The individual supported living (ISL) manual: a planningand review instrument for individual supported livingarrangements for adults with intellectual anddevelopmental disabilitiesE. Cocks,1 S. Thoresen,1 M. Williamson2 & R. Boaden11 Centre for Research into Disability and Society, Curtin University, Perth, Western Australia, Australia2 WA Disability Services Commission, Perth, Western Australia, AustraliaAbstractBackground Following the closure of large residential facilities over the past several decades, emphasison community living for adults with developmentaldisabilities has strengthened. However, the conceptof community living is ambiguous. The term isoften associated with congregation of people withdisabilities in ordinary houses ‘in’ the community.Group homes, the most common contemporaryformal expression of ‘community living’, may useordinary houses and accommodate a small numberof residents comparable to a large family. Individualsupported living (ISL) arrangements around asingle person with a disability using person-centredprinciples are occurring with increasing frequency.The ISL manual was developed over 4 years in twosequential research projects to produce a qualityframework articulating ISL and operationalising theframework into a review and planning instrumentfor ISL arrangements.Method The ISL manual was developed in threestages and overseen by a reference group of keystakeholders purposively recruited as well-versed inISL. The first stage operationalised the qualityframework over two half-day workshops with agroup of key informants. Participants identifiedindicators and sources of evidence for each attributeof the quality framework. The quality framework,indicators, and sources of evidence were compiledinto an initial evaluation instrument of nine themesconsisting of 27 attributes. This was piloted in tworounds to enhance the utility of the instrument anddevelop the final manual which contained eightthemes and 21 attributes. A comprehensive literature search was carried out to identify relevantempirical ISL studies.Results The literature search identified four empirical studies that incorporated ISL over the preceding3 years. A previous literature search from the firstresearch project that produced the quality framework spanned 27 years and identified five empiricalstudies. We concluded that the empirical base fordeveloping evidence for the nature and outcomes ofISL arrangements was sparse. The ISL manual andscoring booklet developed in the current researchproject includes six illustrative case studies of ISL,instructions for potential users to review livingarrangements or set up a new arrangement, and theCorrespondence: Prof Errol Cocks, Centre for Research into Disability and Society, Curtin University, GPO Box U1987, Perth,Western Australia 6845, Australia (e-mail: [email protected]).Journal of Intellectual Disability Research doi: 10.1111/jir.12059volume 58 part 7 pp 614–624 july 2014614bs_bs_banner© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltdreview framework consisting of descriptions ofthemes and attributes, indicators, and sources ofevidence.Conclusions The dearth of empirical studies of ISLarrangements for people with developmental disabilities, despite increased policy emphasis on individualised options, underscores the importance ofplanning and review tools to promote quality outcomes. The ISL manual can assist adults withdevelopmental disabilities, families, carers, andservice providers to plan and review ISL arrangements. Further research will enhance the propertiesof this instrument and establish the relationshipbetween quality of ISL arrangements and outcomessuch as quality of life, and participation andinclusion.Keywords Australia, developmental disability,individual supported living, individualisedliving arrangement, intellectual disabilities,person-centerednessIntroductionThe individual supported living (ISL) manual andISL review scoring booklet (Cocks et al. 2011a,b)are products of two consecutive 2-year researchprojects. The ISL manual was based on the personalised residential supports (PRS) quality framework(Cocks & Boaden 2011) which was developed in thefirst of the research projects. The PRS projectentailed a comprehensive search of the empiricalliterature, identification of relevant non-empiricalliterature, extensive stakeholder consultations, andexamination of six case studies of existing andplanned individualised supported living arrangements. Qualitative analysis of the resulting data produced the PRS quality framework. The subsequentname change from PRS to ISL reflected consensusamong stakeholders to emphasise support for individual people with intellectual and other developmental disabilities that facilitated living full andmeaningful lives and not simply residing in a physical facility or location.The second research project, described in thisarticle, operationalised the quality framework intoan evaluation instrument applicable to ISL arrangements for people with intellectual disabilities (IDs).It is proposed that the framework and evaluationtool are also applicable to people with supportneeds because of other identities, such as otherdisabilities, ageing, and mental illness. However,further work would be needed