“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”

People with learning disabilities who live in inpatient services value their relationships with staff members. Indeed, therapeutic experiences are based around these, with people reporting that relationships with various staff are more important to them than therapeutic interventions per se. Staff have reported that engaging with and spending time with the person is key to the maintenance of relationships, and the avoidance of the need to use coercive practices. Trust, respect, and feeling comfortable together feature in the literature as fundamental. In addition to this, availability and consistency of staff facilitated the progression of supportive relationships when moving through services and into the community. In inpatient services, residents spend much of their time with staff who have many jobs to do, such as cooking, observations and paperwork. They also spend time with staff members who are employed as therapists. This article uses a synthesis of evidence from two qualitative studies to describe how good relationships with staff help people to move through services and back into the community. Staff describe using strategies such as highlighting positive aspects of the person when they are feeling sad, recognising the signs and reassuring people when they are anxious, and carving out safe spaces and time for discussion. People with learning disabilities describe the positive aspects of staff they enjoy, such as sharing responsibilities, demonstrating trust, ensuring involvement of family and friends, and helping out with practical problems. We conclude that flattening the hierarchy between staff and residents is key when supporting people with learning disabilities to move back into the community. Accessible summary: - We talked to people who lived in a secure unit and their staff. We asked them about good relationships with each other. People said that good relationships can help people move back to the community and be ‘in a good space’. - Staff said that good relationships can stop people getting angry. They said that they like to help people and have trust. It is important to have a good staff team who know the person well. - Residents said staff help them and listen to them when they are upset. They like it when staff spend time with them. They did not like it when staff have to watch them in the bathroom. - We decided that services should work on helping people to have good relationships. This way, people can get back to the community quicker