Coming Home Action Plan 2026

1. Introduction

The vision set out in the Coming Home Implementation Report in 2022 was that “the human rights of everybody with complex care needs are respected and protected and they are empowered to live their lives, the same as everyone else”. The importance of embedding a human rights based approach was further emphasised in the Scottish Human Rights Commission’s report ‘Tick Tock… A human rights assessment of progress from institutionalisation to independent living in Scotland’. Human rights are therefore an underpinning focus of Coming Home, with a recognition that currently the human rights of some people with learning disabilities and complex support needs are not being upheld. Freedom to live in your local community, with choice and control over your own life is a human right, and this is essential for people with learning disabilities, regardless of the complexity of their support needs. It is not acceptable for people to be living in institutional settings or to be delayed in hospital for long periods of time purely on the basis that they have learning disabilities and complex support needs.^[1]

The mission statement from the Coming Home Implementation Report stated that “we want and need to see real change with out-of-area placements and inappropriate hospital stays greatly reduced, to the point that out-of-area placements are only made through individual or family choices and people are only in hospital for as long as they require assessment and treatment”. There has been significant work done to deliver the first phase of the Coming Home agenda, and this is outlined below. However, despite all of the work to date, and the time and commitment from many in the sector, it is clear to all involved that the vision and mission have not yet been achieved.

Recognising that more focused action was required to continue to drive progress towards the Coming Home vision and mission, a Coming Home Short Life Working Group was established in July 2025. The purpose of this group was to develop a focused action plan to address the outstanding recommendations in the Coming Home Implementation Report, and outline priorities for future implementation. This report and the action plan within it will provide an update on progress to date, address the outstanding recommendations from the Coming Home Implementation Report, and identify further actions required to achieve the Coming Home vision and mission.

This work will need commitment from all stakeholders. Effective planning and delivery can only take place locally, but it is important that this is underpinned by a national approach and is grounded in the genuine desire that exists to ensure people with learning disabilities and complex needs are provided with real choice and control over their lives, and that their human rights are upheld.

Dr Anne MacDonald

Chair of Coming Home Action Plan Short Life Working Group and Author of the Coming Home Report

Coming Home….. Living an Ordinary Life

Jonathan is a funny, witty man. He loves Irn-Bru, cooking, going to get his daily newspaper and working out at the gym. He has a part-time job at a local animal charity and loves going for a drive in the car. He lives in his own home, supported by a team who he knows and trusts. His family are incredibly important to him, and he sees them often. All in all, Jonathan lives a very ordinary life.

However, life wasn’t always like this for Jonathan. Still only in his 30s, he has spent most of his life in secure, institutional settings, several hundreds of miles from his home and family and from the places and people he loves most.

For almost twenty years Jonathan’s day-to-day life was heavily restricted, and he was often subject to 3:1 support and a range of treatments including medication and electroconvulsive therapy (ECT). With a diagnosis of schizoaffective disorder, autism, and a mild learning disability, he had experienced frequent violent and aggressive incidents, received as required medication, was physically restrained and often distressed.

Transitioning to something very different, where Jonathan could make choices, enjoy his community, and recover from the trauma of his experiences, required an approach which acknowledged these challenges and embraced his uniqueness. The service provider worked closely with the Health and Social Care Partnership senior leaders to plan, coordinate and establish a true collaboration and shared commitment to develop and support Jonathan’s service and his move to a new home.

The service provider’s approach started with surrounding Jonathan with people who were committed to getting to know him, rather than the reputation he’d been given. His new team travelled to the hospital where he lived, nurturing trust and important relationships before his move, and working alongside his hospital team, over a planned four-month period, to ensure they had the knowledge they needed to support him well.

The service provider also invested in developing his team’s skills. Using Positive Behaviour Support principles, Jonathan’s team adopted a consistent approach which focuses on de-escalation in the times when Jonathan finds a situation difficult. The team has a range of strategies which support Jonanthan positively, creatively, and with compassion and dignity.

Building trusting relationships between Jonathan’s new team, his family and professional partners was vital too. After such a long time in a secure health setting, away from his family and local community, some concerns persisted around whether community-based provision could work for Jonathan.

Everyone - Jonathan, his team, his family and commissioning partners, needed to be involved in his move. They all had a part to play in the transition and the long-term success of his new life. Jonathan’s care team understood and respected this. They knew that as well as supporting Jonathan to build a life away from an institutional setting, part of their role was to enable the people in Jonathan’s life to reconnect with him and each other, especially as there had been a considerable physical distance between them for such a long time.

They achieved this by listening, being flexible and responsive, and delivering on their promises. They were committed to ensuring that Jonathan’s needs, wants, likes and dislikes were at the very heart of all their efforts.

The place he would call home was important too. It needed to be somewhere, not just where he felt safe, but which also kept him safe. He needed to know he could be himself there and not have to worry about being moved if things got difficult for him.

Jonathan now has control over his home and life. His team learned from the practices that had worked for him in hospital but, crucially, it’s not simply his old life transposed to a community setting. Jonathan has his own tenancy in a modern purpose-built development of six flats, as part of a wider core and cluster service. His home has its own front door, a private, easily accessed garden space, and is full of things that matter to Jonathan, which he has chosen, including the colour scheme.

Because Jonathan feels safe in his own home, and his team know him so well, he enjoys the ordinariness of everyday life: the cooking, the cleaning, giving his team marks out of ten, particularly on the quality of their macaroni cheese!

Since moving closer to home almost 4 years ago, Jonathan has discovered new things and achieved outcomes which everyone had assumed would be out of his reach. It’s a great life, which costs a quarter of what it did for him to live in an institutional setting.

“Our son has the ordinary life we always wanted him to have, but he has extraordinary support – it really wasn’t that difficult after all!” (Jonathan’s Dad)

*Jonathan’s name has been changed to protect his privacy

Underpinning Principles

The Coming Home Implementation Report (2022) was based on the foundation that people with learning disabilities have the same human rights and should have the same opportunities as anyone else to live satisfying and valued lives and to be treated with the same dignity and respect. This is irrespective of any complex care need or behaviour that is perceived as challenging to others, either present or historic.

Everyone living in Scotland has a right to a home within their local community, to be able to develop and maintain relationships, and to get the support they need to live a healthy, safe and fulfilling life. Being placed in an inappropriate out-of-area placement, in a poor-quality institutional setting, or being delayed from discharge from hospital when there is no clinical reason to be there, is an excessive restriction on liberty and the right to a home life.

The action plan will build on that foundation by taking a human rights-based approach and underpinning actions within the PANEL principles:

Participation: people should be involved in decisions that affect their rights

Accountability: there should be monitoring of how people’s rights are being affected, as well as remedies when things go wrong

Non-Discrimination and Equality: all forms of discrimination must be prohibited, prevented and eliminated. People who face the biggest barriers to realising their rights should be prioritised

Empowerment: everyone should understand their rights and be fully supported to take part in developing policy and practices which affect their lives

Legality: approaches should be grounded in the legal rights that are set out in domestic and international laws

Working Principles

• Ensure individuals and their families are supported to participate meaningfully, safely and in respect of their rights in the implementation and review of the plan
• Work collaboratively with all relevant organisations and professionals involved in supporting the implementation of this plan
• Regular monitoring, reviewing and reporting of the implementation of the action plan and provision of safe and confidential feedback mechanisms
• Work to ensure everyone has equal access to services and supports and promote inclusivity and fairness in practice