scholarly journals Cultural competence as a technology of whiteness: race and responsibilisation in Scottish health and social care

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lani Russell
Keyword(s):  
Cultural Competence ◽  
Social Care ◽  
Good Practice ◽  
Critical Discussion ◽  
Individual Responsibility ◽  
Content Type ◽  
Academic Literature ◽  
The Social ◽  
Health And Social Care ◽  
Practical Implications

Purpose The purpose of this paper is to explore and extend understanding of the concept of cultural competence in relation to whiteness, particularly the implications of this link in the context of heightened concerns about safety and risk connected with the responsibilisation of health and social care. Design/methodology/approach The paper is a critical review of academic literature about cultural competence in health and social care, focussing on Scotland. The discussion develops understandings of cultural competence in light of important writing about whiteness and draws on recent related research, for example, about racial patterning in relation to disciplinary proceedings. Findings Cultural competence is an example of the neoliberal fusion of the ideals of quality and equality. It is a technology of whiteness which may reinforce racial disadvantage especially in the current environment of responsibilisation. Cultural competence is associated with individual responsibility tropes which undermine state-funded welfare provision and re-inscribe traditional inequalities. Practical implications The findings reinforce the importance of a focus on the social determinants of health and challenge “audit” approaches to competence of all kinds, favouring instead the promotion of creativity from the margins. Originality/value This paper brings together several areas of literature, which have perhaps previously not overlapped, to identify under-recognised implications of cultural competence in the sector, thus linking the critical discussion to decolonisation and good practice in new ways.

Why is it important to consider so-called “invisible” older people in UK healthcare?

2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Policy Makers ◽  
Content Type ◽  
Academic Literature ◽  
Health And Social Care ◽  
Preliminary Account ◽  
Government Statistics ◽  
Practical Implications

Purpose – The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach – The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one “invisible” group each and comparisons and conclusions were then made collaboratively. Findings – Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Research limitations/implications – This is not a systematic review but a preliminary account of the problem. Practical implications – There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications – There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value – There is little written which brings together the lack of attention paid to these groups as a whole.

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.

Frailty – from bedside to buzzword?

2015 ◽  
Vol 23 (3) ◽  
pp. 120-128 ◽  
Author(s):  
Jill Manthorpe ◽  
Steve Iliffe
Keyword(s):  
Policy Development ◽  
English Language ◽  
Social Care ◽  
Content Type ◽  
The Public ◽  
The Social ◽  
Health And Social Care ◽  
The Subject ◽  
To Come ◽  
Recent Policy

Purpose – The purpose of this paper is to explore common usage and understanding of the term “frailty”, which is increasingly used in health care debates in England. Design/methodology/approach – This is a commentary from the perspectives of health and social care researchers. Recent policy and research are drawn upon in the arguments presented. Findings – Most research on the subject of frailty comes from clinical practice although a parallel sociological or gerontological critique of the social construction is emerging. The public is likely to come across the term frailty through the media’s adoption of the term. Different definitions of frailty mean that estimates of the numbers of “frail people” will vary. Research limitations/implications – The commentary draws on material in the English language and on policy, commentary, and research material. Practical implications – The commentary may prompt reflection in practice and policy development on the usage of the term frailty and promote efforts to ensure that its meaning is clear and that it is acceptable to those to whom it is applied. Originality/value – The paper contributes to debates about frailty by considering the implications of using the term across health and social care and in integrated settings and encounters. It draws on medical presentations of the term frailty and on critiques of it as a powerful discourse.

