I own and run learning disability and mental health homes, and I have bought the wrong care system twice. Both times the demo was good and the product turned out to be a residential care system with a learning disability label on the brochure. This is the guide I wish someone had given me: what to demand, what to ask on a demo, how to compare prices that are deliberately hard to compare, and how to run a trial that tells you the truth.
The short answer
Choose a learning disability system on seven things: positive behaviour support plans, ABC charts you can analyse, restrictive practice recording that produces a count, communication passports on the person's profile, easy-read care plans and health action plans, epilepsy and seizure records, and health flags such as the IDDSI level visible before anything else opens. Everything else, including the daily notes, the rota and the invoicing, is broadly the same across the market. Those seven are where systems built for older people's residential care fall over, and they are where your service lives.
Why most care software does not fit a learning disability service
Most UK care management systems were built first for older people's residential and nursing homes, or for home care, because that is where the volume is. The data model follows: a resident, a room, a set of clinical charts, a medication round, a fee. That model does not describe a person with a tenancy, a positive behaviour support plan, a communication passport and 30 hours of commissioned one-to-one support.
The symptoms are easy to spot once you know them. Care plans organised around personal care tasks rather than the person's goals. Behaviour recorded as an incident rather than an ABC entry you can analyse. No concept of a restriction. Easy read treated as an attachment. None of that means those systems are bad. It means they were built to solve a different problem, and you will spend five years working around the gap.
What makes a learning disability service different to record
Four things change when you move from a residential home for older people to a learning disability or supported living service, and each of them changes what the software has to do.
First, the record is about a life, not an episode, so goals and progress over years matter more than admission assessments. Second, behaviour and communication are clinical: what elsewhere is a note is here the primary evidence for prescribing, restriction reduction and safeguarding. Third, restriction is pervasive and has to be counted. Fourth, the person is often a tenant with their own front door, their own money and their own right to take risks.
A system that handles those four properly will handle the rest. A system that handles the rest beautifully and none of those four will make your job harder every day.
The learning disability requirements checklist
Take this into every demo and score each system out of five on every row. Make the salesperson show you each one rather than describe it.
| Requirement | Why it matters | What to make them show you | Priority |
|---|---|---|---|
| Positive behaviour support plan | It is the primary support document, not an attachment | A structured PBS plan with functions, primary, secondary and reactive strategies, and early warning signs, on a worker's phone | Must have |
| ABC charts | Evidence for prescribing, PBS and restriction reduction | Adding an ABC entry in under a minute, then a report grouping by antecedent, time of day and day of week | Must have |
| Restrictive practice register | You cannot reduce what you cannot count | A restriction type list, a count per person per month, and a trend over twelve months | Must have |
| Communication passport | Every other plan depends on it | The passport appearing on the profile before the daily notes, and printing from the same record | Must have |
| Easy-read care plan and health action plan | The person should be able to hold their own plan | An easy-read version kept in step with the professional version, with images, printed | Must have |
| Epilepsy and seizure records | Pattern change is what triggers a neurology review | A seizure entry with type, duration, rescue medicine and recovery, plus a frequency chart | Must have where relevant |
| Health flags on the profile | Bank staff must see the IDDSI level and allergies first | A flag area showing IDDSI food and drink levels, allergies, epilepsy and choking risk before anything else | Must have |
| Goals and outcomes over time | Right support, right care, right culture is about whether life is improving | A goal with steps, progress recorded by workers, and a twelve-month view | Must have |
| One-to-one hours | Commissioners pay for them and ask for evidence | Recording hours against the person and producing a report for a funder | Must have in supported living |
| Person's own money | Tenants have their own finances and audits go wrong here | A personal money ledger with receipts, balances and a two-signature check | Must have in supported living |
| eMAR with PRN protocols | PRN psychotropics are restrictive practice | A PRN given with the protocol on screen, the reason, what was tried first and the effect an hour later | Must have |
| Hospital passport | It must match the record, not a two-year-old document | Printing a current hospital passport from the live record | Must have |
| Community and activity records | Much of the person's day is outside the building | Recording an outing on a phone with no signal, and it saving later | Must have |
| Agency and bank access | Attribution and data protection | Creating a login limited to today and to named people, then showing it expire | Must have |
| Body maps | Injuries after restraint and unexplained marks | A body map attached to an incident, with photographs | Must have |
| Reporting you can run yourself | Evidence without ringing support | The manager building a report on screen without vendor help | Must have |
| Rota linked to the record | Training expiry and who is on shift tonight | A shift showing whether the worker's training is in date | Nice to have |
Non-negotiable one: positive behaviour support plans
A learning disability system must hold the positive behaviour support plan as a structured document that workers actually read on shift, not as an uploaded PDF. If the PBS plan is an attachment, staff will not open it, and the plan will not be followed.
