‘Them two are around when I need their help’ The importance of good relationships in supporting people with learning disabilities to be ‘in a good space’

Background: Despite repeated policy initiatives an enduring number of people with learning disabilities remain resident in secure settings (also referred to as locked wards). The distance, geographic and emotional, from family and friends when resident in these settings makes relationships with staff central to people’s lives and a critical factor in residents’ ability to be in a successfully transition or ‘move on’ to make their home in the community. Materials and Methods This article uses a synthesis of evidence from two qualitative studies. Data from field notes and transcripts of interviews with people with learning disabilities resident in secure settings and with staff who worked with them were analysed. The purpose of the original studies was service improvement, however relationships, particularly with between staff and residents emerged as a significant theme in both studies. Therefore, the data was revisited to explore these relationships in more depth and comparatively between both studies. Results and Discussion The analysis identified that positive relationships with staff was critical in enabling residents to be ‘being in a good space’, something they and staff viewed as a crucial factor for moving to less secure hospital settings and ultimately being at home in the community. The analysis identified four main themes: (i) the characteristics of positive relationships. (ii) the challenges for positive relationships, (iii) how positive relationships can be encouraged and (iv) how they support people to move on. Conclusion: We conclude that flattening the hierarchy between staff and residents is key when supporting people with learning disabilities to move back into the community. There is a pressing need for research with people who have made the transition from hospital to generate retrospective narratives about what elements of these relationships are most significant in supporting a successful transition to life in the community