Recent efforts to survey the opinions of people with learning disabilities have tended to include only those with mild to moderate disabilities, or those with relatively good communication skills. Here, Graham Collins and Lisa Goodman describe how one service has, for the last ten years, used direct observations as a method of gathering the views of people with severe and profound learning disabilities

Good practice in meeting service users’ needs and wishes is acknowledged as being central to all services (NHS Executive 1998). In 2001, the Department of Health introduced person-centred planning as a government policy and this has been one of the key initiatives in the successful implementation of Valuing People (Department of Health (DH) 2001, Adams et al 2006). Person-centred planning is an approach intended for organising support and assistance for people with learning disabilities, and reflects the unique circumstances of the individual (Mansell and Beadle-Brown 2003). As a result, there is now an increased awareness of the need to consider individuals’ own perceptions of their life and quality of life.