Effectiveness of disability services

Two people pointing to a stand of flowers.

The work in this theme is primarily concerned with building an evidence base to improve the effectiveness of disability services and thus improve the quality of life for people with cognitive disability who utilise those services. Our researchers work closely with people with disability and disability services to investigate new models of service, such as supported living and new practices such as support for decision making. We are also continually exploring how to improve outcomes in group homes through embedding Active Support and Practice Leadership.

Current projects

Active Support, Practice Leadership and Organisational Culture: A longitudinal study of the determinants of the quality of supported accommodation services for people with intellectual disability

Research Team:
Professor Christine Bigby - La Trobe University
Dr Lincoln Humphreys - La Trobe University
Jane Bowden-Dodd - La Trobe University

Project aim: The overarching aim of this project is to improve the quality of front-line staff practices and practice leadership in services and thus the quality of life of people with intellectual disabilities using services. The project builds on an ARC Linkage study that identified the factors that predicted good Active Support in supported accommodation services (see report for summary). This project continues the longitudinal and multi organisational approach of the orginal ARC Linkage study, but it widens the focus to explore the impact of culture, teamwork and other organisational features that have an impact on the quality of support. The project is funded by industry partners, who also gain access to an annual independent report on the quality of support in their services.

Partners and Funding: annecto, Dundaloo Services, Focus Individualised Support Services, GenU, Golden City Support Services, Help Enterprises, Identitywa, Jewish Care, Oak Possibility, Rocky Bay, Unisson Disability Services, Yooralla
Date: 2018
Contact: Professor Christine Bigby - C.Bigby@latrobe.edu.au

Identifying quality: Resources for delivering and monitoring quality of evidence-informed practice

Research Team
Professor Christine Bigby - La Trobe University
Professor Teresa Iacono - La Trobe University
Dr Lincoln Humphreys - La Trobe University
Dr Tal Araten-Berman - La Trobe University
Dr David Henderson - La Trobe University
Dr Werner Vogels - La Trobe University
Charity Sims-Jenkins - La Trobe University

Project aim: This project aims to develop resources to build NDIS service providers’ capacity to deliver high quality evidence-informed practice to people with intellectual disabilities in supported living services. Essentially, the project is concerned with embedding practices that support people with intellectual disabilities to exercise choice and control, and to be engaged and active participants in their own lives. Over the course of two years, this project will develop a new training program on Front Line Practice Leadership, update an online resource outlining the key tenets of Active Support, develop a new easy to use Tool for Observing Practice, and produce Guides on what makes a difference to service quality tailored for organisations, families and people with intellectual disabilities.  The project draws on ten years of practice quality research in supported living services and aims to increase the capacity of NDIS providers to deliver high quality evidence- informed practice.

Funding: NDIS, Quality and Safeguards Commission
Date: 2019
Contact: Professor Christine Bigby - C.Bigby@latrobe.edu.au

Identifying quality: Quantifying features of organisational structures and leadership that contribute to sustained quality of Active Support practice in supported accommodation services

Project Team
Professor Christine Bigby - La Trobe University
Dr Lincoln Humphreys - La Trobe University
Professor Teresa Iacono - La Trobe University
Dr Tal Araten-Bergman - La Trobe University

Project aim: This project is part of the Identifying Quality research program. The aim of this projct to develop a scale of Organisational Factors Supporting Sustained Active Support and evaluate its psychometric properties. This scale will provide the means to quantify and measure those variables that emerged from our qualitative Active Support study, thereby enabling an efficient way to gather data required to determine the extent to which organisational factors complete our understanding of how to sustain good Active Support. This scale will also form the basis of a simple checklist by which families and people with disabilities, as well as service delivery organisations can identify organisational features research has identified as being associated with good Active Support

Funding: Lorna Hodgkinson foundation
Date: 2019
Contact: Professor Christine Bigby - C.Bigby@latrobe.edu.au

Aging with intellectual disability: Exploring the impact of the NDIS on service provision

Research Team
Dr Tal Areaten-Bergman - La Trobe University 
Professor Christine Bigby - La Trobe University

Project aim:

