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AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONPeople with acquired neurological disability have the right to quality disability support, yet there is still limited user insights shaping disability services. This research aimed to develop a comprehensive understanding of quality support for adults with acquired neurological disability based on lived experiences.Using a constructivist grounded theory approach, this project engaged 12 adults with acquired neurological disability, 12 support workers, and 10 close others in individual interviews. Each perspective was analysed independently and subsequently merged to construct a holistic model of quality support grounded in lived experience.The model of quality support encompasses interconnected themes spanning dyadic relationships, support worker competency, team dynamics, provider practices, and sector-wide considerations. Key elements include recognising the individual’s expertise in their support needs, nurturing effective support relationships, fostering a capable support team, and upholding sector accountability. Authentic choice and personal agency emerged as paramount factors in achieving quality support.The findings align with disability rights and individualised funding principles, emphasising the centrality of people with lived experience in shaping support services. The research underscores the need to prioritise authentic choice and individual empowerment, offering valuable insights for both practice and policy development in the disability support sector.The perspective of people with lived experience is paramount to designing quality disability support services aligned with people’s needs and preferences.The person with disability needs to be at the centre of all decisions regarding their support and needs to be supported to lead their supports.Quality disability support relies primarily on the interaction between the person with disability and their support worker, and therefore quality support relationships need to be developed and maintained.The perspective of people with lived experience is paramount to designing quality disability support services aligned with people’s needs and preferences.The person with disability needs to be at the centre of all decisions regarding their support and needs to be supported to lead their supports.Quality disability support relies primarily on the interaction between the person with disability and their support worker, and therefore quality support relationships need to be developed and maintained. [ABSTRACT FROM AUTHOR]

Purpose: Close others of people with acquired neurological disability often play a key role in supporting their relative to get necessary support, and therefore have valuable insight into what facilitates quality support. Situated within a series of studies aiming to build a holistic model of quality support grounded in the lived experience of adults with acquired neurological disability, support workers and close others, this study explores the perspective of close others. Method: Following grounded theory methodology, ten close others participated. In-depth interview data was analyzed using constructivist grounded theory methods to develop themes and explore relationships between the themes. Results: A multi-level system model characterizing quality support at three levels was developed. Key factors at the dyadic level included the support worker recognizing the person as an individual and the dyad working well together. At the team level, it was important for the support team, close others, and providers to engage constructively together. At the sector level, building quality systems to develop the workforce emerged as essential. Conclusions: The findings complement the perspective of people with disability and support the key notion of quality support honouring the person's autonomy and highlight the need to raise accountability in the disability sector. [ABSTRACT FROM AUTHOR]

Purpose: Quality disability support is fundamental to the lives of many adults with acquired neurological disability. However, little is known about the factors that influence the quality of paid support. This study is part of a larger project to develop a holistic understanding of quality support, grounded in the experience of people with acquired neurological disability, close others, and disability support workers. The current study focuses on the support worker perspective. Methods: Following constructivist grounded theory methodology, interviews were conducted with 12 support workers. Grounded theory analysis was followed to develop themes and subthemes and build a model of quality support. Results: Five key themes, with fifteen subthemes emerged to depict factors influencing the quality of support. The five themes are: being the right person for the role, delivering quality support in practice, working well together, maintaining and improving quality support, and considering the broader context. Findings emphasise the importance of the support worker recognising the person as an individual and respecting their autonomy. Conclusions: Critical to quality support is centring the needs and preferences of people with disability, improving support worker working conditions and supporting people with disability and support workers to build effective, balanced working relationships. [ABSTRACT FROM AUTHOR]

Adults with acquired neurological disability often require paid disability support to live an ordinary life. However, little is known about what facilitates quality support. This study aims to explore the lived experience of people with acquired neurological disability to develop an understanding of the factors that influence the quality of support. Guided by constructivist grounded theory, in-depth qualitative interviews were conducted with 12 adults with acquired neurological disability. Data analysis followed an iterative process to develop themes and subthemes and explore relations between themes to build a model of quality support. Nine key factors emerged in the dyadic space, with the support worker recognising the person as an individual as foundational to quality support. Beyond the dyadic space, three broader contextual factors were identified as influential on the quality of support by mechanism of facilitating or constraining the person with disability's choice. Finally, the provision of quality support was characterised by the person feeling in control. Findings support the rights of people with disability to quality, individualised support, and a need for interventions to better prepare the disability workforce to deliver support in line with the needs and preferences of people with acquired neurological disability. To provide quality support, disability support workers need to recognise the person with disability as an individual and the expert in their support needs and preferences. The quality of paid disability support is primarily determined by the way the person with disability and support worker work together in the dyadic space. Ensuring people with acquired neurological disability have authentic choice over their support arrangements and daily living is critical to facilitate quality support, and in turn help the person with disability to feel in control. [ABSTRACT FROM AUTHOR]