What to look for: named sections for the hypothesised functions of the behaviour, the proactive strategies, the early warning signs, the active strategies for each stage of escalation, the reactive strategies including any agreed physical intervention, and the post-incident plan. It should be visible from the person's profile in one tap, it should be printable for the fridge door, and every change should be versioned so you can see what the plan said on the day of an incident.
Ask how the plan links to incidents. When a worker records an incident, can they see the plan on the same screen, and does the incident record which strategies were used? Our worked PBS plan example shows the sections a system should hold.
Non-negotiable two: ABC charts that can be analysed
ABC recording is only useful if it can be aggregated, which means antecedent, behaviour and consequence must be structured fields with pick lists, not one free-text box. Free text cannot be grouped, and ungrouped ABC data has never changed a prescribing decision.
In the demo, ask for an ABC entry to be completed on a phone in under a minute, then ask for a report of the last three months grouped by antecedent, by time of day and by day of the week. If the answer involves exporting to a spreadsheet, that is your answer. A psychiatrist looking at a chart showing that incidents cluster between 4pm and 6pm on weekdays will make a different decision from one reading twelve paragraphs.
Check severity and duration are recorded too, because frequency alone hides whether things are improving. Our guide to ABC charts covers the fields.
Non-negotiable three: restrictive practice recording that produces a count
The system must treat a restriction as a countable record with a type, a duration, a legal basis and a review date, and it must produce a count per person per month. A note in the daily log saying staff supported him to his room is not a restriction record.
This is the single biggest gap in general care software and the one that costs services most at inspection. Ask to see a restriction type list covering physical, mechanical, chemical, environmental, surveillance and restrictions on choice, a report showing restrictions per person per month with a twelve-month trend, and whether a PRN psychotropic given to manage behaviour appears in that count automatically.
If a vendor does not understand the question, they have not built for this sector. Our guide to restrictive practice and restraint reduction lists the fields a proper record needs.
Non-negotiable four: communication passports on the profile
The communication passport must live on the person's profile and open before the daily notes, because a bank worker's first three minutes with a person decide how the shift goes. A passport stored as a document in a folder within the system is no better than paper.
Ask to see it from the worker's view on a phone: photograph, how the person understands you, how they tell you things, how they say yes and no. Ask whether it prints, whether it feeds the hospital passport, and whether there is a record of which workers have read it, because that is what an inspector asks.
Ask whether it holds structured signal tables rather than only prose, and whether it prompts a review after an incident where communication was a factor. Our guide to communication passports and total communication sets out what should be in one.
Non-negotiable five: easy-read plans the person can hold
Every person should have an easy-read version of their care plan and health action plan, and the system should keep it in step with the professional version rather than making somebody maintain two documents by hand.
Look for a person-facing version produced from the same underlying record, with images, large text and one idea per line, printable and shareable. Ask what happens when the professional plan changes: does the easy-read version flag as out of date, or silently become wrong?
Ask also about health action plans specifically, because they are where actions go to die. You want each action to become a task with an owner and a due date that appears on somebody's list, not a line in a PDF. Health action plan actions that do not become tasks with owners and dates do not happen.
Non-negotiable six: epilepsy and seizure records
Epilepsy is far more common in this population than in the general population, and a seizure record is not a daily note. You need seizure type, start and end time, duration, what happened before, injury, rescue medicine given with dose and route, recovery time and who observed.
