Being self in later life: maintaining continuity in the face of change

2016 ◽  
Vol 17 (2) ◽  
pp. 141-150
Author(s):  
Gareth O'Rourke
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Consumer Choice ◽  
Social Care ◽  
Later Life ◽  
Small Scale ◽  
Care Needs ◽  
Helping Relationships ◽  
Content Type ◽  
Care Services

Purpose – The purpose of this paper is to build upon existing knowledge of personalisation through an improved understanding of how the use of personalised social care services can support older people’s sense of self. It contains perspectives that are helpful to the development of personalisation policy and practice and to the future commissioning of social care services. Design/methodology/approach – The research involved a qualitative study with eight participants in two local authority areas in England. A series of three in-depth interviews conducted with each participant over a four to six week period explored their experience of using (in one case refusing) a direct payment to meet their social care needs. Ethical approval was obtained prior to the start of fieldwork via the research ethics committee of the author’s home university. Findings – Two inter-related themes emerge as findings of the research. First, that the locus of personalisation resides within the interpersonal dynamics of helping relationships; participants experienced personalisation when carers helped to meet needs in ways that validated their narrative of self. Second, whilst the experience of personalisation is not strongly related to consumer choice, it is important that older people are able to exercise control over and within helping relationships. Research limitations/implications – This is a small scale qualitative study conducted with only eight participants. Whilst it offers valid insights into what constitutes personalisation and the processes by which it was achieved for the participants, caution is required in applying the findings more generally. With the exception of one case, the study is focused exclusively on first person accounts of older people. Future studies might usefully be designed to incorporate the accounts of other involved parties such as family members and paid carers. Originality/value – The paper provides an alternative way of approaching personalisation of social care services for older people by exploring it in terms of its impact on self. It identifies the development of accommodations of “special requirements of Self” in helping relationships as a key mechanism of personalisation. This offers a balance to the current focus on consumer choice and control through the development of market like mechanisms.

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.

Living well in later life in Scotland

2017 ◽  
Vol 21 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Anne Hendry
Keyword(s):  
Older People ◽  
Social Care ◽  
Action Plan ◽  
Later Life ◽  
Ageing Population ◽  
Content Type ◽  
Living Well ◽  
Care Services ◽  
Health And Social Care ◽  
Scottish Government

Purpose The purpose of this paper is to describe the development, implementation and early impact of a national action plan for active and healthy ageing in Scotland. Design/methodology/approach The Joint Improvement Team, NHS Health Scotland, the Scottish Government and the Health and Social Care Alliance Scotland (ALLIANCE) co-produced the action plan with older people from the Scottish Older People’s Assembly. Together they supported partnerships to embed the action plan as an important element of the reshaping care for older people transformation programme in Scotland. Findings A cross-sector improvement network supported health, housing and care partnerships to use a £300 million Change Fund to implement evidence based preventative approaches to enable older people to live well. Older people in Scotland spent over two million days at home than would have been expected based on previous balance of care and impact of ageing. Practical implications Improving the health and wellbeing of older people is not just the responsibility of health and social care services. Enabling older people to live independent, active and fulfilling lives requires coordinated effort that spans national and local government policy areas, mobilises all sectors of society, and involves all health and care disciplines. Success starts with listening to what matters to older people, and working together, and with older people and local communities, to make that a reality. Originality/value This case study from Scotland offers transferable learning for other systems who have an ageing population and an ambitions to enable them to live well in later life.

scholarly journals Exploring the role of volunteers in social care for older adults

2020 ◽  
Vol 21 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Paul B. Willis ◽  
Liz Lloyd ◽  
Randall Smith
Keyword(s):  
Older Adults ◽  
Older People ◽  
Social Care ◽  
Evidence Base ◽  
Care Staff ◽  
Small Scale ◽  
The South ◽  
Content Type ◽  
South West

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.

scholarly journals CMHTs for older people: team managers’ views surveyed

2014 ◽  
Vol 22 (5/6) ◽  
pp. 208-219 ◽  
Author(s):  
Michele Abendstern ◽  
Christian Brand ◽  
Val Harrington ◽  
Rowan Jasper ◽  
Sue Tucker ◽  
...  
Keyword(s):  
Older People ◽  
Quantitative Research ◽  
Social Care ◽  
Free Text ◽  
Content Type ◽  
Care Services ◽  
Open Questions ◽  
Key Issues ◽  
Text Information ◽  
High Level

Purpose – The purpose of this paper is to identify features of community mental health teams (CMHTs) for older people valued by their managers, and those they would most like to change. Design/methodology/approach – Content analysis was used to analyse “free text” responses to open questions from a national survey about CMHTs’ organisational structures and processes. Responses were sorted into statements which were categorised into content areas and higher level dimensions. Findings – Free text information was provided by 376 teams (an 88 per cent response rate). Eight higher level dimensions were identified. One related specifically to integration with social care services, whilst several more included material about other aspects of intra-team integration (e.g. documentation and location). The largest proportion of statements related to staffing and teamwork. Statements about inter-personal and inter-professional issues were largely positive, whilst statements about resources, bureaucracy and integration with social care services typically detailed desired changes. Practical implications – Four key issues emerged comprising a high level of support from managers to develop integrated practices; a need to define the focus of CMHTs for older people and to be fully resourced; and the importance of a nurturing and supportive team environment. Originality/value – The methodology provides a bridge between qualitative and quantitative research, exploring the volume of statements on particular topics and their meaning.

