Ms Anne O'Connor:

We could not provide all those services. The reality is that we often have people who have highly specialised needs. We would not be able to keep those services going in respect of staffing, etc. We rely on private providers who often specialise in a specific condition. Our challenge is to ensure that we respond in a more agile way to people's needs. Just because people go into a placement one day does not mean that they should have the same staffing and remain in the same place forever. We must ensure we have a system of reviewing placements to meet their changing needs. This is particularly the case if they go in when they are younger and grow older, or their condition changes, or whatever. Many things can change. The idea is that we look at getting the most appropriate care setting.

There is definitely a value for money component. Sometimes we find that three or four CHOs may be dealing with one provider, unaware that the other CHOs are also talking to the provider. This impacts on the cost and staffing levels. We are trying to join all of that up nationally to make sure that when we are talking to a provider, particularly where there might be three or four people in a house funded by different areas, that we bring all of that together and look at its appropriateness. The most important thing is we meet the person's needs in the most appropriate way.