Then you need the chart, because the point of a seizure diary is that a change in pattern triggers a neurology review, so the system must show seizures per month by type over at least a year. Ask whether the seizure management plan sits on the profile with the rescue medicine protocol, for example buccal midazolam 10mg with the time to call an ambulance.
Ask what happens at night and in the community. A worker should be able to record a seizure on a phone, offline, in under a minute.
Non-negotiable seven: health flags before anything else
The person's profile must show the critical health flags before anything else: IDDSI food and drink levels, allergies, epilepsy, choking risk, diabetes, and anything that would harm the person if a new worker did not know it within ten seconds.
Test this in the demo by asking the presenter to log in as a bank worker who has never met the person, open the profile, and tell you what they would need to know before supporting a meal. If the IDDSI level is three taps away in a nutrition section, the level will be missed, and our guide to dysphagia and IDDSI in learning disability homes explains what that costs.
Ask whether flags are structured fields or free text, because free text means updating it in two places, which means it will be wrong within a year.
Supported living: what changes when it is the person's own home
In supported living the person is a tenant, which changes consent, access, money and hours, and a system built for a care home will fight you on all four.
Check these specifically: support hours recorded against the individual rather than the building; a personal money ledger with receipts and balances that survives an audit; the person's own ability to see their plan; outings recorded on a phone offline; and running one service across several scattered flats rather than one building.
Ask what a rota looks like when three people in three flats have different commissioned hours. Good supported living software treats the person as the unit and the building as incidental, and a residential system inverts that.
Goals, outcomes and Right support, right care, right culture
Inspectors in this sector want evidence that people's lives are getting better, not just that tasks were completed, so the system has to hold goals with steps, record progress over months, and produce a view a reviewer can read.
A good implementation looks like a goal written in the person's words, broken into steps, each step recorded by whoever supported it, and a chart showing the trajectory over a year. A bad one is a goals field filled in at admission and never touched. Ask to see a twelve-month view of one person's goals, ask how a keyworker is prompted to review them, and ask whether the person can see their own progress in an accessible format.
One-to-one hours, funders and money
Commissioners pay for hours and ask for evidence, so the system must record support hours against the person and produce a report a funder will accept. This is the most commonly missing feature in systems built for a flat weekly residential fee.
Ask how one person's package is recorded when it is funded partly by the local authority, partly by continuing healthcare and partly by a direct payment, how the invoice comes out, and what happens when the rate changes mid-year. Ask whether unused hours are visible, because that conversation with a commissioner is easier with a report than with a claim.
Also ask about the person's own money. Tenants' finances are audited, misappropriation is a real safeguarding risk, and a paper cash book in a drawer is a weak control. A ledger with a running balance, receipts attached and a second signature is a much better answer, and it belongs in the same system as everything else. Good care home billing software should cover both funder invoicing and personal money without a separate spreadsheet.
eMAR in a learning disability service
Medicines in a learning disability service are given by support workers, often in several buildings, sometimes in the community, and at times that follow the person's day rather than a drug round. An eMAR built around a trolley and a corridor will not fit.
Ask how it handles medicines given away from home, social leave, PRN psychotropics with a protocol requiring non-drug approaches first, covert administration with a capacity assessment attached, time-critical epilepsy medicines, and rescue medicines given in a car park at 9pm.
Then ask for the PRN report: every PRN psychotropic, per person, per month, with the reason and the outcome. That single report is what you take to a STOMP review, and it is worth more than any other medicines feature.
What to avoid
Some things are warning signs regardless of how good the rest of the product looks. These are the ones I would walk away from.
- A system where the PBS plan, communication passport and easy-read plan are uploaded documents rather than structured records.
- No concept of a restriction, or restrictions recorded only as free-text incidents.
- ABC recording as a single text box.
- Reporting that requires you to email the vendor, or that costs extra.
- Any claim that the system is approved or endorsed by the regulator, because no such approval exists.
- A contract longer than a year for a new customer, especially with an early termination charge.
- Per-module pricing where the modules you need for this sector are all the expensive ones.
- No offline working on a phone, when half the day happens outside the building.
- Shared logins, or no way to give an agency worker time-limited access.
- A vendor who cannot name a learning disability or supported living service of your size using the product today.
