Managing relational autonomy in interactions: People with intellectual disabilities.

Background: This article is about interactions that occur when someone with intellectual disabilities is engaged in everyday activities with a personal assistant (PA) or a support worker.

Method: We examine the detail of nine hours of naturally occurring video-recorded interactions, to explore how "relational autonomy" is done in practice. Nine people with ID and seven staff took part in the research, which took place in England from 2016-17.

At sea with disability! Transformative learning in medical undergraduates voyaging with disabled sailors.

Context: Attitudinal objectives are difficult to formulate, teach and assess; yet good attitudes are fundamental to good practice. For instance, studies highlight negative attitudes to disability in the medical student community that contrast with the self-conceptions of disabled persons. This study was designed to better understand attitudinal learning, inadequately addressed by contemporary programmes, through the application of Mezirow's 'transformative learning theory' (TLT) to a novel educational intervention.

The Meaning of 'choice and control' for People with Intellectual Disabilities who are Planning their Social Care and Support.

Background: This paper questions consumerist assumptions in current English social care policy and aims to look behind the processes of personalization to interrogate what 'choice and control' means in the lives of a diverse group of people with intellectual disabilities.

Methods: Data were from multiple interviews and direct practice recordings with nine people using personal budgets and were analysed using an interpretative approach.

Results: Identity, other people and personal budget processes were all important for choice and control.

Indirect payments: when the Mental Capacity Act interacts with the personalisation agenda.

This paper reports findings from a study that aimed to explore how practitioners were bringing together the demands of the personalisation agenda, in particular the offer of direct payments (DPs), with the Mental Capacity Act, and to investigate current practices of offering and administering indirect payments for people who lack capacity to consent to them, including the use of 'suitable person' proxies under the new regulations (DH, 2009). The study adopted a qualitative interview-based design; participants were social work practitioners (67) and recipients of 'indirect' payments (18) in six local authorities in England in 2011-2012. The paper reports on five key decision-making points in the indirect payments process: the decision to take on an indirect payment, the assessment of mental capacity, the identification of a suitable person, the establishment of the care recipient's best interests and the decisions about how to execute the indirect payment.

Third-party turns and shared knowledge: Supports and challenges to disabled people in social care and research settings.

Adopting a conversation analysis (CA) perspective, this paper explores data which include disabled people in three-party contexts, where the institutional goal is to focus on the wishes, voice and agency of the disabled person. It explores 274 occasions where a third party self-selects for a turn, during social care planning meetings and research interviews. Five broad action patterns are discussed, showing how third parties used their epistemic closeness to the disabled person in order to (1) clarify, (2) respond, (3) prompt, (4) expand and (5) challenge.

Beginning to explore the experience of managing a direct payment for someone with dementia: The perspectives of suitable people and adult social care practitioners.

Following legal improvements made around mental capacity together with the Health and Social Care Act, it is now possible for a direct payment to be paid to a 'Suitable Person' to manage on someone's behalf to purchase directly care and support services. People with dementia are a key group affected by this change in England of adult social care. We interviewed nine social care practitioners and seven Suitable People for people with dementia across five English local authorities to begin to examine their experiences of this new method of social care provision.

Best interests decisions: professional practices in health and social care.

This paper reports on data collected in 2011 from a national study about the operation of the best interests principle, a key feature of the Mental Capacity Act (MCA) 2005 for England and Wales. The objective was to provide a picture of current professional practices in best interests decision-making. Four contrasting sample sites were selected, in which National Health Service trusts, social care and other organisations were recruited to participate.

In search of a national approach to professional supervision for mental health and addiction nurses: The New Zealand experience.

A competent nursing workforce is crucial for recovery of mental health and addiction service users. Professional supervision is central to facilitating this competency. This article reports on research that scoped the current provision of professional supervision then explores possibilities for developing a standardised national approach to professional supervision for mental health and addiction nurses in New Zealand.

'Did you solve it yourself?': Evaluation of self narratives of discrimination by people with 'learning difficulties'.

Narratives about personal experience are shaped by the interactional context, and people are required to tell their own stories in a variety of social contexts. For people with 'learning difficulties', veracity is a particular and paradoxical problem. New policies and strategies require them to take part in public debates, while they are traditionally judged to be incompetent to be witnesses to the 'truth'.