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Abstract：
BACKGROUND: Transforming Care is making mixed progress in supporting people with intellectual and developmental disabilities, and complex needs, move to more appropriate specialist accommodations closer to home. Community support staff often spend greatest amounts of time with service-users, yet are some of the least heard voices about why placements succeed and fail to varying extents.
METHODS: Managers and support staff (n = 13), working in ostensibly \"specialist\" community placements, were interviewed about perceived barriers and facilitators to implementing Transforming Care. Transcripts were subjected to thematic analysis.
RESULTS: Participants identified difficulties balancing people\'s rights, safety and quality of life needs, and felt the system\'s expectations of them are hard to deliver within the resources, legislation, values and support models provided them. Multidisciplinary expertise was highly valued for both emotional and practical support, but was least valued when perceived as overly blaming or inspectorial. Specialist health input was seen to withdraw prematurely for this particular client group.
CONCLUSIONS: Recommendations are provided for how staff perspectives should inform Transforming Care in interests of service-users.
METHODS: Managers and support staff (n = 13), working in ostensibly \"specialist\" community placements, were interviewed about perceived barriers and facilitators to implementing Transforming Care. Transcripts were subjected to thematic analysis.
RESULTS: Participants identified difficulties balancing people\'s rights, safety and quality of life needs, and felt the system\'s expectations of them are hard to deliver within the resources, legislation, values and support models provided them. Multidisciplinary expertise was highly valued for both emotional and practical support, but was least valued when perceived as overly blaming or inspectorial. Specialist health input was seen to withdraw prematurely for this particular client group.
CONCLUSIONS: Recommendations are provided for how staff perspectives should inform Transforming Care in interests of service-users.
摘要：
背景：转化护理在支持智力和发育障碍的人方面取得了不同的进展，和复杂的需求，搬到离家更近的更合适的专业住宿。社区支持人员通常花费最大的时间与服务用户在一起，然而，一些关于为什么安置成功和失败程度不同的声音最少。
方法：经理和支持人员（n=13），表面上在“专家”社区工作，接受了关于实施转化护理的感知障碍和促进者的采访。对成绩单进行主题分析。
结果：参与者发现了平衡人们权利的困难，安全和生活质量的需求，并感到系统对它们的期望很难在资源范围内实现，立法,值和支持模型提供了它们。多学科的专业知识在情感和实践支持方面都得到了高度重视，但当被认为是过度指责或检查时，价值最低。对于这个特定的客户群体，专家健康投入被认为过早撤回。
结论：提供了有关员工观点应如何为服务使用者的利益提供信息的建议。
方法：经理和支持人员（n=13），表面上在“专家”社区工作，接受了关于实施转化护理的感知障碍和促进者的采访。对成绩单进行主题分析。
结果：参与者发现了平衡人们权利的困难，安全和生活质量的需求，并感到系统对它们的期望很难在资源范围内实现，立法,值和支持模型提供了它们。多学科的专业知识在情感和实践支持方面都得到了高度重视，但当被认为是过度指责或检查时，价值最低。对于这个特定的客户群体，专家健康投入被认为过早撤回。
结论：提供了有关员工观点应如何为服务使用者的利益提供信息的建议。
