Positive risk taking: debating the research agenda in the context of adult protection and COVID

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Erin King ◽  
Karen Davies ◽  
Michele Abendstern

Purpose The purpose of this paper is to present the case for examining the concept of positive risk taking (PRT) in the context of adult protection. The paper argues there is a need for empirical research to understand the application of and attitudes to PRT to explore whether the concept has moved beyond a principle to make an identifiable difference to service users. Design/methodology/approach By investigating evidence from policy, literature and professional opinion, this paper presents the ethical tensions for professional practice in adult protection between respecting a service user’s freedom to make choices to enhance their independence while preserving safety for service users and society. This is considered in the context of risk in health and social care and the recent changes in society resulting from COVID-19. Findings Inherent tensions are apparent in the evidence in health and social care between attitudes propounding safety first and those arguing for the benefits of risk taking. This indicates not only a need for a paradigm shift in attitudes but also a research agenda that promotes empirical studies of the implications of PRT from service user and professional perspectives. Originality/value This paper draws attention to the relatively limited research into both professionals’ and service user’s perspectives and experiences of PRT in practice.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daryl Mahon

Purpose Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL). Design/methodology/approach A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model. Findings Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles. Research limitations/implications A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model. Practical implications TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership. Social implications This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity. Originality/value To the best of the author’s knowledge, this is a novel approach, the first of its kind.


2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville

Purpose – The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013). Design/methodology/approach – This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team. Findings – This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve. Originality/value – The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.


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.


2017 ◽  
Vol 25 (4) ◽  
pp. 256-264 ◽  
Author(s):  
John Wilderspin

Purpose A critical commentary on policy and practice over time in English health and social care. The paper aims to discuss these issues. Design/methodology/approach Personal reflections based on prior experience as a senior leader in the English health and care system, combined with insights and relevant evidence from other senior leaders and health and care “think-tanks”. Findings Shifting the balance of care from a hospital to a community setting can potentially be cost-effective as well as improving quality for service users. However, it will require a change in the approach to planning and implementation, by focussing on service users and communities, rather than on statutory organisations. It will also require a greater level of integration between primary care, community health services, social care and the voluntary sector, and greater levels of “co-production” with service users and the public. Research limitations/implications Front-line health and care leaders are generally unaware of the evidence base in this field. Emergent findings in this field need to be rapidly evaluated and then communicated to front-line leaders and practitioners. Originality/value Incorporates direct experience of senior leaders in the field together with the existing and emerging evidence base.


2018 ◽  
Vol 11 (2) ◽  
pp. 83-90 ◽  
Author(s):  
Adam Dinham

Purpose The purpose of this paper is to report on an action research programme in the UK to address this through the notion of religious literacy. Design/methodology/approach Drawing on original research and analysis in UK higher education settings, the article will argue that health and social care educators, policy makers and practitioners need to develop their religious literacy in order to engage fully and competently with the religion and belief identities of their service users in a religiously diverse and complex world. Findings The relationship between religion and belief on the one hand and health and social care practice has been scarcely addressed, despite the important work of Furness and Gilligan in the UK and Canada in the USA. Their work appears as exceptional within a wider context of professions which have been forged in a predominantly secular milieu, despite having their roots in Christian social services in the USA, Canada and the UK. New research in the sociology of religion shows that religion and belief themselves vary in form, number and mix around the world, and that the religious landscape itself has changed enormously in the period during which secular social work has been changing significantly in recent years. It has been observed that in the UK secular assumptions reached a peak of confidence in the 1960s, when social work was most rapidly consolidating as a public profession (Dinham 2015). The inheritance has been generations of health and social care practitioners and educators who are ill-equipped to address the religion and belief identities which they encounter. In recent years this has become a pressing issue as societies across the West come to terms with the persistent – and in some ways growing – presence of religion or belief, against the expectations of secularism. In total, 84 per cent of the global population declares a religious affiliation (Pew, 2012); globalisation and migration put us all in to daily encounter with religious plurality as citizens, neighbours, service users and professionals; and internationally, mixed economies of welfare increasingly involve faith groups in service provision, including in social work and welfare settings across Europe and North America. Yet the twentieth century – the secular century – leaves behind a lamentable quality of conversation about religion and belief. Public professionals find themselves precarious on the subject, and largely unable to engage systematically and informedly with religion and belief as they encounter them. Originality/value Religion and belief have been bracketed off in education in departments of Theology and Religious Studies. Social work education has largely neglected them, and professional standards, benchmarks, values and toolkits, have tended to use proxies for religion and belief, such as “spirituality”, which are often ill-defined and vague. In a context of the reemergence of public faith, and a widespread acknowledgement that religion and belief did not go away after all, health and social care face the pressing challenge of engaging skilfully. This article draws on an action research programme in the UK to address this through the notion of religious literacy. Reflecting on original research and analysis in UK higher education settings, the article will argue that health and social care educators, policy makers and practitioners need to develop their religious literacy in order to engage fully and competently with the religion and belief identities of their service users in a religiously diverse and complex world.


2021 ◽  
pp. 1-22
Author(s):  
Susan Mary Benbow ◽  
Charlotte Eost-Telling ◽  
Paul Kingston

Abstract We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring

Purpose Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework.


2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite

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.


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