to establish anevidence base in those areas.The present study was overseen by a referencegroup of key stakeholders from peak industry andgovernment organisations, family members ofpeople with IDs, academics, and others with expertise in ISL. Ethics approval was obtained from theCurtin University Human Research Ethics Committee in 2010. Many of the reference groupmembers had been involved in the precedingresearch project.By definition, ISL is different from congregatemodels of supported living despite the frequentreference to ‘community living’ when describinggroup homes. ISL enables the person with a disability to live in his or her own home. The conceptof home is socially and culturally embedded and,although reflecting a multitude of variations, isusually recognised and acknowledged in its essence(Annison 2000). ISL does not equate to a personwith a disability being ‘placed’ in an ‘individualoption’ or with strangers, and without due regardto his/her real preferences and needs. People withdisabilities in ISL arrangements share their homeswith other people with disabilities, if this is theirchoice, because of reasons such as friendships orrelationships, not agency policies or financial motivations. ISL does not require ‘readiness’, such as aminimum level of skills, for living in a person’sown home, rather, ISL arrangements ensure thatflexible and appropriate supports are available toaddress a person’s changing needs. Emphasis shiftsfrom the disability-related characteristics of the personto the processes of support. ISL promotes the person’s lifestyle, well-being, valued social roles, socialinclusion, and community participation throughopportunities for growth and development. ISLarrangements support typical homes with thetypical benefits and responsibilities (Cocks et al.2011a).This paper sets out the policy context in whichISL arrangements have emerged in Australia, andsummarises the empirical literature in the area. Itthen describes the second of the research projectswhich operationalised the ISL framework andfurther developed it in a series of pilot evaluations.615Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons LtdPolicy contextReflecting international policy, in the last decade inAustralia there has been a raft of person-centredgovernment policies supporting individualisedfunding, self-directed service approaches, and strategies to achieve better social outcomes [ProductivityCommission 2011; Australian Institute of Healthand Welfare (AIHW) 2011a], and models of supported accommodation (Fisher et al. 2007; Kozmaet al. 2009; Mansell & Beadle-Brown 2010). Sincethe late 1990s, fuelled by policies of deinstitutionalisation, group homes have become the most prominent supported accommodation option for peoplewith disabilities. This is beginning to shift withmore interest in individualised accommodationapproaches (Mansell & Beadle-Brown 2010).The roles and responsibilities of AustralianGovernments are incorporated in the NationalDisability Agreement, which aims for people withdisabilities and their carers to have an enhancedquality of life and participation as valued membersof the community (Council of AustralianGovernments 2012, p. 3). The National DisabilityStrategy (Commonwealth of Australia 2011) calledfor all areas of Australian society to work towardsocial change to ensure the inclusion and economicparticipation of people with disabilities. Underpinning these reforms is acknowledgement that thecurrent system of disability supports and services isnot achieving desired outcomes and is inefficient(Productivity Commission 2011, pp. 2–7). Australiandisability policy is now teetering on significantreform. The National Disability Insurance Scheme(NDIS) proposed by the Australian ProductivityCommission has recommended new ways ofresourcing and administering disability support andservices. The report recommends a no-fault disability insurance system based on entitlement, longterm security, opportunity for individualisedapproaches, and choice in services and supports.The Australian Federal Government has expressedsupport for the NDIS and will partner with someAustralian States to begin pilots of the scheme in2013.The AIHW (2011b) publishes annual data of participation in the full range of disability services provided by all Australian Governments. AIHW defineddisability as ‘one or more of 17 limitations, restrictions or impairments which have lasted or are likelyto last, for a period of six months or more, andwhich restrict a person’s everyday activities’ (AIHW2012). Unfortunately, AIHW does not report datathat identifies people with specific disabilities,including ID, who may be living in the variousforms of supported accommodation, including thosethat may be ISL arrangements. In 2009–2010, dataon 295 000 people with disabilities, including IDs,were reported. The total number of people withdisabilities accessing accommodation services acrossAustralia increased from 37 895 in 2007/08 to39 854 in 2009/2010 (AIHW 2011b). AIHW definedaccommodation types according to numbers of residents. ‘Institutions’ were defined as places such ashostels or nursing homes where seven or morepeople are accommodated. ‘Group homes’ weredefined as places where fewer than seven peoplereside. There