scholarly journals On self-neglect and safeguarding adult reviews: diminishing returns or adding value?

2017 ◽  
Vol 19 (2) ◽  
pp. 53-66 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Annual Reports ◽  
National Database ◽  
Service Improvement ◽  
Policy And Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core

Purpose The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case reviews (SCRs) and safeguarding adult reviews (SARs), and accompanying thematic analysis; second, to respond to the critique in the Wood Report of SCRs commissioned by Local Safeguarding Children Boards (LSCBs) by exploring the degree to which the reviews scrutinised here can transform and improve the quality of adult safeguarding practice. Design/methodology/approach Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs) and from contacts with SAB independent chairs and business managers. Thematic analysis is updated using the four domains employed previously. The findings are then further used to respond to the critique in the Wood Report of SCRs commissioned by LSCBs, with implications discussed for Safeguarding Adult Boards. Findings Thematic analysis within and recommendations from reviews have tended to focus on the micro context, namely, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis enables an understanding of local geography. However, there are other wider systems that impact on and influence this work. If review findings and recommendations are to fully answer the question “why”, systemic analysis should appreciate the influence of national geography. Review findings and recommendations may also be used to contest the critique of reviews, namely, that they fail to engage practitioners, are insufficiently systemic and of variable quality, and generate repetitive findings from which lessons are not learned. Research limitations/implications There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here against the strands in the critique of SCRs enables conclusions to be reached about their potential to transform adult safeguarding policy and practice. Practical implications Answering the question “why” is a significant challenge for SARs. Different approaches have been recommended, some rooted in systems theory. The critique of SCRs challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice. Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of conducting SARs by using the analysis of themes and recommendations within this data set to evaluate the critique that reviews are insufficiently systemic, fail to engage those involved in reviewed cases and in their repetitive conclusions demonstrate that lessons are not being learned.

scholarly journals Learning from safeguarding adult reviews on self-neglect: addressing the challenge of change

2018 ◽  
Vol 20 (2) ◽  
pp. 78-92 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Action Plan ◽  
Evidence Base ◽  
Practice Change ◽  
National Database ◽  
Policy And Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core

Purpose The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis, and to address the challenge of change, exploring the necessary components beyond an action plan to ensure that findings and recommendations are embedded in policy and practice. Design/methodology/approach Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. The repetitive nature of the findings prompts questions about how to embed policy and practice change, to ensure impactful use of learning from SARs. A framework for taking forward an action plan derived from an SAR findings and recommendations is presented. Findings Familiar, even repetitive findings emerge once again from the thematic analysis. This level of analysis enables an understanding of both local geography and the national legal, policy and financial climate within which it sits. Such learning is valuable in itself, contributing to the evidence base of what good practice with adults who self-neglect looks like. However, to avoid the accusation that lessons are not learned, something more than a straightforward action plan to implement the recommendations is necessary. A framework is conceptualised for a strategic and longer-term approach to embedding policy and practice change. Research limitations/implications There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here enables conclusions to be reached about issues to address locally and nationally to transform adult safeguarding policy and practice. Practical implications Answering the question “how to create sustainable change” is a significant challenge for SARs. A framework is presented here, drawn from research on change management and learning from the review process itself. The critique of serious case reviews challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice. Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of following up SARs by using the findings and recommendations systematically within a framework designed to embed change in policy and practice.

scholarly journals Self-neglect and safeguarding adult reviews: towards a model of understanding facilitators and barriers to best practice

2019 ◽  
Vol 21 (4) ◽  
pp. 219-234 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Good Practice ◽  
National Database ◽  
Evidence Based ◽  
Effective Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core ◽  
Evidence Based Model

Purpose The purpose of this paper is twofold: first, to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis; second, to draw together the learning available from this data set of reviews to propose a model of good practice that can be used as the basis for subsequent SARs. Design/methodology/approach Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. A sufficient number of reviews have been performed from which to construct an evidence-based model of good practice. A framework is presented with the proposition that this can be used as a proportional methodology for further SARs where self-neglect is in focus. Findings Familiar findings emerge from the thematic analysis. This level of analysis, constructed over time and across reviews, enables a framework to be developed that pulls together the findings into a model of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners involved in such cases. This framework can then be used as an evidence-based model with which to review new cases where SARs are commissioned. Research limitations/implications The national database of reviews commissioned by SABs is incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless enables conclusions to be proposed about the components of effective practice, and effective policy and organisational arrangements for practice. Future reviews can then explore what enables such effective to be achieved and what barriers obstruct the realisation of effective practice. Practical implications Answering the question “why” is a significant challenge for SARs. A framework is presented here, drawn from research on SARs featuring self-neglect, that enables those involved in reviews to explore the enablers and barriers with respect to an evidence-based model of effective practice. The framework introduces explicitly research and review evidence into the review process. Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also proposes a new approach to SARs by using the findings and recommendations systematically within a framework designed to answer “why” questions – what promotes and what obstructs effective practice.