- A demo where you are not allowed to touch the keyboard.
Which systems will you be shown?
The UK care software market has a few dozen credible products, and a buyer searching today will usually be shown some combination of Log My Care, Birdie, Nourish, Person Centred Software, CareDocs, Care Control Systems, CarelineLive, everyLIFE PASS, CoolCare and Access Care Planning. Kiwi is in that market too. The list is not exhaustive and it is not a ranking.
What is fair to say about the market as a whole is that most of these products grew up serving older people's residential care or home care, which are much larger markets than learning disability and supported living, and several have added learning disability capability since. That is not a criticism. It is a reason to test rather than assume.
So do not take my word, or anybody's, for what any of them can do. Take the checklist above into a demo with each one you shortlist and make them show you the seven non-negotiables on a phone, with your staff driving, because the only evidence that counts is what you saw on screen. It is also worth checking which products are currently on the NHS England assured supplier list, since that list changes and assurance is a baseline rather than a verdict.
How to shortlist without wasting a month
Shortlist to three. More and the process stalls, fewer and you are choosing between a good demo and a bad one. Three filters do it in an afternoon. Can they name a learning disability or supported living service of roughly your size using the product today, and will they let you ring it without them on the call? Do they give you a price before a discovery call? Do they have structured restrictive practice recording and structured ABC, which you can establish in five minutes on the phone?
Then send all three the same brief: your service type, your numbers, your seven non-negotiables and your three demo scenarios. Tell them your staff will be driving. The way a vendor responds to that email tells you a lot before you have seen anything.
What questions should you ask on a demo?
Ask the questions vendors are not used to answering, because the rehearsed parts of a demo tell you nothing. These are the ones that have changed my mind about a product.
- Show me an ABC entry being written on a phone, then show me three months of them grouped by antecedent.
- Show me your restriction type list, and a count per person per month.
- Does a PRN psychotropic given for behaviour appear automatically in the restriction count?
- Show me a bank worker's first view of a person they have never met, and tell me how many taps the IDDSI level is from the home screen.
- Show me the easy-read care plan printing, and tell me what happens when the professional version changes.
- Show me a seizure recorded offline in a car park and syncing later.
- How does an agency worker get access for one shift, limited to their people, and how does it end?
- Where is our data hosted, is it in its own database, and who at your company can see it?
- What exactly do we get if we leave, in what format, how fast, and at what cost?
- Name a learning disability service of our size using this today, and let me ring them unaccompanied.
- What does support look like at 9pm on a Sunday, and who answers?
Three demo scenarios for a learning disability service
Send these in advance, and insist that your own staff use the keyboard. A vendor who refuses has told you something useful.
Scenario one: the escalation
Marcus becomes distressed at 5pm during a change of activity. A worker needs to find his PBS plan on a phone, use the named early warning strategies, record an ABC entry, record that a two-person hold was used for four minutes, record no injury, and flag it to the manager. The manager then needs to see it within the hour, add a review, and see Marcus's restriction count for the last three months.
Scenario two: the new bank worker
A bank worker arrives at 4pm for a shift supporting Jordan, who they have never met. In five minutes they need to know his IDDSI food and drink levels, his thickener recipe, how he says yes and no, what his signs mean, his epilepsy plan and his medicines due tonight. Then at 6pm they need to record a meal, including the texture actually served.
Scenario three: the review
Priya has a psychiatric review next week. The manager needs to produce, without help, three months of ABC data grouped by time of day, every PRN lorazepam with the reason and the effect, her weight trend, her restriction count and her goals progress, as one pack to take to the appointment.
How do the pricing models compare?
There are three common structures in this market: per person or per bed per month, per home or per service per month, and per user per month. They are not equivalent, and the headline number is designed to be hard to compare.
| Model | How it behaves | Best for | Watch out for |
|---|---|---|---|
| Per person or per bed | Cost rises with occupancy | Very small services and start-ups | Punishes growth; a supported living service with scattered flats can get expensive quickly |
| Per home or per service | Flat monthly fee whatever your numbers | Most services, and easiest to budget | Check how a service is defined, especially when one registration covers several houses |
| Per user | Cost rises with the number of logins | Services with very few staff | Punishes giving every worker their own login, which you must do anyway for attribution |
| Modular | A low base price with paid add-ons | Buyers who genuinely need only the base | The learning disability modules are often the paid ones, so the real price is three times the headline |
Whatever the model, ask for one number: the total cost over three years for your actual service, including setup, training, data migration, every module you would need, devices and any annual price rise clause. Then compare that number. We publish a flat price per service on our pricing page because that is the number I wanted to see when I was buying, but the discipline matters more than who you buy from.
