Introduction
This article has been written in response to recent conversations, books and articles which suggest that the Reach Standards do not apply to people with profound and complex disabilities. Too often, the assumption is made, sometimes quietly, sometimes quite directly, that people with the highest support needs cannot exercise choice, or that these rights only “fit” those who can make decisions in conventional ways. We believe this is a serious misunderstanding. The Reach Standards were always intended for everyone, without exception.
The Reach Standards are a set of nationally recognised guidelines designed to ensure that people with learning disabilities or others requiring support can live fulfilling, and self-determined lives. One of the most critical themes running through all the Reach Standards is choice and preference. These principles are not just ideals, they are rights that go to the heart of person-centred support and inclusive living. In this article, we explore why choice and preference are central to the Reach Standards and why they matter deeply in the everyday lives of people who draw on support.
What are the Reach Standards?
The Reach Standards, developed by Paradigm and partners, promote supported living that is truly person-centred. They outline what good support looks like when someone lives in their own home with help to do so. These standards cover areas such as:
- I choose who I live with
- I choose where I live
- I have my own home
- I choose who supports me and how I am supported
- I choose my friends and relationships
- I get help to make changes in my life
- I choose how I am part of my community
- I have the same rights and responsibilities as other citizens
Across these standards, the thread of individual choice and preference runs strong and clear.
Supported living: Not a “model” but a rights-based approach
It is important to understand that supported living is not a “model” of care. It is an overarching, rights-based approach that upholds the belief that people with disabilities should have the same opportunities as everyone else: to live in their own home, have a tenancy (or own their own home), and receive support that is tailored to their needs and aspirations.
Supported living is not about buildings, shift patterns, or services – it is about support for living. It is about supporting people to live their lives, not just to be safe or managed, but to thrive, connect, and grow as citizens.
Too often, people say that “supported living doesn’t work” when what has failed is not the principles of supported living, but poor support. When people are not listened to, when choices are limited or ignored, when staff are not trained or values-driven, then of course the outcomes are poor. But that is a failure of implementation, not of the vision. The Reach Standards help re-centre the purpose of supported living: to enable ordinary, meaningful lives where people have control, belonging, and hope.
The role of choice in autonomy and control
Having real choices is fundamental to autonomy – the ability to shape one’s own life. For people with learning disabilities, many aspects of life have historically (and often still) been chosen for them: where to live, who supports them, what they do in their day, even what time they go to bed. The Reach Standards challenge this legacy by emphasising control over one’s own life.
When someone can make decisions – big or small – they gain confidence, a sense of self-worth, and ownership of their future. Whether it’s choosing a support worker they get on with, decorating their flat in their own style, or deciding what to eat, these choices matter deeply. They affirm that the person is not passive, but active and capable.
Preferences: Why what you like really matters
Recognising someone’s preferences is not just about being polite or considerate, it’s about dignity and respect. Preference’s express identity: what someone enjoys, values, and believes in. When support services ignore or override preferences, they risk dehumanising people.
By aligning support with each person’s preferences – whether around routines, communication, food, personal care, or relationships – services show that they see the whole person, not just their needs. This leads to greater wellbeing, satisfaction, and a stronger sense of belonging.
What about people perceived as unable to make choices?
A critical and often overlooked issue is how we treat people who are perceived as unable to make choices – particularly those with profound and multiple learning disabilities, or those who don’t communicate in conventional ways. These people are often most at risk of having decisions made about them, rather than with them.
Some parents and professionals express concern that ‘choice’ plays too strong a role in the Reach Standards – that people with complex needs don’t have the capacity to make informed decisions or that prioritising choice could lead to harm, neglect, or confusion. These concerns often come from a place of deep care and protectiveness. But removing or minimising choice is not the answer.
Instead, we need to rethink what choice looks like, and how we support it. Choice does not mean abandoning someone to make unsupported decisions. It means creating the conditions where preferences, patterns, cues and histories are noticed, respected, and responded to. Taking away the principle of choice is taking away someone’s right to direct their own life, even in small, meaningful ways. The Reach Standards aren’t about forcing independence; they are about affirming humanity. Supporting choice well requires patience, creativity, and commitment, not assumptions about what someone can or can’t do.
The Reach Standards make it clear: everyone can express preferences, and everyone has the right to be heard. It is the responsibility of supporters and services to:
- Use creative and consistent communication strategies
- Pay close attention to behaviour, expression, and mood
- Involve people who know the person well, including family and friends
- Take time, build trust, and never assume incapacity based on disability
Dr Jo Watson’s work has been especially influential here. Her advocacy around the concept of “preference indicators” challenges the assumption that people with profound disabilities cannot express choice. She reminds us that “just because a person doesn’t use words doesn’t mean they have nothing to say.” Through observation, trust, and respectful curiosity, support workers can begin to understand how someone communicates preference, through facial expressions, vocalisations, changes in behaviour, or reactions to people and situations. Watson’s approach is grounded in the belief that all behaviour is communicative. Take Tom for example who shows preference through his movement and sounds. Watson explains that when he is happy he gently rocks and makes ‘a hum that is almost zen like’. When he is unhappy he rocks quickly and makes a ‘very high pitch, disturbing noise’. It is important that those who know and truly care about Tom recognise, acknowledge and interpret Tom’s preferences, through how he responds in different situations and that these preferences are built into decisions about his life. As Watson says ‘For Tom, autonomy is not an individualised process, it’s a collective one, and isn’t that how we all make decisions?’
This approach reinforces the core message of the Reach Standards: everyone has the right to be heard, understood, and supported in ways that honour their preferences – no matter how they communicate.
Choice and risk: Balancing safety and freedom
Sometimes, support services worry about letting people make “risky” choices. But the Reach Standards encourage us to think differently. Everyone takes risks in life, it’s part of growth and learning. True person-centred support means helping people weigh up risks, understand consequences, and still support their right to choose.
Time for a rethink: Changing minds, changing systems
Embedding choice and preference within services demands a cultural shift. It means moving away from a system-led model (“we know best”) to a person-led model (“you know best about your own life”). This requires:
- Skilled and reflective support workers
- Managers and leaders who promote flexible, empowering practice
- Mechanisms for feedback, review, and accountability when people’s choices are not being heard
When services use the Reach Standards well, they are constantly asking: Are we really enabling this person to choose, or are we just giving the illusion of choice?
Conclusion
Choice and preference are not optional extras in people’s lives, they are fundamental rights that underpin freedom, dignity, and equality. The Reach Standards place these rights at the centre, demanding a shift in power, a commitment to listening, and a belief that everyone is the expert in their own life. This includes people who are rarely given that recognition. By listening more carefully, interpreting more creatively, and presuming capacity rather than incapacity, we move closer to a society where everyone can live an “ordinary life” that reflects their own dreams and decisions – not someone else’s assumptions.
And let’s be clear, people are failed when they are supported in a way that does not honour choice, that limits freedom, that devalues people – that fails. Supported living (support for living), when done well, is about far more than housing and support. It is about the right to a real life: a home of one’s own, relationships that matter, freedom to be part of the world, and support that enables – not controls.
Moving forward
As part of our ongoing work to shine a light on the importance of great support, Paradigm is co-producing a new resource: The Guide to Being a Gr8 Support Worker.
Co-authored by self-advocates, family members, academics, and social care practitioners, this guide will inspire and equip support workers to deliver truly person-centred, values-driven support that honours choice and preference at every level. By bringing together diverse voices and real-life experiences, it will celebrate what great support looks like and offer practical ideas to make it happen.
Launching in Spring 2025, the guide will be freely available to help shape the future of support, so everyone can live meaningful, self-directed lives.