has been a trend of decreasingnumbers of people with disabilities in institutionalaccommodation (e.g. from 4448 in 2007/2008 to4184 in 2009/2010) and an increase in take-up ofgroup home options (e.g. from 12 934 to 13 435 inthe same period). In 2009–2010, 48% of peoplewith disabilities who accessed services lived withtheir families and 19% lived alone. The greatestincrease in numbers occurred with people accessing‘attendant care, in-home accommodation support,alternative family placement and other’ (from22 147 people in 2007/2008 to 23 928 in 2009/2010) (AIHW 2009, 2011b). This last group is theone most likely to include people in ISL arrangements, but the proportion cannot be determined.There has been a new wave of interest in whethergroup homes, once seen as the alternative of choiceto institutions, can achieve the best outcomes forpeople with disabilities. At the same time, some evidence suggests that factors other than the types ofaccommodation models are likely to lead to betteroutcomes (Kozma et al. 2009). ISL is more likely tolead to better outcomes than other forms of accommodation such as group homes, albeit that somevariability of quality is to be expected (Fisher et al.2007; McConkey 2007; Kozma et al. 2009). Evidence is consistent that smaller accommodation settings are likely to provide better outcomes thanlarger, with single person residences yielding thebest outcomes (Tossebro 1995; Stancliffe 1997;Saloviita & Aberg 2000; Stancliffe et al. 2000,616Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltd2007); however, our literature searches haverevealed little direct evidence of the quality of outcomes of ISL arrangements.Literature reviewIn the first research project, an initial comprehensive literature search for papers that reported outcomes of ISL found that only five articles from atotal of 784 met the inclusion criteria, however theirfocus was limited to comparisons of accommodation size as noted above (Cocks & Boaden 2011).This search was replicated in April 2012, andcovered the three years following the initial search.The same three databases (PschINFO, CINAHL,and Current Contents Connect) and search terms,singular and plural, (disability, impairment, handicap, retardation, accommodation, residence, home,living, facility, house, apartment, individual, person,community, independent, inclusive, integrated, size,single, group, congregated) were used.The new search returned a total of 461 peerreviewed articles. The second author carried out aninitial screening of article titles using the inclusioncriteria of the original search. Participants had toinclude people with intellectual/developmentaldisabilities aged 18 years or older, with residentialsupports planned and provided for individualsextending beyond support provided by familymembers. There needed to be an emphasis on livingarrangements for individuals, not groups or congregations, and outcomes examined across a range ofmeasures including quality of life, well-being,choice, self-determination, service satisfaction, socialinclusion, community participation, service satisfaction, and personal development. Following a reviewof article titles, 51 abstracts were reviewed by boththe first and second authors. Sixteen articles wereselected for full review.Among the 16 articles, seven were found to havesome relevance to ISL. Additional hand searchesidentified a further two articles. Of these ninearticles, three were non-empirical, one reflected apolicy position (Bigby & Fyffe 2009), and the othertwo articles were reprints of historical theoreticalpapers (Wolfensberger 2011a,b). Of the six empirical articles, two were tangential as they had a weakconnection to any form of quality outcome of ISL.One article presented the level of choice regardingwhere and with whom to live across different livingarrangements (Stancliffe et al. 2011), while thesecond article focused on attitudes of adults withIDs and their parents, who often were primarycarers, regarding where to live (Shaw et al. 2011).The latter article did not include any address ofquality outcomes of living arrangements.Only four empirical studies met the inclusion criteria listed above, although the scope of outcomemeasures was narrow in some cases. The first studyreported on the development of the quality framework from which the ISL manual was developed(Cocks & Boaden 2011). The second study examined the availability of, and satisfaction for, supportacross group homes, independent living, familymodel homes, and living at home. The findingsreported increased level of choice and control insmall settings and concluded that there is a need formeasures to ensure effective support in these livingarrangements (Stainton et al. 2011). The third studyinvestigated the benefits of generic community agedcare support to support ageing people with disabilities, including IDs, to remain in their homes. Thestudy found that community-based aged caresupports led to increased participation in leisureactivities, increased independence, and supportedparticipants remaining in their homes (Elilison et al.2011). The fourth study identified quality of lifeoutcomes for adults with IDs living in small grouphomes, cluster block apartments, or independently.When controlling