A new health and social care context in Wales

2017 ◽  
Vol 25 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Stewart Greenwell ◽  
Daniel Antebi
Keyword(s):  
Social Services ◽  
Social Care ◽  
Well Being ◽  
Content Type ◽  
Frontline Workers ◽  
The People ◽  
Specialist Services ◽  
The Social ◽  
Health And Social Care ◽  
Making A Difference

Purpose The Social Services and Wellbeing (Wales) Act 2014 and the Well-being of Future Generations (Wales) Act 2015 provide a direction of travel for all public services in Wales and a framework for delivering the aspirations in the legislation. Although specifically referring to social care, both pieces of legislation are as relevant to the NHS as they are to other public bodies, providing an opportunity for NHS Wales and local government, in particular, to be equal partners in making a difference to the people and communities they serve. The paper aims to discuss these issues. Design/methodology/approach A viewpoint paper. Findings In Wales the time is right to do things differently in health and social care, so the authors will reflect on why current services are struggling and propose an approach that is rooted in communities rather than in specialities. The authors suggest developing a centre of gravity in the community through a multi-agency collaboration to achieve the greatest health, social care and economic impact. Originality/value Attention needs to be directed to supporting people, communities and frontline workers to become more resilient, rather than our current focus on specialist services.

Co-production in integrated health and social care programmes: a pragmatic model

2018 ◽  
Vol 26 (1) ◽  
pp. 87-96 ◽  
Author(s):  
Axel Kaehne ◽  
Andrea Beacham ◽  
Julie Feather
Keyword(s):  
Social Care ◽  
Good Practice ◽  
Essential Elements ◽  
Discussion Paper ◽  
Content Type ◽  
Academic Knowledge ◽  
Care Services ◽  
Current Thinking ◽  
Health And Social Care ◽  
Integrated Health

Purpose The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme. Design/methodology/approach A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors. Findings The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts. Practical implications The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances. Originality/value The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.

Constructing accountability in inter-organisational collaboration

2014 ◽  
Vol 28 (5) ◽  
pp. 619-634 ◽  
Author(s):  
Johanna Andersson ◽  
Ewa Wikström
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Annual Reports ◽  
National Agency ◽  
Content Type ◽  
Health And Social Care ◽  
Reporting Systems ◽  
Empirical Context ◽  
And Performance ◽  
Practical Implications

Purpose – The purpose of this paper is to analyse how accounts of collaboration practice were made and used to construct accountability in the empirical context of coordination associations, a Swedish form of collaboration between four authorities in health and social care. They feature pooled budgets, joint leadership and joint reporting systems, intended to facilitate both collaboration and (shared) accountability. Design/methodology/approach – Empirical data were collected in field observations in local, regional and national settings. In addition, the study is based on analysis of local association documents such as evaluations and annual reports, and analysis of national agency reports. Findings – Accountability is constructed hierarchically with a narrow focus on performance, and horizontal (shared) accountability as well as outcomes are de-emphasised. Through this narrow construction of accountability the coordination associations are re-created as hierarchical and accountability is delegated rather than shared. Research limitations/implications – Features such as pooled budgets, joint leadership and joint reporting systems can support collaboration but do not necessarily translate into shared accountability if accountability is interpreted and constructed hierarchically. Practical implications – When practice conforms to what is counted and accounted for, using the hierarchical and narrow construction of accountability, the result may be that the associations become an additional authority. That would increase rather than decrease fragmentation in the field. Originality/value – This research derives from first-hand observations of actor-to-actor episodes complemented with the analysis of documents and reports. It provides critical analysis of the construction and evaluation of accounts and accountability related to practice and performance in collaboration. The main contribution is the finding that despite the conditions intended to facilitate inter-organisational collaboration and horizontal accountability, the hierarchical accountability persisted.

scholarly journals The effective ingredients of social support at home for people with dementia: a literature review

2017 ◽  
Vol 25 (2) ◽  
pp. 110-119
Author(s):  
Elaine Argyle ◽  
Tony Kelly ◽  
John Gladman ◽  
Rob Jones
Keyword(s):  
Social Support ◽  
Social Care ◽  
Good Practice ◽  
Relevant Literature ◽  
Optimal Timing ◽  
Content Type ◽  
People With Dementia ◽  
Health And Social Care ◽  
Search And Selection ◽  
At Home