Funding: School of Allied Health, Human Services and Sport, La Trobe University.
Date: 2019
Contact: T.Araten-Bgerman@latrobe.edu.au

How is service quality understood and measured in disability services (PhD)

Research Team 
Jade McEwen (PhD Candidate) – La Trobe University
Professor Christine Bigby – La Trobe University
Professor Jacinta Douglas – La Trobe University

Project aim: Since the early 1990s, the Victorian disability sector has measure the quality of services for people with intellectual disability on a annual basis, yet research suggests that service users experience low levels of engagement with others, have restricted opportunities for decision making and choice, and often experience boredom and bullying. The aim of this project is to explore and understand how service quality is measured in disability services. By doing so, this project will highlight the current and future capacity of Victorian day services to identify the quality of the support they provide by measuring how people with disabilities, in both a positive and negative context, experience services.

Funding:
Date
Contact:

Outputs:
McEwan, J., Bigby, C., & Douglas, J. (2014). What are Victorian Disability Standards really measuring, Research and Practice in Intellectual and Developmental Disability, 2, 283-295. 10.1080/23297018.2014.956385

Recent projects

Living the good life: Embedding Active Support and Practice Leadership

Research Team
Professor Christine Bigby
Professor Teresa Iacono
Professor Julie Beadle-Brown
Dr Emma Bould
Dr Lincoln Humphreys

Project background: Although the quality of life outcome for residents with intellectual disability in supported accommodation compares very favourably to cluster type housing or traditional institutions, it does not consistently deliver high quality support. Good staff support is linked to good outcomes for residents in supported accommodation. Some residents have very low levels of engagement in meaningful activity and relationships, and outcomes can vary enormously both within and between services.

Although many disability services in Australia have embraced Active Support, it has proved difficult to implement (Mansell & Beadle-Brown, 2012). The aim of this study is to identify the organisational structures and processes associated with the successful and sustained delivery of Active Support. The longitudinal study to be completed over 5 years, aims to improve front-line staff practices and the delivery of Active Support, and thus the quality of life of people with intellectual disability.

Project Aim: It will provide key knowledge about

  • the successful implementation of Active Support in Australia,
  • provide benchmark data of service performance that can be used as a key outcome indicator in new funding and accountability models of support for people with more severe intellectual disability,
  • enable organisations to align their values, policies and procedures to promote rather than undermine Active Support and;
  • enable funders and families to make more informed judgments about the quality of services

See Active support resources for more information.

Funding: Australian Research Council Linkage Grant
Partners: annecto, Aruma, Bayley House, CARA, Civic, Sydney, Endeavour Foundation, GenU, Golden City Support Services, Greystanes Disability Services, Help Enterprises, Identitywa, Jewish Care, Melba Disability Services, Unisson Disability Services, Yooralla
Date: 2009 - 2018

Outputs:
Bigby, C., Bould, E., & Beadle-Brown, J. ( 2019) Implementation of active support over time in Australia. Journal of Intellectual and Developmental Disability
Bould, E., Beadle-Brown, J., Bigby, C., Iacono, T (2018) The role of practice leadership in active support: impact of practice leaders’ presence in services. International Journal of Developmental Disabilities, 64, 2, 75-80
Bould, E., Beadle-Brown, J., & Bigby, C. (2018). Measuring practice leadership in supported accommodation services for people with intellectual disability: Comparing staff-rated and observational measures. Journal of Intellectual and Developmental Disability, 43(2).
Bigby, C., Bould, E., & Beadle-Brown, J. ( 2017) Implementation of active support over time in Australia. Journal of Intellectual and Developmental Disability
Bould, E., Beadle-Brown, J.,Bigby, C. (2016). Measuring practice leadership in supported accommodation services for people with intellectual disability: Comparing staff–rated and observational measures. Journal of Intellectual and Developmental Disability. doi: 10.1352/1934-9556-54.5.316 (http://hdl.handle.net/1959.9/558761)
Beadle-Brown, J., Bigby, C., Bould, E. (2015). Development of an observational measure of practice leadership. Journal of Intellectual Disability Research. DOI: 10.1111/jir.12208
Beadle-Brown, J., Bigby, C., Bould, E. (2015). Observing Practice Leadership in intellectual disability services. Journal of Intellectual Disability Research. DOI: 10.1111/jir.12208
Beadle-Brown, J., Radwanski, A. (2015). Person-centred active support – the cake not the icing. In Handbook on Intellectual Disability and Clinical Psychology (second edition) Edited by Linehan, C., Noonan-Walsh, P., McEvoy, J., O'Reilly, G. and Carr, A.
Bigby, C., Beadle-Brown, J., & Bould, E. (2014, November). The nature, extent and role of practice leadership for staff teams supporting people with intellectual disability. Paper presented at the 2014 annual conference of the Australasian Association for Intellectual Disability, Fremantle, Australia [Abstract published in Journal of Applied Research in Intellectual Disabilities. 27(4), 352].
Iacono, T., Bould, E., Beadle‐Brown, J., & Bigby, C. (2019). An exploration of communication within active support for adults with high and low support needsJournal of Applied Research in Intellectual Disabilities32(1), 61-70.
Iacono, T., Bigby, C., Bould, E., & Beadle-Brown, J. (2014, July). The Relationship between Communication and Quality of Person Centred Active Support.  Paper presented at the International Association for the Scientific Study of Intellectual & Developmental Disabilities. Vienna, Austria [Abstract published in Journal of Applied Research in Intellectual Disabilities, 27(4), 351].

