The characteristics and turnover of direct-care staff in two housing services for adults with moderate, severe or profound mental handicaps are described. Both staff groups were predominantly female with a good representation of staff aged under 30, and between 30 and 50 years. Most had prior experience in a caring capacity before taking up their current posts, but only a quarter to a third had a relevant vocational qualification. Turnover was similar in the two services, but varied considerably between settings in each. Average annual turnover ranged fi-om 8 to 39% in one and from 5 to 48% in the other. However, most houses still had a core of long-serving staff providing continuity over time. The implications of the level of staff turnover found for management and staff training are discussed, as are the reasons for leaving given by former staff of one of the services, together with their views on job satisfaction, conditions of work, and the adequacy of management and training.

The paper examines the concept of an interprofessional ethical advisory group and the contribution which it might make towards improving care provision for people with learning disabilities. It describes briefly the policy and professional practice background and outlines the aims and functions of such a group, focusing upon that established within the Southern Derbyshire Community NHS Trust.