On (not) learning from self-neglect safeguarding adult reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Good Practice ◽  
Evidence Base ◽  
National Database ◽  
Effective Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core ◽  
National Analysis

Purpose The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. It also explores whether lessons are being learned from the findings and recommendations of an increasing number of reviews on self-neglect cases. Design/methodology/approach Further published reviews are added to the core data set, mainly drawn from the websites of safeguarding adults boards (SABs). Thematic analysis is updated using the domains used previously. The domains and the thematic analysis are grounded in the evidence-based model of good practice, reported in this journal previously. Findings Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness and alcohol misuse are prominent. Some SABs are having to return to further cases of self-neglect to review, inviting scrutiny of what is (not) being learned from earlier findings and recommendations. Research limitations/implications The national database of reviews commissioned by SABs remains incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. National Health Service Digital annual data sets do not enable the identification of reviews by types of abuse and neglect. However, the first national analysis of SARs has found self-neglect to be the most prominent type of abuse and/or neglect reviewed. Drawing together the findings builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Practical implications Answering the question “why” remains a significant challenge for SARs. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question. Greater scrutiny is needed of the impact of the national legal, policy and financial context within which adult safeguarding is situated. Originality/value The paper extends the thematic analysis of available reviews that focus on study with adults who self-neglect, further reinforcing the evidence base for practice. Propositions are explored, concerned with whether learning is being maximised from the process of case review.

scholarly journals Safeguarding adult reviews: informing and enriching policy and practice on self-neglect

2020 ◽  
Vol 22 (4) ◽  
pp. 199-215 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Good Practice ◽  
Evidence Base ◽  
National Database ◽  
Annual Data ◽  
Effective Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core

Purpose The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to which SARs draw upon available research and learning from other completed reviews. Design/methodology/approach Further published reviews are added to the core data set, mainly drawn from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains used previously. The four domains and the thematic analysis are rounded in the evidence-based model of good practice, reported in this journal previously. Multiple exclusion homelessness and alcohol misuse are prominent in this sample of reviews. Findings Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness emerges as a subset within this sample, demonstrating that SABs are engaging in reviews of people who die on the streets or in temporary accommodation. Research limitations/implications The national database of reviews commissioned by SABs remains incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. NHS Digital annual data sets do not enable identification of reviews by types of abuse and neglect. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Practical implications Answering the question “why” remains a significant challenge for safeguarding adult reviews. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question, drawing attention where appropriate to policies being pursued by the central government that undermine any initiative to end rough sleeping. Originality/value This paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence-base for practice. The evidence-base also supports practice with individuals who experience multiple exclusion homelessness. Policymakers and practitioners have an approach to follow in this complex, challenging and demanding area of practice.

scholarly journals Towards explanations for the findings of serious case reviews: understanding what happens in self-neglect work

2016 ◽  
Vol 18 (3) ◽  
pp. 131-148 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Evidence Base ◽  
Annual Reports ◽  
National Database ◽  
Service Improvement ◽  
Content Type ◽  
Personal Impact ◽  
Systemic Analysis ◽  
Systemic Theory ◽  
Level Of Analysis

Purpose – The purpose of this paper is to draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of scrutiny, in order to understand how complex contexts impact on self-neglect work. It also updates the dataset of self-neglect SCRs and accompanying thematic analysis. Design/methodology/approach – Psychodynamic and systemic ideas are applied to the content of published SCRs in order to understand how different contexts – societal, legal, organisational, professional and personal – impact on and are influenced by work with adults who self-neglect. Further published reviews are added to the core dataset, with thematic analysis updated using four domains. Findings – Thematic analysis within and recommendations from SCRs have focused on the micro context, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis also commonly extends to how organisations have worked together and how Local Safeguarding Adults Board (LSABs) have supported and scrutinised their collaboration. This level of analysis enables an understanding of local geography. However, there are wider systems that impact on and influence this work, especially law and the societal context. If review findings and recommendations are to fully answer the question why, systemic analysis should be extended to appreciate the influence of national geography. Research limitations/implications – There is still no national database of reviews commissioned by LSABs so the dataset reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in LSAB annual reports. This makes learning for service improvement challenging. Practical implications – Answering the question why is a significant challenge for safeguarding adults reviews (SARs). Different approaches have been recommended, some rooted in systems theory. The theoretical formulations here extend the lens of systemic analysis on the different contexts that influence how practitioners work with adults who self-neglect and simultaneously are shaped by that work. This adds to the practice, management and organisational evidence base for working with adults who self-neglect but also shines the analytic lens on legal and policy mandates. Originality/value – The paper extends the use of systemic theory for understanding and learning from practice with adults who self-neglect and additionally offers psychodynamic formulations to appreciate what happens within and between practitioners and their organisations. The paper therefore contributes new perspectives to the methodology for conducting SARs. It also extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice.