View the research summary poster [PDF:2.8Mb]

Every moment has potential: Person centred active support practice in Australia

Research Team
Professor Christine Bigby - La Trobe University
Dr Emma Bould - La Trobe University
Silvia Warren
Prue Adams
Arna Radovich

Project aim: Every moment has potential is an online learning resource that provides an introduction to Person Centred Active Support - a way of working that enables everyone, no matter what their level of intellectual or physical disability, to make choices and participate in meaningful activities and social relationships.

Funders: Department of Industry, Greystanes Disability Services, Living with Disability Research Group at La Trobe University.

Outputs:

View the resource

Guide to good group homes

Research Team
Professor Christine Bigby - La Trobe University
Dr Emma Bould - La Trobe University

Project aim: The Guide to Visiting and Good Group Homes is a resource based on research evidence to describe what a good group home for people with more severe levels of intellectual disability looks like, what you should expect to see and hear if residents are experiencing a good quality of life. Written in collaboration with The Office of the Public Advocate (Victoria), this guide was based on research and written for Community Visitors who visit and report of the quality of life of people living in supported and group accommodation.

Funding:

Outputs:
Bigby, C., & Bould, E. (2014). Guide to Visiting and Good Group Homes. Melbourne: Living with Disability Research Group, La Trobe University.

Centre for Applied Disability Research; A Guide to Good Group Homes (Action guide).

Optimising outcomes for people with intellectual disabilities in supported living arrangements.

Research Team
Professor Christine Bigby - La Trobe University
Dr Emma Bould - La Trobe University
Dr Julie Beadle-Brown - University of Kent

Project background: Block funded, shared supported accommodation - group homes - have been the dominant service model in Australia since the 1970s. Recently, with dissatisfaction with the group home model increasing the growth of ‘supported living’ has emerged. This model separates provision of housing and direct support and has the potential to deliver more individually tailored community living support. However, little evidence exists about outcomes of supported living or the support arrangements that make it successful.

Project aim: The study aimed to develop knowledge about the type of support arrangements and contexts that optimise the success of supported living arrangements and quality of life for service users with intellectual disability. Increased knowledge about the contributing factors to good quality of life outcomes for people who live in supported living arrangements will be important to the National Disability Insurance Agency in making individualised funding decisions, to the disability sector in developing services and necessary practice skills, and to people with intellectual disability and their families in making choices about housing and support options.

