support and inclusion in society (Reinders 2002; Reinders 2008a,b). While our data reflected these difficulties, they may persist as long as transition review

Paid job

Evening/weekend job

Work experience

Skills/competencies

Relationships

Community activities

4 0 6

Broad goals set

7 8 9 2 0 10

Concrete goals set

16 3 2 0

5

10

15

20

Figure 3 Goals set in person-centred review records for future monitoring.

meeting participants fail to agree on particular tasks for support staff (Fig. 3). An analysis of the goals set in transition reviews for all services confirmed the main thrust of transition planning. Goals related mainly to skills and competencies that could be taught in school and work experience, areas that benefited from additional resources in our study. This may reflect the need for additional resources to develop other post-school options such as employment. In a sense, our study corroborated previous research findings that person-centred planning during transition may contribute little to person-centred service delivery but rather prepare young people for transition into existing services in a person-centred way (Claes et al. 2010). As long as post-school options appear to reflect availability of services rather than young people’s needs and preferences this is unlikely to improve. The main method to gauge the involvement of young people in our study was by assessing the accessibility of transition plans. We developed a list of criteria against which every plan was judged. The checklist included items such as ‘simple language used’, ‘pictures and photos used throughout the plan’ and ‘acronyms and jargon avoided’. Thirtynine per cent of all plans in our study used language that was simple and avoided jargon and acronyms altogether. An additional 56% of plans contained





only one or two instances of jargon or acronyms such as ‘IT’ for computer. This indicates that accessibility may be an easy win for everyone, and may be achieved by consistently using easy-read templates, which are widely available to school staff in England and Wales.

Discussion In line with Claes et al.’s suggestions, our study focused on singular components in order to improve the evaluative framework for person-centred planning (Claes et al. 2010). Thus, instead of asking whether person-centred planning improves transition planning in general, we will discuss below some of the aspects where PCP may have made a difference. This approach is in line with forming realistic expectations about what PCP can and cannot do. It also speaks to the difficulty researchers have in assessing PCP’s impact on service outcomes in a methodologically robust manner. In addition, it has the benefit of directly relating to the evidence produced by our analysis with respect to meeting attendance and the issues discussed during the review meetings. We acknowledge the complexity of person-centred planning and transition support, yet believe that focusing on specific, clearly defined components of service delivery is a precondition for identifying potential links between service elements that work and improved service outcomes. Research recognises that the two policy domains of choice and inclusion in transition planning are intrinsically linked to the issues of participation and accessibility. Previous studies have shown that lack of attendance at transition meetings often translates into fewer options and choices for young people with ID once they leave school (Kaehne 2009; Kaehne & Beyer 2009). Consistent attendance is conducive to improved involvement of stakeholders, be they parents, young people or agency staff. Our study revealed higher attendance rates than usual for young people, families and some professionals throughout the project (Beyer et al. 2008). Some agencies however continued to be absent at transition review meetings. This may impact on the topics discussed and goals set for each young person. It is an encouraging sign however that conducting transition review meetings within a PCP framework

can increase attendance from some stakeholders, notably from young people and families themselves. The consistent absence of adult social services may have several reasons. First, it may be that not all leavers in our study were recipients of social service input. Second, adult social service eligibility assessments following handover from children services may simply take place too late to ensure consistent attendance levels of social workers at transition meetings. The result of this is that transition into adult social services, which is a critical element of transition planning for many young people with ID (Kaehne 2010), may fail to play a significant role in transition review meetings. Whatever positive effects originated in improved transition planning meetings, these effects may dissipate as transition into adult social services does not play a role in transition review meetings. Claes et al.’s (2010) suspicion that PCP may easily become a paper exercise as some planning may not bridge some professional boundaries appears to be justified in this respect. The absence of employment agencies at transition review meetings is equally concerning. Their lack of involvement may adversely affect the development of viable post-school options, narrowing choice for young people with ID leaving school. We have previously noted that effective involvement of outside employment agencies is necessary for developing viable post-school outcomes in the world of work (Beyer & Kaehne 2008). There is also some research on how to improve the inclusion of employment agencies and its positive effects on choice (Kaehne 2009). When asked about the low level of involvement of these agencies in our study, school staff in our study argued that employment goals may still be identified for some individuals at a later stage. We would maintain however that developing viable employment options for young people in transition depends on consistent and early engagement of employment agencies in PCR meetings. Our study clearly showed that organising transition review meetings in a PCP manner by itself does not produce improved post-school options and hence better choices for service users. Personcentred transition meetings may however improve the chances of young people and parents to articulate their needs and preferences in a