Modules versus everything included
Modular pricing is not dishonest, but it changes what you should compare. A low base price with eMAR, HR, rota, finance and reporting charged separately can easily cost more than a higher flat price with everything in.
The trap in this sector is that the features you need most are rarely in the base package. Behaviour recording, restrictive practice, easy read and reporting are exactly the things sold as add-ons, so price the bundle you will use on day one plus the one you will want in year two. The second-order effect matters too: if reporting is an add-on, managers will not run reports, and if eMAR has a separate login, medicines drift away from the care record. That is the argument for a single learning disability care management platform over three good specialist tools.
Contracts, data and exit terms
Read the exit terms before the price. You are the data controller for your residents' records, and the practical question is what happens on the day you decide to leave.
Get written answers to these: where is the data hosted and is it in the UK; does our organisation have its own database; who at the vendor can see our records and is that logged; do you complete the Data Security and Protection Toolkit; is two-factor authentication available for managers; what exactly is in the export if we leave, in what format, within how many days and at what cost.
On contracts, a year is reasonable for a new customer and three is not. Ask about setup fees, whether training is included, the notice period, and whether prices can rise mid-term. A vendor confident in the product does not need to lock you in.
Data migration: what actually moves
Almost nothing migrates automatically, and anyone who tells you otherwise is selling. Care plans, risk assessments and PBS plans are almost always retyped, because they are structured differently in every system, and that retyping is an opportunity rather than a chore.
What usually imports: the list of people with basic demographics, staff records, and sometimes medicines lists. What usually does not: care plan content, historical daily notes in a usable form, documents with their metadata, and anything from paper. Plan for historical records to be archived as a readable export rather than loaded into the new system.
My advice, having done this twice: rewrite the care plans as you load them. Twelve plans per week, two people, four weeks, with a senior checking each one. You will find plans that have not been reviewed in two years, restrictions nobody remembers agreeing and goals that were written by somebody who left in 2019.
How do you run a trial properly?
Run the trial on one real house, with real people, real plans and real staff, for at least two full rota cycles, including nights, a weekend and at least one bank or agency worker. A trial that does not include a bad night tells you nothing.
Set it up properly rather than poking at it. Load every person in that house with their real plans, communication passports and medicines. Write real notes, record real incidents and review them, and produce one person's evidence pack at the end as though for a review.
Then score the system again on the checklist, with the same three people who scored the demo: the manager, a senior support worker and someone from nights. A system that scores lower after the trial than after the demo was oversold, and one that scores higher was undersold. The gap is usually the most useful number in the process.
Making the decision and the first ninety days
Put the three scored sheets side by side and let the people who will use the system decide, with the owner holding the commercial terms. If two are close, trial both on different houses.
Then plan the move before you sign. Pick a go-live date that is not in a school holiday and not while your deputy is away. Name one person who owns the migration. Decide the day paper stops and make it a single day rather than a drift. Train everyone including bank and agency, and record the competency. Audit daily for the first week, weekly for the first month, then monthly.
Implementations fail because nobody owned them, not because the software was wrong.
Does this apply to other kinds of service?
Yes, with different weightings. A mental health service needs risk formulations, capacity records and positive risk-taking. A residential home for older people needs falls, skin integrity and end of life. A nursing home needs wound care, clinical scoring and a deeper eMAR.
If your provider runs more than one type of service, and many do, check that one system genuinely covers all of them rather than forcing your learning disability houses into a residential template. Vendors offering care planning software for care homes and nursing home software alongside a learning disability product should be able to show you the same person-level record configured three different ways, not three different products with one logo.
