Meeting the private sector housing condition and adaptation needs of older people: responses from London’s environmental health and allied services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jill Stewart
Keyword(s):  
Private Sector ◽  
Older People ◽  
Environmental Health ◽  
Online Survey ◽  
Relevant Information ◽  
Housing Condition ◽  
Front Line ◽  
Care Needs ◽  
Content Type ◽  
Health And Social Care

Purpose This study aims to explore the environmental health role in meeting the housing condition, adaptation and associated needs of older people living in private sector housing in London, including those living with and at risk of dementia. Design/methodology/approach A multi-method approach was adopted. First, relevant public-facing websites in London were scrutinised. Second, a Qualtrics online survey was designed and circulated to capture relevant information around relevant services offered. Third, seven face-to-face interviews were conducted with front-line practitioners involved in providing housing services to private sector owners and tenants. These were transcribed verbatim and analysed using NVivo software before categorising into themes arising. Findings An erratic picture emerged around the meaning of “older people” and the services offered. A mixture of organisational arrangements and types of assistance available was reported, with different ways of access and referral to services, with a range of discretionary grants offered including for dementia. Some local authorities offered minimal specialist services, with others providing highly integrated and client-led, flexible interventions to meet a range of needs. Limited inclusion of research, evidence and evaluation of the effectiveness of interventions was reported overall, although client feedback was noted as good where services were provided. Originality/value There is very little published around environmental health work in supporting older people living in London and their housing, health and social care needs. This paper captures a snapshot of current and proposed services offered across London for owner-occupiers and private sector tenants, as a basis for further research for evidence-based, effective front-line services going forward.

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.

Third sector partnerships for older people: insights from live at home schemes in the UK

2018 ◽  
Vol 22 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Olumide Adisa
Keyword(s):  
Older People ◽  
Online Survey ◽  
Third Sector ◽  
Later Life ◽  
Evidence Base ◽  
Content Type ◽  
Health And Social Care ◽  
Wide Range ◽  
The Uk ◽  
At Home

Purpose While there is a rich literature on the role of partnerships between statutory agencies and third sector organisations for public service delivery in health and social care, the evidence base on, partnerships between community-based groups and charities for older people in the UK is lacking. Drawing on quantitative and qualitative data, the purpose of this paper is to examines partnerships within 46 live at home (LAH) schemes. These schemes were specifically designed to tackle isolation and promote independence and wellbeing by providing a wide range of activities, based on the needs of its members. Design/methodology/approach This study is based on an online survey of 46 LAH schemes and face-to-face interviews with seven scheme managers to capture data on the various partnership initiatives within the LAH schemes. Findings Third sector partnerships for older people varied by type – formal, semi-formal and informal. In addition, third sector partnership working fosters the achievement of clear outcomes for older people who LAH and could be a mechanism for building social capital in communities. The study also identified barriers to developing third sector partnerships within this context. Mapping existing partnerships in LAH schemes were considered to be useful in engaging with partners. LAH scheme managers were better able to identify partnerships that could be deepened and broadened, depending on the desired outcomes. Originality/value To the author’s knowledge, there are few studies on third sector partnership working in LAH schemes for older people. According to Age UK, there are 1.2m chronically lonely older people in the UK. Over half of all people aged 75 and over live alone (ONS, 2015). Loneliness and social isolation in later life are considered to be two of the largest health concerns we face. Scaling up these third sector partnerships may offer a credible way to shore up support for older people who live alone or want to live at home.

scholarly journals A qualitative study of older people with minimal care needs experiences of their admission to a nursing home with Registered Nurse care

2015 ◽  
Vol 16 (2) ◽  
pp. 94-105 ◽  
Author(s):  
Alice K. Stevens ◽  
Helen Raphael ◽  
Sue M. Green
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Older People ◽  
Registered Nurse ◽  
Care Home ◽  
Care Homes ◽  
Care Needs ◽  
Content Type ◽  
Health And Social Care

Purpose – Residential care for older people in the UK includes care homes with and without 24-hour Registered Nurse (RN) care. Reduced autonomy and personal wealth can result when people assessed as having minimal care needs, enter and reside in care homes with RN care. The purpose of this paper is to explore the experiences of older people with minimal care needs admission to care homes with RN care. Design/methodology/approach – A qualitative study using a grounded theory method was undertaken. In total, 12 care home with RN care residents assessed as not requiring nursing care were interviewed. Initial sampling was purposive and progressed to theoretical. Interviews were analysed using the grounded theory analysis method of constant comparison and theory development. Findings – Two main categories emerged: “choosing the path”, which concerned the decision to enter the home, and “settling in”, which related to adaptation to the environment. Findings suggested participants who perceived they had greater control over the decision-making process found it easier to settle in the care home. The two categories linked to form an emerging framework of “crossing the bridge” from independent living to care home resident. Research limitations/implications – The findings contribute to the understanding of factors influencing admission of older people with minimal care needs to care homes with RN care and highlight the importance of informed decision making. Practical implications – Health and social care professionals must give informed support and advice to older people seeking care options to ensure their needs are best met. Originality/value – This study enabled older people with minimal care needs admission to care homes with RN care to voice their experiences.