prominent forum. It may also increase the involvement of all relevant stakeholder in the process as long as they are willing to engage. Transition review meetings therefore offer a unique opportunity for everyone to contribute to better transition planning and reconcile different planning trajectories. Whether PCP review meetings achieve this depends largely on the involvement of post-transition agencies, their flexibility and contribution to planning outcomes. In order to place the needs and wishes of the young person at the centre of the planning process, accessibility is key. It is a necessary condition for involving young people in a meaningful way in planning their future. Yet, where accessibility is achieved, other barriers such as lack of options and resources or the lack of involvement of some agencies is brought into sharp relief. As young people are given more chances to articulate their ideas about their own future, services may increasingly struggle to meet the newly articulated demands. Person-centred transition reviews therefore are likely to create new service demands and it remains to be seen whether all agencies can cope with this change effectively. The alternative is that transition plans identify clear goals and actions for individual staff yet young people are eventually simply placed into available service structures against their original preferences. In this scenario, Claes’s word of ‘paternalistic steering process’ (Claes et al. 2010, p. 448) comes to mind. Another important issue that our study examined is whether or not person-centred transition review meetings would be a suitable mechanism to increase choices for service users. Two key factors impact on this issue: the setting of concrete goals, actionable for service staff, and the discussion of relevant issues at the meeting (Kaehne 2009). In our study, discussions at transition meetings were dominated by educational pathways, which may reflect the path of least resistance for everyone involved. Leaving the often holistic care of special schools poses a significant challenge to parents and young people. Looking for a continuation of this provision in a similar educational environment may seem for many stakeholders the most plausible next step. Services such as Connexions may also favour placing leavers in further education colleges. There

is some evidence that FE attendance simply delays much needed vocational experiences where colleges fail to provide necessary real life work placements and training (Beyer & Kaehne 2008). A convergence of some institutional stakeholders’ preferences towards the college pathway may make the development of alternative post-school options more difficult. Services may focus resources on the existing, well tested singular pathway option of further education to the detriment of alternative pathways. While college may be a suitable placement for some young people leaving school, our study showed that failing to develop alternative placement options means that choices of young people and families are being disregarded (Kaehne 2009). Previous research has highlighted the gap between first choices for post-school options by parents and young people and actual placements (Beyer et al. 2008; Hogansen et al. 2008; Blacher et al. 2010). Discussion of alternative post-school options at transition meetings need to be taken more seriously by staff and lead to the development of a broader span of placement options. Participation of all key contributing stakeholders is closely associated with the successful development of additional options (Kaehne 2009; Kaehne 2010). The range of topics discussed at transition reviews in our study appear to be a reflection of the participation (or lack thereof) of agencies in meetings. It seems plausible that without widening the participation of agencies, progress in developing alternative options will remain difficult. There was also some evidence in our study that meeting participation influenced setting goals in transition plans. Most goals were educational in nature and while staff made some progress in formulating clear and actionable goals, the limited thematic range of goals reflected the absence of some agencies vital to develop further goals and objectives with young people. As the school in our study benefited from additional transition planning capacity (provided by the school and local authority) the findings are however unlikely to be representative of transition planning across the UK.

Conclusion Person-centred planning may improve the involvement of some stakeholders, most notably the young





people themselves and their families. Involving them in planning their future represents significant progress on the choice, rights and inclusion agenda (Department of Health 2001). Yet the exact impact of person-centred planning on developing transition options and service delivery may be limited. Personcentred transition planning can only influence outcomes for users if all stakeholders take part in the review meetings, receive and accept their responsibility to contribute to the future of the young person, and commit to take account of the young person and the families’ wishes. Our study confirms to a large extent Claes et al.’s (2010) suspicion that even the best person-centred process in transition planning may remain a paper exercise unless services perceive person-centred planning as a mechanism to develop a genuinely personalised and individual service to young people with ID and their families. To do this, services need to embrace person-centred transition reviews as an integral part of their service planning across professional boundaries.

Acknowledgement The authors gratefully acknowledge funding for this study from the Department of Health (England), through the Getting a Life programme.

References Beyer S. & Kaehne A. (2008) The transition of young people with learning disabilities to employment: what works? Journal on Developmental Disabilities 14, 81–90.

