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Health and Social Care (Adults)
Good Support for People with Complex Needs: Examples of Potential Good Practice

Researchers: Kate Gridley, Jenni Brooks, Caroline Glendinning

Funder: NIHR School for Social Care Research

Duration: June 2010 to February 2012

The examples of potential good practice we are making available here (see below) were identified during a consultation with people with severe and complex needs, and those who support them. We asked for their views on good practice in social care. Sixty-seven people took part in the consultation between September 2010 and June 2011. It was part of a broader study by the Social Policy Research Unit to scope the evidence on good practice in social care for disabled and older people with severe and complex needs and to find out what this group considered to be key features of good support.

Please note that we have not independently evaluated any of these services and wish to make no claims about their effectiveness.

These descriptions are being presented here to illustrate how some of the key features of good support, identified by people who use services, can be delivered in practice. These descriptions could provide a useful starting point for future research into service models that are highly valued, but have not, as yet, been robustly evaluated.

The consultation

As ‘complex needs’ is a broad term, the study focussed on three specific groups:

  • young adults with complex or life-limiting conditions
  • adults with brain or spinal injury and complex needs
  • older people with dementia and additional physical or sensory impairments.

All participants had complex support needs themselves, or supported (either as a family carer or through a specialist organisation) people who did (Table 1).

Table 1 Participants by role and ‘exemplar’ group

People with complex needs

Family carers

Members of organisations


Young People





Brain or Spinal Injury
















Features of good support

Table 2: Summary Features of Good Social Care


Key Features of Good Practice

Individual Level Support

Person-centred ways of working

Meeting practical, emotional and social needs

Reliable, well coordinated delivery

Staff attitudes and approach

Continuity in support

Sufficient resources

How Services are Organised



Specialist expertise

Support to access and use information

Key workers and coordination

Timely, proactive approach

Commissioning Social Care for People with Complex Needs


Specialist expertise

Crossing boundaries


More details about these, and the study as a whole, can be found in the project summary. (PDF)

Inclusion and exclusion criteria for case examples

These ten examples were drawn from 33 potential examples of good practice. 29 were identified through the consultation with people with complex needs, carers, and professionals. Four were identified through a survey of local authorities carried out by PSSRU . We only included examples that:

  • were models of care or support for people with severe and complex needs OR a whole systems approach to meeting the needs of (one or more of) the study groups
  • appeared to have two or more of the features of good practice identified through our consultation (based on the information available – see below)
  • were fully operational at the time (October 2011)
  • were community-based
  • operated in England.

We excluded examples identified from the consultation that:

  • were not currently operational
  • were in very early stages/not yet developed
  • were residential care homes
  • did not want to take part
  • we could not make contact with after two attempts
  • another very similar example is already included
  • were not transferable – there is no potential to generate learning about good practice that is transferable to other groups with complex needs
  • didn't provide enough information to ascertain if example fitted the criteria.

We looked into each example that was suggested to us. If it was clear from an organisation’s website that it did not fit the criteria it was excluded at this stage; if not we attempted to ring the service.

The case examples

Ten case examples were identified that fitted the above criteria. Each of these was asked to nominate an appropriate member of staff to provide the research team with an overview of their organisation and its services. We conducted one guided telephone conversation with the nominated individual from each of the ten included case examples, focussing on the ways in which they might be able to demonstrate key features of good practice.

Summaries drawn from these conversations, together with details of how to access further information, can be viewed by clicking on the links below:

1. The Good Care Group

2. North Somerset Personalisation Team

3. Cambridgeshire Transitions Service

4. Independent Living Programme - Stoke Mandeville Spinal Injuries Unit

5. Orchard Manor Transition Service (Scope)

6. Origin Recruitment - specialist spinal injuries agency (National)

7. Brain Injury Case Management (Dudley)

8. Essex Dementia Care

9. Brain Injury Specialist Social Work Team (Sheffield)

10. Commissioning for People with Dementia in Salford

Back to main project page

If you require further information about the project, please contact Kate Gridley email Kate Gridley

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