People with mobility impairment have the right to live in accessible housing that meets their needs. Although the Australian National Construction Code for residential housing will be amended to include minimum accessibility standards in September 2022, some states have chosen not to adopt these standards (New South Wales, Western Australia and South Australia). The inclusion of people with lived experience in decisions surrounding accessible housing design is lacking. This study sought the perspective of people with mobility impairment on the most important modifications they would make to the design of their own homes, and the homes of their friends and family, to make them more accessible. An online survey was completed from February to March 2021 by 145 people living in Australia including 112 people with mobility impairment, and 33 family members. Results indicated that 71 per cent of the participants were living in housing that did not fully meet their accessibility needs. Descriptive qualitative analyses demonstrated that commonly reported modifications included a step‐free entrance, wider internal doors and corridors, and level access throughout the home. These modifications would promote social inclusion, functioning, independence and overall quality of life. These results have policy implications for the implementation of accessibility standards in the National Construction Code. [ABSTRACT FROM AUTHOR]

This paper describes the development and preliminary evaluation of a novel participant‐led video (PLV) intervention to support people with disability (PWD) and cognitive and communication impairments to communicate their needs and preferences to their disability support workers. The PLV intervention was designed following a scoping literature review and workshop with PWD and close others. Subsequently, it was piloted with five primary participants with acquired brain injury and cognitive and communication impairments, five close other supporters and five facilitators. An independent mixed methods evaluation of the pilot was conducted with participants, close others and facilitators. All pilot evaluation participants reported high levels of satisfaction with the PLV intervention (mean ratings: primary participants 4.5/5.0; supporters 5.0/5.0; facilitators 4.8/5.0). When primary participants and their supporters were asked to rate how likely they were to recommend the PLV intervention, responses were extremely positive with the mean rating exceeding eight on a 10‐point scale. Qualitative analysis of interview data revealed the PLV to be a person‐centred experience for primary participants that was structured around sense of self and included having a voice and taking control in directing their lives, personal growth through participation and feeling validated through the experience. The production and use of PLV training resources has much potential to improve the delivery of support and maximise support outcomes by enabling people with cognitive and communication impairments to have choice and control, set their own goals and direct their supports. Further research is required with a larger sample size and longitudinal evaluation of participant outcomes. [ABSTRACT FROM AUTHOR]

The article offers brief information on the Housing Toolkit software from the organization Summer Foundation.

Over 4500 people under 65 years of age live in residential aged care (RAC) in Australia, and they experience poorer quality of life than people with similar disabilities in other settings. Governments have long aimed to reduce admissions of young people to RAC, but in 2019, for the first time, the Australian Government adopted target dates for resolving the issue. The targets include reducing admissions of young people to near zero by 2022 and ensuring almost no one remains in RAC beyond 2025. The national strategy focuses mostly on housing and support needs being met via the National Disability Insurance Scheme. The present study drew on quarterly data from the National Aged Care Data Clearinghouse to examine progress toward these targets. Significant progress was evident in terms of young people entering RAC: admissions reduced each quarter between September 2018 and July 2020, halving over two years. No progress was evident in terms of young people leaving RAC for better arrangements; the trend neither increased nor decreased. Prospects for achieving the targets are discussed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine use of electronic assistive technology for social networking by people with disability living in shared supported accommodation (SSA), and compare participants' Electronic Social Networking (ESN) integration with Australian ESN normative data. Method: Telephone surveys and the ESN subscale of the Community Integration Questionnaire-Revised (CIQ-R) were administered with SSA managers. Surveys gathered demographic data, and data on Internet access, technology use and ESN integration, of 91 people with disability who were identified technology users and living in SSA. Participant ESN data were then matched with existing CIQ-R ESN normative data (N = 359). Relative risk of reduced ESN integration was calculated. Results: This study identified that, despite access to mainstream technologies, people with disability living in SSA experience low ESN integration, and use ESN for social contact less than other Australians. This group were 210% more likely to report reduced ESN integration than the matched normative sample when key demographic variables were held constant. Conclusions: Factors related to disability, including high care and support needs and greater time spent completing essential activities of daily living (such as personal care), may explain the low electronic social networking integration for people with disability living in SSA identified in this study. Further research that examines factors that influence ESN access and use following disability is necessary to inform practice to bridge the digital divide that exists between this group and other Australians. [ABSTRACT FROM AUTHOR]

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation: Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals. [ABSTRACT FROM AUTHOR]