Staffing and staff performance in services for people with severe or profound learning disability and serious challenging behaviour.

Eighteen people with severe or profound learning disability and very serious challenging behaviour were tracked for four and a half years. Thirteen subjects moved to staffed houses in the community. A multiple time-series design and direct observation were used to evaluate whether there was any change in staffing and staff contact. The houses had higher staff ratios and proportionately even higher levels of assistance and other contact with clients, who showed significant improvement in engagement in meaningful activity without overall increase in major problem behaviour.