for level of ID, the study foundthat living more independently together withemployment enhanced personal outcomes (Claeset al. 2012).Across the 30 years covered by the two comprehensive literature searches, only nine identifiedempirical studies met the inclusion criteria of thereview. References to community living consistentlyencompassed congregate accommodation settings,such as group homes. There was a dearth of empirical studies of ISL models and little evidence of theirefficacy.Operationalising the quality frameworkThe quality framework consisting of nine themesand 27 attributes developed from the first research617Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltdproject was operationalised over two half-day workshops in May 2010. Key stakeholders from the government sector, non-government service providers,family members and carers of people with IDs,academics, and advocates with experience and acommitment to ISL participated. Members of thereference group also participated and referred participants experienced in ISL to the workshops. Thepurpose of these workshops was to identify indicators and evidence for each attribute of the qualityframework. This was carried out through a modifiedversion of the World Café dialogue (Brown & Isaacs2005; Tan & Brown 2005). The World Café dialogue consists of conversations in small groups withpeople moving between the conversations at ‘smallcafé-style tables’, linking and evolving ideas throughknowledge sharing as the conversations evolved(Tan & Brown 2005). The World Café dialoguemethodology has been used successfully for policydiscussions (Bridge et al. 2011). About a dozen participants attended each workshop and were dividedinto small groups of three or four. A facilitator wasstationed at each table to guide the discussions toelicit indicators and sources of evidence for eachattribute of the quality framework. After 20–30 mindiscussion, the groups rotated and the facilitatorsummarised the previous discussion to the newgroup arriving at the table. The new group wouldcontinue the discussion and propose final indicatorsand sources of evidence for the attribute. Agreementfor the final indicators and sources of evidence wasreached through plenary discussion with all workshop participants following the initial World Cafédialogue group discussions.The researchers consolidated the indicators andsources of evidence identified over the two workshops into a review framework and scoring sheet.The review framework also included descriptions ofeach theme and attribute from the initial qualityframework. The reference group was consulted ateach step of the development of the review framework, and continued to play a valuable role in thedevelopment and improvement of the ISL manualthrough the subsequent two rounds of pilot reviews.Pilot reviewsFive pilots focused on individuals in ISL arrangements, including persons with high support needs,were carried out in the first round of reviews in late2010 and early 2011 in both metropolitan andregional locations of Western Australia. Prior tothese reviews, a training day with 15 participantswas held, consisting of background informationregarding the development of ISL, the purpose andprocess of the reviews, and the review framework.There were three different methods adopted for thisround of pilot reviews.1 Self-reviews, where a person with disabilities,family, and other stakeholders such as representatives from the supporting agency, evaluated theirown arrangement.2 Support agency personnel evaluated their ownarrangement.3 A team that was independent of the arrangementevaluated the arrangement.The authors were involved in all five reviews asfacilitators. This also enabled the researchers toidentify unclear content in the ISL material or processes and to facilitate the consensus within thegroup for each attribute. Table 1 summarises theliving arrangements reviewed in the first round ofpilots. Reviewers, particularly those not involved inthe arrangement being reviewed, made themselvesfamiliar with the arrangement as part of the reviewprocess. This included obtaining appropriateconsent from people involved in the arrangement,including each person with disabilities and family ifappropriate, interviewing key stakeholders, andspending time in the arrangement to get to knowand understand the situation and person whosearrangement was being reviewed. Reviewers werereminded that the reviews involved people’s livesand homes and the approach had to accommodatethe preferences of the focal person. No more thanone or two people visited a person’s home andreported their observations and impressions back tothe rest of the reviewers during the review process.Reviews involved each participant on the teamsscoring the ISL arrangement independently. Then,following discussion within the team context, a conciliated score was obtained.Reviewers were asked to provide feedback on theinstrument. A number of crucial observations andimprovements to the review instrument followed.For self and agency reviews, a significant and consistent observation was the increased understandingand identification of additional opportunities for618Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltdcontinued development which followed