Off the Radar? Addressing housing disrepair to improve health in later life

2017 ◽  
Vol 21 (4) ◽  
pp. 224-228 ◽  
Author(s):  
Susan Marie Adams
Keyword(s):  
Private Sector ◽  
Older People ◽  
Social Care ◽  
Housing Stock ◽  
Local Level ◽  
Later Life ◽  
Content Type ◽  
Health And Wellbeing ◽  
Health And Social Care ◽  
Housing Services

Purpose The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age. Design/methodology/approach The author uses data from housing and health, combined with the author’s experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition. Findings As well as its massive economic impact, housing greatly affects people’s health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be “on the radar” of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person’s tenure, requires vision and innovation and is an essential element in the integration of health, social care – and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back “On the Radar” of national government policy. Social implications There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing. Originality/value The author draws on over 30 years’ experience of innovation, development and evaluation of older people’s housing, services and policy development to provide a vision for greater integration across health, care and housing.

scholarly journals The importance of a room with a view for older people with limited mobility

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Structured Interviews ◽  
Content Type ◽  
Limited Mobility ◽  
Human Element ◽  
Health And Social Care ◽  
Vantage Points ◽  
Practical Implications

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.

scholarly journals Informing patterns of health and social care utilisation in Irish older people according to the Clinical Frailty Scale

2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Markov Models ◽  
Classification Tree ◽  
Community Health Services ◽  
Health Services Use ◽  
Care Needs ◽  
Clinical Frailty Scale ◽  
Care Utilisation ◽  
Health And Social Care

Background: There is increasing policy interest in the consideration of frailty measures (rather than chronological age alone) to inform more equitable allocation of health and social care resources. In this study the Clinical Frailty Scale (CFS) classification tree was applied to data from The Irish Longitudinal Study on Ageing (TILDA) and correlated with health and social care utilisation. CFS transitions over time were also explored. Methods: Applying the CFS classification tree algorithm, secondary analyses of TILDA data were performed to examine distributions of health and social care by CFS categories using descriptive statistics weighted to the population of Ireland aged ≥65 years at Wave 5 (n=3,441; mean age 74.5 (SD ±7.0) years, 54.7% female). CFS transitions over 8 years and (Waves 1-5) were investigated using multi-state Markov models and alluvial charts. Results: The prevalence of CFS categories at Wave 5 were: 6% ‘very fit’, 36% ‘fit’, 31% ‘managing well’, 16% ‘vulnerable’, 6% ‘mildly frail’, 4% ‘moderately frail’ and 1% ‘severely frail’. No participants were ‘very severely frail’ or ‘terminally ill’. Increasing CFS categories were associated with increasing hospital and community health services use and increasing hours of formal and informal social care provision. The transitions analyses suggested CFS transitions are dynamic, with 2-year probability of transitioning from ‘fit’ (CFS1-3) to ‘vulnerable’ (CFS4), and ‘fit’ to ‘frail’ (CFS5+) at 34% and 6%, respectively. ‘Vulnerable’ and ‘frail’ had a 22% and 17% probability of reversal to ‘fit’ and ‘vulnerable’, respectively. Conclusions: Our results suggest that the CFS classification tree stratified the TILDA population aged ≥65 years into subgroups with increasing health and social care needs. The CFS could be used to aid the allocation of health and social care resources in older people in Ireland. We recommend that CFS status in individuals is reviewed at least every 2 years.

Role of the Single Assessment Process in the Care of Older People. How Will Primary Dental Care Practitioners be Involved?

2006 ◽  
Vol os13 (4) ◽  
pp. 130-134 ◽  
Author(s):  
Elizabeth A Lane ◽  
Jennifer E Gallagher
Keyword(s):  
Older People ◽  
Dental Care ◽  
Social Care ◽  
Assessment Process ◽  
Care Needs ◽  
National Service Framework ◽  
Health And Social Care ◽  
Dental Practitioners ◽  
One Stop

Following the publication of the National Service Framework for Older People, there have been developments across health and social care to facilitate holistic assessment of older people's needs, through what is called a ‘single assessment process’ or ‘SAP’. In this paper, readers are introduced to the SAP. The process can be seen as a ‘one-stop’ approach to the assessment of vulnerable older people that facilitates cross-referral between the agencies involved and triggers access to dental care. The paper explores the benefits of this new way of working in support of older people and how it will provide an opportunity for innovative dental practitioners to integrate oral healthcare for people with complex health and social care needs into the SAP. In concludes that as local commissioning evolves, opportunities for practitioners to develop targeted services for this important patient group should be expanded to improve the uptake of healthcare and oral healthcare.