Shareholder rights, telecommunications and director attendance around the world

2019 ◽  
Vol 32 (2) ◽  
pp. 221-235
Author(s):  
John Nowland
Keyword(s):  
Emerging Markets ◽  
Annual Reports ◽  
Shareholder Rights ◽  
Data Set ◽  
Content Type ◽  
Telecommunications Infrastructure ◽  
Corporate Decisions ◽  
The World ◽  
Director Liability

Purpose This study aims to document the variation in director attendance rates around the world and investigate the influence of cross-country differences in law and infrastructure on director attendance practices. Design/methodology/approach Director attendance data are hand-collected from company annual reports and are related to differences in shareholder rights, director liability and transportation and telecommunications infrastructure across countries. Findings Using a hand-collected data set of 4,344 directorships from 33 countries, the results indicate that director attendance is significantly lower in emerging markets and is positively related to the extent of shareholder rights and the quality of telecommunications infrastructure. Originality/value For policymakers and shareholders, the findings of this study indicate that there is substantial variation in director attendance practices around the world. Across all markets, director attendance is higher when the telecommunications infrastructure better enables the potential for virtual attendance, thereby allowing directors to participate in meetings when they cannot be physically present. In emerging markets, director attendance is also higher where there is a stronger emphasis on shareholder rights, highlighting an avenue for improved director attendance by strengthening shareholder involvement in major corporate decisions.

Cost effectiveness in palliative care setting

2018 ◽  
Vol 21 (2) ◽  
pp. 62-71
Author(s):  
Henry O’Lawrence ◽  
Rohan Chowlkar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Hospice Care ◽  
Home Health ◽  
Data Set ◽  
Content Type ◽  
Care Services ◽  
The Cost

Purpose The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old. Design/methodology/approach Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level. Findings The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex. Research limitations/implications The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same. Practical implications While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing. Social implications With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting. Originality/value The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.

Technical services and user service improvement

2006 ◽  
Vol 27 (6/7) ◽  
pp. 505-514 ◽  
Author(s):  
Jie Huang ◽  
Katherine Wong
Keyword(s):  
Point Of View ◽  
Service Improvement ◽  
Key Factors ◽  
Content Type ◽  
University Of Oklahoma ◽  
Online Catalog ◽  
Efficient Processing ◽  
The University ◽  
Technical Services

PurposeFrom the cataloging librarians' point of view, this paper aims to present how technical services, especially the cataloging department, can play important roles in the improvement of user services.Design/methodology/approachThe paper examines the practices of the University of Oklahoma Libraries.FindingsThe paper identifies several aspects in which technical services can enhance the quality of user services, especially in the cataloging department. A library's online catalog becomes the first point of access to the library's information resources. Its quality can be improved and enriched in many ways to raise users’ satisfaction. Aside from the improvement in technical aspects, efforts should also be made to promote collaboration between technical and public services so as to ensure efficient processing of materials and to meet the needs of library users.Originality/valueThe value of the paper is in showing that the quality of an online catalog and the cooperation between public and technical services are two of the key factors in achieving high quality of user services.

Who is a “Senior”? Looking for a definition in the healthcare system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Monica Consolandi
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Design Methodology ◽  
Social Role ◽  
Content Type ◽  
The Core ◽  
Starting Point

Purpose Seniors are nowadays at the core of important reflections to understand both how to ensure them a proper quality of life and better recognize their social role, providing them services and proper health care to value them as persons and resources. This paper aims to find a through definition about who is a senior, in the author’s opinion the starting point to help them flourishing. Design/methodology/approach As an example of definitions, an online dictionary and two geriatric text-books are quoted, highlighting qualities and rights referred to seniors especially in the delicate context of the health-care system. Findings The lack of a commonly shared perspective on this delicate kind of patient entails the difficulty to reach a coherent and satisfying definition about who a senior is. Originality/value The lack of a commonly shared definition leads to inevitable misunderstandings and could explain the arduousness of considering seniors in all their aspects. Further investigations are suggested.

Commentary on “The experiences of older carers of people with learning disabilities: ‘I just carry on with it’”

2021 ◽  
Vol 26 (1) ◽  
pp. 58-62
Author(s):  
Jan Sunman
Keyword(s):  
Quality Of Life ◽  
Learning Disabilities ◽  
Lived Experiences ◽  
Design Methodology ◽  
Policy And Practice ◽  
Content Type ◽  
The Voice

Purpose The purpose of this paper is to provide a commentary on the article by Rachel Forrester-Jones on the experiences of older carers of people with learning disabilities. Design/methodology/approach The commentary reflects on the themes identified in the original article, comparing its findings to the lived experiences of those taking part in older carers’ projects in Oxfordshire, England. Findings Similar broad themes were identified in both samples. Given these findings, the extent to which matters have changed, since the Valuing People work on older carers is considered. Originality/value The paper discusses policy and practice implications to improve the quality of life of older carers and their families and explores how the voice of older carers can be strengthened to enable them to shape practice and policy.

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