ABSTRACTTwo studies examined the frequency of community and family contacts of 10 adults with severe and profound mental handicaps living in small, community‐based homes, first with their previous institutional experience and second in comparison with adults with similar handicaps living in larger community units.Adults in the small homes used community amenities significantly more than they did when in institutions and also significantly more than residents of larger community units. They experienced greater family contact than when they lived in more distant institutions, but not significantly more than residents of larger community units which also served local areas. Within the small homes, people newly admitted from their family homes had significantly greater family involvement than those transferred from institutions. The results are related to the characteristics of the residential settings, such as location, staff factors, operational policy, and autonomy of management.

This study describes the systems used in planning and implementing a community‐based service for adults with severe or profound mental handicaps over a three year period. These systems were: a global method of individual programme planning; a formal structure for one‐to‐one teaching; and a more general form of opportunity planning for developing and practising skills. A content analysis of the type of goals set and the extent of their implementation and success is presented.

In a replication of a study by Warren and Mondy (1971), we observed the responses of staff in four institutional setting, three large community units, and five small community houses to the behavior of a total of 90 severely and profoundly mentally retarded adults. In the institutions and large community units, staff members showed problems in their responding similar to those reported by Warren and Mondy, in particular a lack of responding to appropriate behavior. Staff in the small community houses showed a greater level of encouragement of appropriate behavior and a discrimination in attending to appropriate as opposed to other behavior of 3:1. Whether this finding was due to the difference in size of the residential settings, their organization, or staff characteristics and training was discussed.

Turnover of staff in a small home service for adults with severe and profound mental handicaps was compared to that in a number of larger units also based in the community and serving people with similar handicaps. Turnover was higher in the two small homes studied although recruitment was able to match staff loss so that the proportion of staff in post was maintained. Reasons for staff leaving were discussed. The main difference between the settings to account for the difference in turnover was size.

SUMMARYThis paper compares the capital costs of providing ordinary housing for adults with severe and profound mental handicaps with those of providing larger 24–26 place community‐based units. No increase in costs for the smaller homes was found. The method of acquisition, the NHS purchasing and converting property or building on a vacant site, was found to produce equally high costs in all cases. The need to clarify why NHS costs are high was discussed, as were other property acquisition options.

Recently, much interest has centered on the transfer of mentally handicapped people from institutions to other settings. Most studies in this area have focused indirectly on the behavior of the mentally retarded client, usually measured intermittently by global assessments such as the American Association On Mental Deficiency's Adaptive Behavior Scale. In contrast, the present study combined these indirect measures with direct continuous observation of each subject. In doing so, it examined the effects of such a transfer to small community-based homes on the behavioral functioning of severely and profoundly mentally handicapped adults. In addition, staff activity, in terms both of providing opportunities for engagement in activity and of consequating client behavior, was also measured. Two comparisons were made, those being between a group of clients in a small home and a comparable group in institutions and between the latter group when in the institutions and after having moved to a small home. Results show increased client functioning in the small homes, particularly in domestic activity and interaction with staff, and a markedly higher level of staff provision of opportunity to engage in activities. The results are discussed in terms of size, design, staff-client ratio, and staff training in small community-based residential services. The need for more research on the determination of staff performances is highlighted.

A demographic sample of 28 severely and profoundly mentally handicapped adults with a mental age of four years and below were assessed on Part 1 of the Adaptive Behavior Scale (ABS) at three points 18 months apart. The Griffiths Mental Development Scales and Reynell Developmental Language Scales were also conducted at the first and last assessment points. The subjects were resident in either a small community-based home, the parental home or other residential institutions. The small-home group showed the greatest adaptive behaviour change particularly in the areas of independent functioning, domestic skills and self-direction and on the scale total. Although reservations are expressed on the accuracy of assessment, the ABS data and the comparative result received some validation from the mental age and language assessments. Gains were independent of subject characteristics. The study adds to the literature showing adaptive behaviour gains arising from transfer from institutional to more normal residential environments. However, in attributing the results found to the general characteristics of the residential settings, the explicit programming emphasis of the small-home service should not be overlooked.