Hierarchy of impairment: the impact

2012 ◽  
Vol 5 (2) ◽  
pp. 70-71 ◽  
Author(s):  
Angela Smith

PurposeThis paper aims to focus on the experiences and observations of a black disabled woman in the UK.Design/methodology/approachThe paper is a personal commentary from a black disabled woman who uses health and social care services in the UK. It details the author's disability and some recent barriers that she has faced in using services.FindingsThe author gives some examples of her recent experiences in relation to employment, independent living, healthcare providers and getting her wheelchair repaired.Originality/valueThe paper offers the unique perspective of a service user on UK health and social care services.

2014 ◽  
Vol 22 (2) ◽  
pp. 62-70 ◽  
Author(s):  
Ailsa Cameron ◽  
Lisa Bostock ◽  
Rachel Lart

Purpose – The purpose of this paper is to provide an update to a review of the joint working literature in the field of health and social care for adults, with particular emphasis given to the experiences of users and carers. Design/methodology/approach – The aims of the literature review remained largely the same as those of the original, they were to identify: models of joint working, evidence of effectiveness and cost-effectiveness and the factors promoting or hindering the models. However, to reflect the growing interest in the experiences of users and carers a fourth aim was added to map these experiences. Given their prominence in terms of policy debates about integration, the review focused on jointly organised services for older people and people with mental health problems in the UK only. Findings – The review demonstrates tentative signs that some initiatives designed to join-up or integrate services can deliver outcomes desired by government. Importantly some studies that report the experiences of users of services and carers suggest that they perceive benefits from efforts to join-up or integrate services. However it is our contention that the evidence is less than compelling and does not justify the faith invested in the strategy by current or previous governments. Originality/value – The study updates our knowledge of the impact of joint working in the field of health and social care for adults. Importantly the paper highlights what is known about the experiences of users and carers of joint/integrated services.


2021 ◽  
Vol 26 (3) ◽  
pp. 174-179
Author(s):  
Samantha Flynn ◽  
Chris Hatton

Purpose This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study.


2017 ◽  
Vol 20 (2) ◽  
pp. 60-70 ◽  
Author(s):  
Randall Smith ◽  
Robin Darton ◽  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Liz Lloyd ◽  
...  

Purpose The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing. Design/methodology/approach The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings. Findings The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings. Originality/value Addressing the implementation of OBC in adult social care in England in the context of extra care housing.


2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.


2014 ◽  
Vol 16 (6) ◽  
pp. 411-420
Author(s):  
Tim Spencer-Lane

Purpose – The purpose of this paper is to summarise the Law Commissions’ final report and draft Bill on the regulation of health and social care professionals. Design/methodology/approach – To summarise the key recommendations that are relevant to adult safeguarding. Findings – The final report concludes that new legislation is needed to govern the UK regulators of health and social care professionals. Originality/value – The paper sets out the recommended new legal framework.


2020 ◽  
Vol 28 (2) ◽  
pp. 53-63
Author(s):  
Charlotte Klinga ◽  
Johan Hansson ◽  
Henna Hasson ◽  
Magna Andreen Sachs ◽  
Carolina Wannheden

PurposeThe aim of this study was to identify key components of integrated mental health and social care services that contribute to value for service users in Sweden.Design/methodology/approachAn explorative research study design was used, based on data from four group interviews conducted in June and August 2017 with service user representatives.FindingsThe analysis resulted in eight subcategories reflecting components that were reported to contribute to value for service users. These subcategories were grouped into three main categories: (1) professionals who see and support the whole person, (2) organizational commitment to holistic care and (3) support for equal opportunities and active participation in society.Research limitations/implicationsThe findings are primarily transferable to integrated mental health and social care services, as they emphasize key components that contribute to value for service users in these specific settings.Practical implicationsThe complexity of integrated mental health and social care services requires coordination across the individual and organizational levels as well as ongoing dialogue and partnerships between service users, service user associations and health and social care organizations. In this integration, it is important that service users and service user associations not only are invited but also keen to participate in the design of care and support efforts.Originality/valueService User Associations (SUAs) can act as a bridge between county and municipal services through their participation in the development of local activities; at the regional and national levels, SUAs can help achieve more equitable integrated services. It is important that SUAs are not only invited but encouraged to actively participate in the design of such care and support efforts.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053185
Author(s):  
Megan Armstrong ◽  
Caroline Shulman ◽  
Briony Hudson ◽  
Patrick Stone ◽  
Nigel Hewett