facilitateddiscussions around each attribute. Reviewersinvolved in the arrangement would often review anattribute based on the progress made by the personwith IDs since moving to the current ISL arrangement rather than on opportunities remaining forcontinued development of the person and/or thearrangement. This was particularly the case whenthe person with IDs had overcome a significanthurdle such as challenging behaviour. Followingdiscussion within the teams, the most common shiftin direction of scoring on some attributes was tolower the rating score as participants identified thepotential for further development. These observations led to changes in the rating descriptions toinclude a focus on developmental issues regardingboth the focal person and aspects of the ISLarrangement. There were also specific observationsrelated to the wording, clustering, and presentationof the themes, attributes, indicators, and sources ofevidence within the review framework. The numberof themes was reduced to eight and attributes to 21by collapsing two themes and a number ofattributes.In consultation with the reference group, theresearchers developed the review framework into amanual in early 2011. This included providing morebackground information and examples of ISLarrangements. Additional work on the wording andorganisation of the framework was also undertaken.A review scoring booklet, rather than a scoringsheet, was developed. This material was piloted in asecond round of five pilot reviews in metropolitanand regional locations in WA in mid-2011, againincluding individuals with high support needs. Adecision was made to classify reviews as internal orexternal as more accurate than the initial three categories of reviews. Internal reviews corresponded toreviews carried out by teams that included theperson with a disability, family members, and/orsupport workers. External reviews were carried outby people who had no direct involvement in the ISLarrangement. An overview of the arrangements thatwere part of the second round of pilots is describedin Table 2. The second round of pilot reviews reinforced the observations from the first round andemphasised the need for a more user-friendly language. Areas to improve the accompanying reviewscoring booklet were also identified.Results and discussionFollowing the second set of pilot reviews, the ISLmanual and accompanying scoring booklet weredeveloped in late 2011. The ISL manual includessix examples of ISL arrangements from regional andmetropolitan WA. The examples were case studiesfrom the first of the two sequential researchprojects. The manual can be used to plan a newarrangement or review and improve an existingarrangement. Instructions around this are includedprior to the review framework which is built aroundeight themes with each theme consisting of two orthree attributes. There are 21 attributes in total.The review framework includes a description ofTable 1 Summary of first round of pilotsPerson Description of arrangement Form of review1 Woman in her early 50s with multiple sclerosisand mild intellectual disabilityRented house with a co-tenant with disability,described as a friendSelf-review2 Man in his early 20s with intellectual disability andhigh support needs, requiring 24-h supportShared accommodation with a friend Independent evaluation3 Young woman with intellectual disability and highsupport needsLiving in her family home and planningtransition into independent livingAgency review4 Man in his mid-20s with autism and challengingbehaviours, requiring 24-h supportLives alone in a duplex and is supported by apaid mentorIndependent evaluation5 Man in his mid-40s with intellectual disability Lives alone in a block of units and is supportedby a paid mentor whom lives nearbyIndependent evaluation619Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltdeach theme and attribute, as well as indicators andsources of evidence. The themes and attributes aresummarised in Table 3. Each attribute has one ormore indicators. Evidence can be sourced fromobservations, talking with people, and documentation such as planning documents. Figure 1 illustrates the synergy between the theme, attribute,indicator, and evidence.Although the aim of the pilot reviews was toimprove the ISL manual and accompanying scoringbooklet, several pertinent observations were madeacross both rounds of pilots. Most notable were thebenefits of the reviews being facilitated by someonefamiliar with ISL. Internal reviewers, people reviewing an arrangement they were familiar with, generally scored attributes according to progress madefor each indicator over the development of theliving arrangement, rather than considering thearrangement and the potential for development as itstood at the time of the evaluation. A facilitatorwould engage reviewers to elaborate on the person’sinterests, strength of social connections, and community participation, which would open the discussion to identifying additional opportunities for thearrangement to develop and strengthen according tothe interests of the person whose arrangement wasbeing reviewed.Individual reviewers were asked to score eachattribute independently prior to a facilitated discussion at which consensus was achieved to obtain