Improving access to adult vaccination: a tool for healthy ageing

2014 ◽  
Vol 18 (2) ◽  
pp. 58-66 ◽  
Author(s):  
Jonathan Scrutton ◽  
David Sinclair ◽  
Trinley Walker
Keyword(s):  
Older People ◽  
Group Discussion ◽  
Grey Literature ◽  
Healthy Ageing ◽  
Active Ageing ◽  
Content Type ◽  
Health And Social Care ◽  
Potential Benefits ◽  
The Government ◽  
The Uk

Purpose – The purpose of this paper is to demonstrate how access to vaccination for older people in the UK can be both improved and used as a tool for healthy ageing. Design/methodology/approach – ILC-UK released a report “Adult Immunisation in the UK”, which applied a UK perspective to a 2013 Supporting Active Ageing Through Immunisation (SAATI) report on immunisation. The ILC report combined the SAATI findings with a traditional literature review, a policy review incorporating grey literature and the outcomes of a focus group discussion. This paper highlights the key findings of the ILC-UK report. Findings – Vaccination needs to be included as part of proactive strategies to promote healthy and active ageing. Initiatives need to be explored that increase the rate of delivery of vaccinations. Barriers to the vaccination of health and social care professionals working with older people need to be removed. The government should explore using psychological insights into human behaviour to improve the take-up of vaccinations amongst adults. The range of settings where older people can receive vaccination needs to be expanded. Information on the potential benefits of immunisation should be made readily available and easily accessible to older people. Practical implications – The paper calls for a structural shift in how vaccination services in the UK are organised. Social implications – The paper calls for a cultural shift in how society views immunisation and the role it has to play in the healthy ageing process. Originality/value – The paper uses new European research on immunisation and applies it to the UK's situation.

Faith and spirituality in older people – a Jewish perspective

2015 ◽  
Vol 19 (3) ◽  
pp. 114-122 ◽  
Author(s):  
Sonia Douek
Keyword(s):  
Older People ◽  
Religious Affiliation ◽  
Jewish People ◽  
Psychological Needs ◽  
Systematic Research ◽  
Content Type ◽  
Faith Based ◽  
Health And Social Care ◽  
The Individual ◽  
The Way

Purpose – The purpose of this paper is to explore the role that faith and spirituality play for Jewish people as they age and examine how this is expressed and supported by a health and social care environment. Design/methodology/approach – This is a case study based on work at Jewish Care and supported by other Jewish networks. It also builds on qualitative research on Ageing Well carried out in 2012. Findings – As people age they have a need to connect with their community. Faith-based communities are ready made and often the first point of call for Jewish people. The way in which people express their faith or spirituality may not manifest itself in practice but be more about inclusion and connection. Life circumstances will determine people’s faith, identity and approach to spirituality – e.g. Holocaust survivors. There is a feeling that religious affiliation and the way it is expressed has polarised in the community which means that older people often do not connect with current ways of expressing or connecting to their faith. Research limitations/implications – This is not a systematic research but examines through practice different approaches to supporting people as they age via a faith-based provision. Practical implications – The approach could be replicated by other faith-based providers but also the approach and lessons should be considered by more generalist providers so that they ensure they meet the needs of the individual receiving their services. The inclusion principle reminds the author that care in a vacuum will not support the emotional and psychological needs of people. Social implications – Divisions within a faith group opportunities for younger people to learn from their older peers reminder of more established values around faith. Originality/value – Identifying the way in which faith is often an expression and connection to community and can reduce social isolation. The role that faith-based communities play in connecting and valuing people as they age. The reminder that ritual can be not only reassuring to people as they age but provide structure and purpose to a person’s life.

scholarly journals Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England

2010 ◽  
Vol 30 (7) ◽  
pp. 1115-1134 ◽  
Author(s):  
DAVID CHALLIS ◽  
MICHELE ABENDSTERN ◽  
PAUL CLARKSON ◽  
JANE HUGHES ◽  
CAROLINE SUTCLIFFE
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Comprehensive Assessment ◽  
Assessment Process ◽  
Care Plan ◽  
Assessment Practice ◽  
Care Needs ◽  
Health And Social Care

ABSTRACTThe quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care plan and service allocation, an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their usually complex and multiple problems. Is an adequate range of professionals engaged, and is a multi-disciplinary approach applied? The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005–06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The reported arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. The findings suggest, first, that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing, and second that by and large a systematic multi-disciplinary approach was absent. Policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.

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