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This mainly exploratory study was a one‐point‐in‐time survey of the situation in one English county. This study involved a survey of all social care homes in the county, followed by measures of quality of life/service for a random sample of 30 people identified by the survey, interviews with home managers, service users, family carers and care managers, and focus groups with members of four community learning disability teams. The total number of people placed from out‐of‐area was estimated to be close to 2,000 (1,500 were placed by the local authority within the county). The main reason for such placements was lack of good local services, but cost also seemed important. For many of those who had been in long‐stay hospital, locality appeared not to be important. Effects varied, but at least a third of people were experiencing very poor service quality and quality of life. Family carers generally felt their relative was happy, but fear of losing the placement was a strong theme. Distance was a major difficulty for both family and care manager involvement. For local community learning disability teams, the main problems included increased workload, reduced provision for local residents, difficulty in dealing with placing authority and the poor quality of the homes. Challenges for public agencies include provision of better local services, management of the cost incentives, especially for London Boroughs, and a system where funding follows the person wherever they chose to live.

Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person‐centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid both to training staff and to the motivational structures within the organisation. Both the quality of support provided by staff and the level of engagement increased significantly after the introduction of person‐centred active support. In addition, people experienced decreased self‐stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learnt about the implementation are provided.