Funding: National Disability Research and Development Agenda (Commonwealth, State and Territory governments)

Outputs:

Bigby, C., Bould, E., & Beadle-Brown, J. (2015). ‘Not as connected with people as they want to be’: Optimising outcomes for people with intellectual disability in supported living arrangements. Living with Disability Research Centre, La Trobe University.
Report: Optimising_Outcomes

Bigby, C., Bould., E., Beadle-Brown, J., (2017). Conundrums of supported living: The experiences of people with intellectual disability. Journal of Intellectual and Developmental Disability, 42, 4, 309-319.
DOI:10.3109/13668250.2016.1253051

Bigby, C., Bould., E., Beadle-Brown, J., (2018). Comparing costs and outcomes of supported living with group home in Australia. Journal of Intellectual and Developmental Disabilities, 3, 295-307.
DOI:10.3109/13668250.2017.1299117

Does organisational culture matter in group homes? (PhD)

Research Team
Lincoln Humphreys (PhD Candidate) - La Trobe University
Professor Christine Bigby - La Trobe University
Professor Teresa Iacono - La Trobe University
Dr Emma Bould - La Trobe University

Project background: Research has shown that there is variability in quality of life outcomes for people with intellectual disabilities who live in group homes. Organisational culture has been identified as a factor that influences the quality of staff support and quality of life outcomes. A better understanding of organisational culture in group homes could contribute to developing strategies that enhance service delivery and, in turn, quality of life outcomes.

Project aim: The aim of the study was to develop a quantitative measure of organisational culture in group homes, named the Group Home Culture Scale. Its development followed a theory driven approach based on qualitative research conducted by Bigby and colleagues into group home culture. The Group Home Culture Scale is a self-report questionnaire, which was designed to be completed by disability support workers and frontline supervisors. Using data collected with the Group Home Culture Scale, another aim of the study was to examine the associations between organisational culture and quality of life outcomes for people with intellectual disabilities. The findings suggest that dimensions of group home culture are predictors of certain quality of life outcomes.

Funding: PhD

Outputs:

IASSIDD World Congress presentation (2016). Development of a scale to measure organisational culture in group homes. Melbourne

View the 2018 research summary poster [PDF:2.6Mb]

Exploring frontline staffs’ experiences of paperwork in group homes for people with intellectual disability (PhD)

Research Team
Claire Quilliam (PhD Candidate) - La Trobe Univeristy
Professor Christine Bigby - La Trobe University
Professor Jacinta Douglas - La Trobe University

Project background: Paperwork forms a large part of group home service delivery because it is an important organisational tool that helps transform service objectives into action. Frontline staffs’ paperwork practices impact on service quality, and yet little is known about their experiences of paperwork. Having a better understanding of these experiences could reveal particular paper tools or tool characteristics that help staff provide good support to residents, and could potentially identify how staff manage and use the paper tools available in their work.

Project aim: The aim of this study is to explore frontline staffs’ experiences of paperwork in group homes for people with intellectual disabilities. The study will generate new understanding of how staff reflect on and use paper tools in their workplace. The results will inform disability service organisations on how to best support frontline staff with paper tools so that staff are equipped to support residents to live good lives.

Funding: Australian Postgraduate Award (APA scholarship)

Outputs:

Quilliam, C., Bigby, C., & Douglas, J. (2018). How frontline staff manage paperwork in group homes for people with intellectual disability: Implications for practice. Journal of Applied Research in Intellectual Disabilities.

Quilliam, C., Bigby, C., Douglas, J. (2018). Being a valuable contributor on the frontline: The self-perception of staff in group homes for people with intellectual disability. Journal of Applied Research in Intellectual Disability; 00:1–10.

Quilliam, C., Bigby, C., & Douglas, J. (2018). Staff perspectives on paperwork in group homes for people with intellectual disability. Journal of Intellectual and Developmental Disability, 43(3) 1-10.

Quilliam, C., Bigby, C., & Douglas, J. (November, 2015). An evil necessity: Frontline staffs’ experiences of group home paperwork. Paper presented at the 50th Annual Australasian Society for Intellectual Disability Conference, Melbourne.

Quilliam, C., Bigby, C., & Douglas, J. (2015). Paperwork in group homes for people with intellectual disability. Journal of Intellectual and Developmental Disability, 40(3), 286-296. doi: 10.3109/13668250.2015.1034255

Quilliam, C., Bigby, C., & Douglas, J. (November, 2014). A frontline perspective of paperwork in group homes for people with intellectual disability: Preliminary findings. Paper presented at the 49th Annual Australasian Society for Intellectual Disability Conference, Fremantle.