Costs of village community, residential campus and dispersed housing provision for people with intellectual disability

Abstract

The cost findings should be considered alongside evidence on outcomes. A comparison of village communities and dispersed housing schemes suggests that both models of provision appear be associated with particular benefits, although different types of setting are appropriate for different individuals and therefore, the continued development of a range of residential models is important.

An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

“…Studies have shown that residential accommodation costs account for the large majority of service provision (Hallam et al . ; Knapp et al . ; Hassiotis et al .…”

Intellectual disability, challenging behaviour and cost in care accommodation: what are the links?

“…Three techniques were used to estimate the level of resources invested in the buildings and equipment (capital costs): a figure based on a recent market valuation of the site discounted at 6% over 60 years; a valuation based on the property's council tax banding and discounted at 6% over 60 years; or, where considered to be more accurate than the council tax band, rent payments made by the individual organisations and their own arrangements for depreciation of capital. When the organisation could not provide a realistic replacement cost for fixtures and fittings, 10% of the annual building costs was added (as, for example, in the method used by Hallam et al. 2002).…”

Cluster housing for adults with intellectual disabilities

“…This is a curious conclusion, given that Cummins and Lau themselves cite (selective) results from a recent major study that has examined this very issue (see below). Emerson et al (2000a) report data on the quality and costs of supports provided to 133 adults living in five cluster housing schemes and 281 adults living in 10 dispersed housing schemes (see also Emerson et al, 2000b,c;Hallam et al, 2002;Robertson et al, 2001a,b;Walsh et al, 2001). The data they reported indicated that cluster housing, when compared with dispersed housing and controlling for any differences in participant characteristics, was associated with a number of potential disadvantages including: increased size of living unit; living in a home that was also used for short-term (respite) care; less home-like settings and furnishings; lower staffing ratios; poorer internal procedures for individualised planning, activity planning, allocating staff support to residents and the training and supervision of staff; greater depersonalisation, rigidity of routines, block treatment and social distance between support staff and residents; greater use of anti-psychotic and anti-depressant medication; decreased contact with social workers; less choice; smaller social networks, including having fewer people with intellectual disabilities and ''inclusive'' relationships in the person's social network; greater rates of people leading sedentary lifestyles; having fewer hours per week of scheduled activity; participating in fewer and a smaller range of leisure and social activities.…”