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.

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.

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.

Abuse in care? A research project to identify early indicators of concern in residential and nursing homes for older people

2015 ◽  
Vol 17 (2) ◽  
pp. 111-125 ◽  
Author(s):  
David Marsland ◽  
Peter Oakes ◽  
Caroline White
Keyword(s):  
At Risk ◽  
Nursing Homes ◽  
Older People ◽  
Design Methodology ◽  
Structured Interviews ◽  
Content Type ◽  
Health And Social Care ◽  
Organisational Cultures ◽  
Practical Implications ◽  
Early Indicators

Purpose – The purpose of this paper is to contribute to the prevention of the abuse of older people in residential and nursing homes, through the identification of “early indicators of concern”. Such indicators support practitioners in identifying services in which older people are at risk of abuse, neglect and ill treatment. Design/methodology/approach – Semi-structured interviews were conducted with health and social care practitioners in two local authorities (in England and Scotland), who had visited services in which abuse or neglect had occurred. Practitioners were asked about the things that they had seen within the service which had caused them to become concerned. Findings – Over 90 early indicators of concern were identified. These indicators were grouped within six themes which identify key manifestations of service cultures which may promote the abuse of older people. Practical implications – Information and guidance has been developed to enable practitioners to recognise early indicators and identify services in which older people are at risk and in which actions are required to help prevent the onset of abuse. Originality/value – A range of studies have highlighted the importance of organisational cultures in promoting the abuse of older people. The early indicators identified through this research represent visible signs of such poor service cultures which can be observed by practitioners, enabling them to recognise services in which older people are at greater risk.

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.

“Something to get out of bed for”: creative arts for a happily ageing population

2016 ◽  
Vol 20 (4) ◽  
pp. 190-194 ◽  
Author(s):  
Paul Cann
Keyword(s):  
Older People ◽  
Social Care ◽  
Well Being ◽  
Creative Arts ◽  
Care Providers ◽  
Policy Makers ◽  
Content Type ◽  
The Arts ◽  
Health And Social Care ◽  
The Impact

Purpose The purpose of this paper is to relate the growing body of evidence about the impact of creative arts on the health and well-being of older people to the debate about active ageing, prevention and demographic change. Design/methodology/approach It draws on a range of researched examples in order to illustrate the impact of three different art forms – singing, dance and visual arts – on health and well-being. Findings The evidence exists in increasing volume and diversity that creative arts not only improve personal feelings of well-being but also key physiological measures. The arts are increasingly recognised as playing a major potential role in the delivery of health and social care interventions. Greater recognition and action are needed from policy makers, commissioners and care providers in health and social care that the arts are not a marginal and elitist avenue but a mainstream tool supporting older people to remain active, healthy and independent. Importantly, they represent a powerful source of motivation, agency and confidence. Social implications It argues that creative arts should become an integral and more prominent part of ageing policy. The evidence exists in increasing volume and diversity that creative arts not only improve personal feelings of well-being but also key physiological measures. The arts are increasingly recognised as playing a major potential role in the delivery of health and social care interventions. Greater recognition and action are needed from policy makers, commissioners and care providers in health and social care that the arts are not a marginal and elitist avenue but a mainstream tool supporting older people to remain active, healthy and independent. Importantly, they represent a powerful source of motivation, agency and confidence. Originality/value An important research challenge remains, namely to plot cause (arts intervention) and effect (reduced demand on health and care services), if the creative arts are to occupy a central place in commissioning investment at a time of acute financial stringency in the public sector.

scholarly journals From ovid to COVID: the metamorphosis of advanced decisions to refuse treatment into a safeguarding issue

2020 ◽  
Vol 22 (6) ◽  
pp. 361-369
Author(s):  
Michael Lyne ◽  
Jonathan Parker
Keyword(s):  
Decision Making ◽  
Design Methodology ◽  
Social Care ◽  
Care Staff ◽  
Content Type ◽  
Raising Awareness ◽  
Health And Social Care ◽  
Decision Making Processes ◽  
Advance Decisions ◽  
Practical Implications