The other cross-cutting requirement is evidence for inspection. Whatever the service type, you should be able to produce a person's full record for a date range, an incident trend, a training matrix and an audit history without ringing anyone. That is what care compliance software should mean in practice.
Common mistakes
- Buying on the demo, without your own staff touching the system.
- Scoring features instead of your seven non-negotiables.
- Accepting uploaded PDFs as PBS plans, passports and easy-read plans.
- Not asking whether restrictions can be counted.
- Comparing headline prices instead of three-year totals with modules included.
- Signing a three-year contract to get a discount.
- Assuming care plans will migrate.
- Running the trial in office hours only.
- Letting a funding deadline choose the system, or choosing a polished residential system and working around it for five years.
- Not reading the exit terms.
- Believing any claim of regulator approval, since none exists.
Final conclusion
Buying software for a learning disability or supported living service is not about finding the most features. It is about finding a system that treats behaviour, communication, restriction and the person's own life as first-class records rather than attachments. Hold the seven non-negotiables. Take the checklist into every demo and make them show you, on a phone, with your staff driving. Compare three-year totals rather than headline prices. Expect to retype your care plans and use it as a spring clean. Trial it on a real house with nights and bank staff, and score it again afterwards. Kiwi will happily be scored on that sheet and so should everyone else, and if you want to run the three scenarios above with your own team at the keyboard, book a demo and bring them.
Frequently asked
What should a learning disability care system do that a residential care system does not?
Seven things: structured positive behaviour support plans, ABC charts that can be grouped and analysed, a restrictive practice register that produces a count per person per month, communication passports on the person's profile, easy-read care plans and health action plans, epilepsy and seizure records with a frequency chart, and health flags such as the IDDSI level visible before anything else.
Which care management systems will a UK buyer be shown?
A buyer searching today will usually be shown some combination of Log My Care, Birdie, Nourish, Person Centred Software, CareDocs, Care Control Systems, CarelineLive, everyLIFE PASS, CoolCare, Access Care Planning and Kiwi. That list is neither exhaustive nor a ranking, and most of these products grew up serving older people's residential care or home care, so test each one against the learning disability checklist yourself.
Is per bed or per home pricing better for supported living?
Per home or per service is usually easier to budget and fairer, because per bed pricing punishes growth and gets expensive across scattered flats. Per user pricing punishes giving every worker their own login, which you should be doing for attribution. Whatever the model, compare the three-year total including setup, modules, training and devices.
How long should a care software trial run?
At least two full rota cycles on one real house, with real people, real plans and real staff, including nights, a weekend and at least one bank or agency worker. Score the system again at the end using the same checklist and the same three people who scored the demo.
Does care plan data migrate between systems?
Rarely. Person lists, basic demographics and staff records usually import, and sometimes medicines. Care plans, risk assessments, PBS plans and historical notes almost always have to be retyped or archived as a readable export. Plan for the rewrite and use it as a review of every plan.
Can software be approved or endorsed by the regulator?
No. There is no regulator approval or endorsement for care software, and any vendor who claims it is misleading you. The honest claim is that a system helps you produce the evidence inspectors look for. Judge that by asking it to answer an inspector's question in the demo.
What should you ask about data and exit terms?
Where the data is hosted, whether your organisation has its own database, who at the vendor can see records and whether that is logged, whether they complete the Data Security and Protection Toolkit, whether managers get two-factor authentication, exactly what is in the export if you leave, in what format, within how many days and at what cost.
Should a learning disability service buy a specialist system or a general one?
Either can work, but the test is the same: does it hold PBS plans, ABC charts, restrictions, communication passports and easy-read plans as structured records rather than attachments. A general system that does those things well is fine. A specialist badge on a residential data model is not.
Sources
- NHS England: Digital Social Care Records programme and assured supplier list
- NHS England: Data Security and Protection Toolkit
- Care Quality Commission: Right support, right care, right culture
- Care Quality Commission: single assessment framework and quality statements
- NICE guideline NG11: Challenging behaviour and learning disabilities, prevention and interventions
- Restraint Reduction Network: Training Standards
- Digital Care Hub: guidance on choosing and implementing care technology
- Information Commissioner's Office: UK GDPR guidance for health and social care