families caring for children with severe learning disabilities in rural and urban areas. Journal of Intellectual Disabilities 14, 111–31. Cambridge P. & Carnaby S. (eds) (2005) Person Centred Planning and Care Management with People with Learning Disabilities. Jessica Kingsley, London and Philadelphia. Claes C., Hove G. V., Vendevelde S., Loon J. & Schalock R. L. (2010) Person-centred planning: analysis of research and effectiveness. Intellectual and Development Disabilities 48, 432–53. Cooney B. F. (2002) Exploring perspectives on transition of youth with disabilities: voices of young adults, parents, and professionals. Mental Retardation 40, 425– 35. Cowen A., Murray P. & Duffy S. (2011) Personalised transition: a collaborative approach to funding individual budgets for young disabled people with complex needs leaving school. Journal of Integrated Care 19, 30–6. Department of Health (2001) Valuing People. A New Strategy for Learning Disability for the 21st Century. Stationary Office, London. Duffy S. & Sanderson H. (2005) Relationships between care management and person centred planning. In: Person Centred Planning and Care Management with People with Learning Disabilities (eds P. Cambridge & S. Carnaby), pp. 34–50. Jessica Kingsley, London and Philadelphia. Felce D. (2004) Can person-centred planning fulfil a strategic planning role? Comments on Mansell & BeadleBrown. Journal of Applied Research in Intellectual Disabilities 17, 27–30. Flexer R. W., III, Baer A. W. D., Queen R. M. & Meindl R. S. (2011) An epidemiological model of transition and postschool outcomes. Career Development for Exceptional Individuals 34, 83–94. Grant G. & Ramcharan P. (2007) Valuing People and Research: The Learning Disability Research Initiative. Overview Report (Research Report). Department of Health, London.

Beyer S. & Kaehne A. (2010) Transition to Employment: The Role of Getting a Life in Developing an Employment Pathway for People with Learning Disabilities. Welsh Centre for Learning Disabilities, Cardiff.

Grigal M., Hart D. & Migliore A. (2011) Comparing the transition planning, postsecondary education, and employment outcomes of students with intellectual and other disabilities. Career Development for Exceptional Individuals 34, 4–17.

Beyer S., Kaehne A., Grey J., Sheppard K. & Meek A. (2008) What Works? Transition to Employment forYoung People with Learning Disabilities (Final Report). Shaw Trust, Chippenham.

Heslop P. & Abbott D. (2007) School’s out: pathways for young people with intellectual disabilities from out-ofarea residential schools or colleges. Journal of Intellectual Disability Research 51, 489–96.

Blacher J., Kraemer B. R. & Howell E. J. (2010) Family expectations and transition experiences for young adults with severe disabilities: does syndrome matter? Advances in Mental Health and Learning Disabilities 4, 3–16. Black L.-A., McConkey R., Roberts P. & Ferguson P. (2010) Developing a person-centred support service for

Hogansen J. M., Powers K., Geenen S., Gil-Kashiwabara E. & Powers L. (2008) Transition goals and experiences of females with disabilities: youth, parents, and professionals. Exceptional Children 74, 215–34. Kaehne A. (2009) Choice for young people with learning disabilities in post-education transition. Mental Health Review Journal 14, 37–43.




Kaehne A. (2010) Multi-agency protocols in intellectual disabilities transition partnerships: a survey of Welsh local authorities. Journal of Policy and Practice in Intellectual Disabilities 7, 182–88. Kaehne A. (2012) Partnerships in Local Government. The case of transition support services for young people with learning disabilities. Public Management Review. Available at: http://www.tandfonline.com/doi/pdf/10.1080/ 14719037.2012.698855 (retrieved 30 May 2013). Kaehne A. & Beyer S. (2008) Carer perspectives on the transition of young people with learning disabilities to employment. Journal on Developmental Disabilities 14, 91–100. Kaehne A. & Beyer S. (2009) Views of professionals on aims and outcomes of transition for young people with learning disabilities. British Journal of Learning Disabilities 37, 138–44. Raghavan R. & Pawson N. (2008) Transition and social networks of young people with learning disabilities. Advances in Mental Health and Learning Disabilities 2, 25–8. Reinders H. (2008a) Receiving the Gift of Friendship. Profound Disability, Theological Anthropology and Ethics. Eerdmans, New York. Reinders H. (2008b) The transformation of human services. Journal of Intellectual Disability Research 52, 564–72. Reinders J. S. (2002) The good life for citizens with intellectual disability. Journal of Intellectual Disability Research 46, 1–5.

Robertson J., Merson E., Hatton C. & Elliott J. (2007) Person-centred planning: factors associated with successful outcomes for people with intellectual disabilities. Journal of Intellectual Disability Research 51, 232–43. Stainton T. & Boyce S. (2004) ‘I have got my life back’: users’ experience of direct payments. Disability and Society 19, 443–54. Wagner M., Newman L., Levine P. & Garza N. (2006) An Overview of Findings from Wave 2 of the National Longitudinal Transition Study 2 (NLTS2). Institute of Education Sciences, London. Ward L., Mallett R., Heslop P. & Simons K. (2003) Transition planning: how well does it work for young people with learning disabilities and their families? British Journal of Special Education 30, 132–7. Welsh Government (2007) Shared Planning for Better Outcomes: Planning Guidance and Regulations for Local Authorities and Their Partners on Children andYoung People’s Plans. Welsh Assembly Government, Cardiff. While A., Forbes A., Ullman R., Lewis S., Mathes L. & Griffiths P. (2004) Good practices that address continuity during transition from child to adult care: synthesis of evidence. Child: Care, Health and Development 30, 439–52.

Accepted 9 May 2013