aconciliated score. Facilitated discussions around thethemes and attributes of ISL sometimes led to amarked decrease in the rating of an attribute. Thiscan be attributed to reviewers’ understanding ofISL and mastery of evaluation tasks developingthroughout the process. For example, when scoringthe theme control in the first review during the firstround of pilots, individual reviewers’ scores for eachattribute within this theme ranged from a low of 3to a high or 5 (mean scores between 3 and 4).However, following the facilitated discussion, theconsensus reached among all reviewers was to rateeach attribute in the theme as 1, the lowest possibleconciliated score, reflecting a maturing understanding of ISL among the reviewers.Although deinstitutionalisation studies emphasisethe importance of social and community participation and integration, there is an emphasis on skillsrather than support to enable people with highsupport needs to obtain and maintain ‘community’living. Thorn et al. (2009) stated that ‘[a] consistent factor in both the rate of moving into acommunity-based setting and remaining in acommunity-based setting is individual level ofability’ (p. 892) and that ‘individuals withoutadequate functional skills who are thrust into acommunity living setting may become moreisolated and segregated and can be relegated toliving on the fringes of the community’ (p. 898).However, ISL does not require a minimum set ofindependent living skills, or other forms of readiness. Rather, ISL arrangements ensure that thereare sufficient flexible supports, continuous planning, and contingency plans to enable anyoneto have their own home. Combined with theun-nuanced usage of ‘community living’ within theTable 2 Summary of second round of pilotsPerson Description of arrangementForm ofreview1 Woman in her early 20s with autism and intellectualdisability, requiring 24-h supportLives with her family 1 day a week and in her ownhouse with a live-in carer the other 6 daysInternal2 Woman in her early 50s with intellectual disability Lives alone in a country town with support workers Internal3 Woman in her mid-20s with intellectual disability andepilepsy, requiring 24-h supportLives alone in her own house with 24-h support Internal4 Woman in her early 40s with intellectual disability andnon-verbal, requiring 24-h supportSupported full-time by staff, one of whom staysovernightInternal5 Man in his late 50s with intellectual disability Lives alone in a block of units and supported by apaid mentorExternal620Journal of Intellectual Disability Research volume 58 part 7 july 2014E. Cocks et al. • Individual supported living manual© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities andJohn Wiley & Sons Ltdliterature, which includes many forms of congregate living arrangements, it is clear that ISL is anemerging concept within the empirical literaturedespite decades of advocacy around the principlesof ISL.ConclusionsThe ISL manual and accompanying ISL reviewscoring booklet (Cocks et al. 2011a,b) will assiststakeholders to plan and review ISL arrangementsfor people with intellectual or developmental disabilities. Given the dearth of empirical studies ofISL, a third phase to this research is proposed toinvestigate the relationship of quality of ISLarrangements and measures of well-being, such asquality of life, social inclusion and community participation, participation in the labour market, andextent of social networks. With the increasedemphasis on individualised options and thestepping-stones to significant disability policyreforms in Australia already in place, instruments toassist in the planning or review of quality outcomesare of utmost importance. Research addressingthe gap in the formal empirical literature onISL is needed to document the range of livingTable 3 Themes and attributes of the ISL frameworkTheme Theme description Attribute1. Leadership One or more people among the arrangement’sstakeholders provide leadership based on a clearvision and strong ideas1.1 The arrangement is based on a clear vision andstrong ideas1.2 Key people provide the leadership to set up andcontinue the arrangement2. My Home The ISL arrangement creates the person’s ownhome, not just somewhere to stay2.1 The person has secure tenure and a personal‘stake’ in the home2.2 The person does normal things that people do intheir homes2.3 The person’s home clearly reflects who theperson is and what he or she likes3. One personat a timeEach arrangement is unique, tailored around theidentity of the individual with a disability3.1 The arrangement is developed around the person3.2 The living arrangement does not group peoplewith disability4. Planning Planning is comprehensive, embodiesperson-centred principles, and includessafeguarding measures4.1 Planning focuses on the person4.2 People close to the person are involved in planning4.3 The person’s future is central to planning5. Control Primary control of the arrangement is locatedwith the person with a disability, and/or thoseclose to him or her5.1 The person and those close to him or her havecontrol over the person’s life5.2 Self-determination for the person is central to thearrangement5.3 The person and others close to him or her havecontrol of the arrangement6. Support A