IntroductionThe number of people living in homeless hostels in the UK has steadily increased over the past decade. Despite people experiencing homelessness often having considerable health problems and a range of complex needs frequently in association with addictions, the experiences of hostel staff and residents especially in relation to accessing health and social care support have seldom been explored. The aim of this paper is to identify the barriers and facilitators to accessing health and social care services for people living in homeless hostels.DesignExploratory qualitative baseline data were collected as part of an intervention to facilitate palliative care in-reach into hostels.Setting/participantsInterviews were conducted with 33 participants; 18 homeless hostel managers/support staff and 15 people experiencing homelessness, from six homeless hostels in London and Kent.ResultsThree themes were identified (1) internal and external service barriers to health and social care access due to stigma, lack of communication and information sharing from services and assumptions around capacity and the role of the hostel, (2) the impact of lack of health and social care support on hostel staff leading to burnout, staff going beyond their job role and continuous support given to residents, (3) potential facilitators to health and social care access such in-reach and support from those who understand this population and hostel staff training.DiscussionResidents have multiple complex needs yet both hostel staff and residents face stigma and barriers accessing support from external services. Positive relationships were described between hostel residents and staff, which can be an essential step in engaging with other services. People experiencing homelessness urgently need better access to person-centred, trauma-informed support ideally via in-reach from people who understand the needs of the population.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jill Manthorpe ◽  
Jo Moriarty

Purpose The COVID-19 pandemic has shone a light on long-standing, structural race inequality in Britain. This paper aims to review historic patterns of ethnic diversity among the workforce employed in services for older people to present some of the lessons that can be learned from the pandemic. Design/methodology/approach A historical overview was undertaken of research about ethnic diversity in the social care workforce. Findings Too often, the ethnic diversity of the social care workforce has been taken as evidence that structural racial inequalities do not exist. Early evidence about the impact of coronavirus on workers from black and minority ethnic groups has led to initiatives aimed at reducing risk among social care employers in the independent sector and in local government. This offers a blueprint for further initiatives aimed at reducing ethnic inequalities and promoting ethnic diversity among the workforce supporting older people. Research limitations/implications The increasing ethnic diversity of the older population and the UK labour force highlights the importance of efforts to address what is effective in reducing ethnic inequalities and what works in improving ethnic diversity within the social care workforce and among those using social care services for older people. Originality/value The ethnic makeup of the workforce reflects a complex reality based on multiple factors, including historical patterns of migration and gender and ethnic inequalities in the UK labour market.


2015 ◽  
Vol 20 (4) ◽  
pp. 223-227
Author(s):  
Martin Stevens

Purpose – The purpose of this paper is to explore some of the themes identified by Wark et al.’s paper and to highlight commonalities and differences between the Australian and the UK social and health care regimes. It also points to evidence about other implications for policy and practice of the increasing numbers of people growing older who have learning disabilities. Design/methodology/approach – The commentary analyses some policy and practice documents and identifies a range of other research and commentary on this topic. Findings – Wark et al. have identified areas of importance for supporting older people with learning disabilities, particularly access to suitable and acceptable services and the importance of sufficient support worker time. They also identify gaps in the research on people’s needs and service responses. The commentary also highlights other factors for consideration in work with this group of people, particularly the implementation of personalisation policies in social care and integration between health and social care services. Research limitations/implications – There is a need for further research into developing policy and practice for health and social care for older people with learning disabilities. Some of the evidence supports the case for specialist involvement, particularly by nursing professionals. Originality/value – The paper and this commentary highlight the challenges associated with the increasing number of older people with learning disabilities in contemporary debates about the role of the state and professional specialists.


Author(s):  
Claire Ritchie

Purpose – The purpose of this paper is to inspire services to create Psychologically Informed Environments (PIEs) to support people experiencing homelessness, complex trauma and multiple exclusion. Design/methodology/approach – It outlines key elements of PIEs and how these have been implemented at the Waterloo Project; a 19 bed hostel and integrated health and social care partnership in Lambeth. It considers the importance of meeting individuals emotional and psychological needs to support them out of homelessness. Findings – The service review found a reliable reduction in residents’ mental distress and improved health and wellbeing. Repeat homelessness, anti-social and self-harming behaviour decreased whilst engagement with services, self-care and esteem increased. There are early indications of cost benefits to health and social care services. Staff reported professional development and an increase in their sense of personal accomplishment. Originality/value – The paper aims to share learning, good practice and the outcomes of a psychologically informed approach to working with individuals who have not had their needs met by existing services. It illustrates the actual and potential social and economic impact and value on both individuals and public services.


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