Purpose Recent years have seen an increasing reliance on social support at home for people with dementia and the advocacy of a person centred and integrated approach in its provision. However, little is known about the effective ingredients of this support and how they differ from more generic or health-based services. The purpose of this paper is to explore the existing evidence base. Design/methodology/approach A review of relevant literature was carried out, combining a systematic search and selection of articles with a narrative analysis. Findings The review identified 14 relevant studies of varying research designs which yielded conflicting findings with regard to the optimal timing of interventions and their overall impact. This highlights the problems of review and generalisability when attempting to compare findings of research in this area. This was exacerbated by the blurred divide between health and social care and ambiguities in the meaning of the latter. Research limitations/implications This methodological heterogeneity demonstrates the need for consistency in research approaches if comparisons are to be made. Further questions include the precise components that distinguish social care from health care, the optimal timing for the introduction of this care and whether adherence to good practice in this area can be linked to cost effectiveness. Originality/value The review identifies relevant issues in need of further investigation and tentative themes emerging from the literature which suggest the utility of an adequately resourced, integrated and responsive approach to intervention.

Space, time and demographic change

2017 ◽  
Vol 25 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Hamish Robertson
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Care Service ◽  
Population Ageing ◽  
Social Care Service ◽  
Content Type ◽  
Care Integration ◽  
Health And Social Care ◽  
Geographical Perspective ◽  
Practical Implications

Purpose The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries. Design/methodology/approach The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people. Findings The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems. Research limitations/implications This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept. Practical implications Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping. Social implications The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective. Originality/value This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.

Diagnosis of “acopia”: prescription for neglect?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zoe Hodges
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Content Type ◽  
Appropriate Care ◽  
Care And Support ◽  
Health And Social Care ◽  
The Individual ◽  
Professional Disciplines ◽  
Practical Implications

Purpose This paper aims to reflect upon the usefulness of the word “acopia” as a diagnosis in relation to individuals in hospital. Design/methodology/approach A response to existing literature and consideration of application to practice with adults who may be vulnerable. Findings The term “acopia” is derived from medicine but has gained popularity throughout health and social care. It is a term that has no diagnostic tool or agreed characteristics. Practical implications Practitioners across a number of professional disciplines need to be aware of the individual circumstances, preferences and priorities of individuals to secure the most appropriate care and support for each person. Failure to acknowledge complexity of an individual’s presenting condition at hospital admission may have fatal consequences. Originality/value The importance of language used to refer to adults who are likely to be vulnerable may influence the quality of the care and treatment that they receive.

Commentary on “Building capable environments using practice leadership”

2021 ◽  
Vol 26 (1) ◽  
pp. 9-13
Author(s):  
Edwin Jones
Keyword(s):  
Learning Disabilities ◽  
Early Intervention ◽  
Implementation Science ◽  
Design Methodology ◽  
Social Care ◽  
Future Research ◽  
Content Type ◽  
Health And Social Care ◽  
Care Training ◽  
Practical Implications

Purpose This paper aims to present a conceptual viewpoint highlighting the utility of active support in implementing capable environments and to extend this by presenting a three-tiered preventative model of positive behavioural support (PBS) in UK health and social care. Design/methodology/approach Provision of a commentary on “Building capable environments using practice leadership” by Linda Hume, Nadia Khan and Martin Reilly. Findings Capable environments and active support should be key, universal and essential PBS tier one supports in UK health and social care. Training staff in Active Support and developing practice leadership help implement capable environments. Originality/value The three-tiered PBS model was recently proposed by Leitch et al. (2020) and is worthy of further debate and refinement with the involvement of stakeholders. It has several practical implications including refocussing efforts on early intervention to get tier one supports implemented effectively in recognition that PBS is much wider than intense tier three supports. It could reinforce and motivate existing providers of quality support and indicate where and how other providers can commence the process of implementing PBS. Future research could consider the effectiveness of applying implementation science to the field of learning disabilities and PBS in particular.

Sign in / Sign up

Export Citation Format

Share Document