Purpose This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff. Design/methodology/approach The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs. Findings ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings. Practical implications The authors make recommendations that reflexive training and awareness become the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes. Originality/value This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made; and that of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis.

scholarly journals Potential implications of degree apprenticeships for healthcare education

2019 ◽  
Vol 9 (1) ◽  
pp. 2-17 ◽  
Author(s):  
Denise Baker
Keyword(s):  
Work Experience ◽  
Design Methodology ◽  
English Language ◽  
Social Care ◽  
Healthcare Education ◽  
Content Type ◽  
Health And Social Care ◽  
Professional Body ◽  
The Uk ◽  
Practical Implications

Purpose The purpose of this paper is to critically reflect on evidence relating to the development and delivery of apprenticeships and its potential implications for pre-registration healthcare education. Design/methodology/approach An iterative review of English language literature published after 1995 to date relating to apprentices and apprenticeships was undertaken. In total, 20 studies were identified for inclusion. Only three related to the most recent apprenticeship initiative in the UK, and the majority were UK based. Findings Three key themes were identified: entering an apprenticeship, the learning environment and perceptions of apprenticeships. Successful completion of an apprenticeship relies heavily on both understanding the role the apprentice is seeking to inhabit, as well as well-structured and comprehensive support whilst on the programme. These findings are then discussed with reference to professional body requirements and pre-registration education in healthcare. Practical implications Appropriate work experience and support for learning are critical to apprenticeship success and apprenticeships should be given equal status to traditional healthcare education routes. Originality/value The introduction of the Apprenticeship Levy in April 2017 (Finance Act, 2016), acknowledgement that all National Health Service Trusts will be levy payers and the introduction of targets relating to apprenticeships for public sector employers have all contributed to growing interest in the apprenticeship agenda in health and social care.

scholarly journals Measuring resource efficiency and resource effectiveness in manufacturing

2018 ◽  
Vol 67 (9) ◽  
pp. 1854-1881 ◽  
Author(s):  
Mangesh Gharfalkar ◽  
Zulfiqur Ali ◽  
Graham Hillier
Keyword(s):  
Design Methodology ◽  
Inverse Correlation ◽  
Resource Efficiency ◽  
Waste Generation ◽  
Content Type ◽  
Academic Literature ◽  
Shared Data ◽  
Resource Intensity ◽  
Three Stages ◽  
Practical Implications

Purpose The purpose of this paper is twofold: first, to identify and analyse existing resource efficiency (RE) and resource effectiveness measures and indicators (REMIs); and second, to identify gaps and develop a new indicator of “operational resource effectiveness” (OREft) suitable for manufacturing units. Design/methodology/approach Research methodology consists of three stages: gap identification, development and testing. Through review of academic literature, 40 REMIs are identified and analysed. A survey of manufacturers is carried out to validate the hypothesis and seek inputs on the development of the new indicator. The proposed indicator is tested by comparing OREft index of two manufacturing units with each other, with resource intensity per unit (RIPU), waste intensity per unit (WIPU) and with four other REMIs. Findings Analysis of 40 REMIs clearly points towards the absence of a hypothesised REMI. In total, 78 per cent of manufacturers surveyed in north England substantiate the hypothesis. Inverse correlation established between the proposed OREft indicator, RIPU, WIPU and other comparisons is likely to validate the output generated by the proposed indicator. Research limitations/implications Testing of this indicator is limited to two dissimilar manufacturing units that shared data. Practical implications The proposed indicator is useful for comparing the operational resource effectiveness of individual factories over a period as well as with other factories. RIPU and WIPU captured in this indicator also represent operational RE that can be used to initiate improvement action. Originality/value Inclusion of both, the resource consumption and the waste generation along with discount/multiplying factors that capture the circularity aspects is likely to be the distinguishing feature of this indicator.

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