Contracts and commissioning: what’s happening to social care services for black and minority ethnic older people

2015 ◽  
Vol 19 (2) ◽  
pp. 85-93 ◽  
Author(s):  
Valerie Lipman
Keyword(s):  
Older People ◽  
Social Care ◽  
Service Providers ◽  
Research Literature ◽  
Structured Interviews ◽  
Voluntary Service ◽  
Content Type ◽  
Care Services ◽  
Care And Support ◽  
Minority Ethnic

Purpose – The purpose of this paper is to explore current provision of targeted social care services for the growing populations of Black and Minority Ethnic (BAME) older people in England and Wales. Design/methodology/approach – This was a mixed study. Following a review of the policy and research literature, 12 semi-structured interviews were undertaken in 2013/2014. Most participants were recruited from BAME policy and service provider organisations and organisations focusing on older people. Findings – There is some evidence that BAME voluntary organisations are experiencing disproportionately greater funding cuts than mainstream voluntary service providers: moreover some mainstream providers reported reducing services targeted at BAME older people, while others expressed the view that choices for BAME older people are likely to become more limited following recent health and equalities policy changes. Practical implications – Practitioners should contribute to data collection about protected characteristics, such as race/ethnicity to establish if BAME older people’s needs are being assessed equitably, whether access to care and support is easy; and how market-shaping at local levels can ensure a range of providers. Originality/value – This study provides an overview of voluntary sector provision for the growing numbers of BAME older people in need of care and support that should be useful to practitioners and service commissioners.

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.

Workforce ethnic diversity in older people’s care services: thinking back and thinking ahead in COVID-19 times

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jill Manthorpe ◽  
Jo Moriarty
Keyword(s):  
Older People ◽  
Ethnic Diversity ◽  
Social Care ◽  
Labour Force ◽  
Content Type ◽  
Ethnic Inequalities ◽  
Care Services ◽  
The Social ◽  
The Uk ◽  
The Impact

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.

scholarly journals Housing voices: using theatre and film to engage people in later life housing and health conversations

2019 ◽  
Vol 22 (4) ◽  
pp. 181-192
Author(s):  
Cathy Bailey ◽  
Natalie Forster ◽  
Barbara Douglas ◽  
Claire Webster Saaremets ◽  
Esther Salamon
Keyword(s):  
Older People ◽  
Social Care ◽  
Later Life ◽  
Select Committee ◽  
Content Type ◽  
North East ◽  
The North ◽  
Primary Responsibility ◽  
Health And Social Care ◽  
Types Of Information

Purpose Quality, accessible and appropriate housing is key to older people’s ability to live independently. The purpose of this paper is to understand older people’s housing aspirations and whether these are currently being met. Evidence suggests one in five households occupied by older people in England does not meet the standard of a decent home. The Building Research Establishment has calculated that poor housing costs the English National Health Service £1,4bn annually (Roys et al., 2016). Design/methodology/approach This paper reports on the findings of a participatory theatre approach to engaging with those not often heard from – notably, those ageing without children and older people with primary responsibility for ageing relatives – about planning for housing decisions in later life. The project was led by an older people’s forum, Elders Council, with Skimstone Arts organisation and Northumbria University, in the north east of England. Findings Findings suggest there is an urgent need to listen to and engage with people about their later life housing aspirations. There is also a need to use this evidence to inform housing, health and social care policy makers, practitioners, service commissioners and providers and product and service designers, to encourage older people to become informed and plan ahead. Research limitations/implications Use of a participatory theatre approach facilitated people to explore their own decision making and identify the types of information and support they need to make critical decisions about their housing in later life. Such insights can generate evidence for future housing, social care and health needs. Findings endorse the recent Communities and Local Government (2018) Select Committee Inquiry and report on Housing for Older People and the need for a national strategy for older people’s housing. Originality/value Although this call is evidenced through an English national case study, from within the context of global population ageing, it has international relevance.

Commentary on “Assisting individuals ageing with learning disability: support worker perspectives”

2015 ◽  
Vol 20 (4) ◽  
pp. 223-227
Author(s):  
Martin Stevens
Keyword(s):  
Learning Disabilities ◽  
Older People ◽  
Social Care ◽  
Support Worker ◽  
Policy And Practice ◽  
Content Type ◽  
Care Services ◽  
Role Of The State ◽  
Health And Social Care ◽  
The Uk

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.

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