How NHS Sutton Clinical Commissioning Group is working with care homes to improve the health and wellbeing of older residents

2015 ◽  
Vol 19 (2) ◽  
pp. 60-68
Author(s):  
Christine Harger

Purpose – The purpose of this paper is to describe how NHS Sutton Clinical Commissioning Group (Sutton CCG) is working with nursing homes, residential homes and other health and social care organisations in Sutton to improve the quality of provision for residents in nursing and residential homes “care homes”. Design/methodology/approach – The paper explains how Sutton CCG engaged with care homes initially to seek their views on whether they wanted support and what support they would value. It describes what arrangements Sutton CCG put in place for managers and staff in local care homes to provide support face-to-face. The paper outlines the key areas for improvement that Sutton CCG and the care homes are focusing on. It includes examples of work carried out jointly by the care homes and Sutton CCG to improve the quality of care for residents. It goes on to describe joint-working arrangements between the CCG, London Borough of Sutton and other health and social care organisations to ensure the overall quality of care homes in Sutton. Findings – The paper outlines feedback from care home managers and staff who were invited to share their views about what support they wanted from Sutton CCG. It includes early feedback from care homes about the support put in place and the areas where they have found it most useful. Practical implications – In the UK many older people live in care homes. Britain has an ageing population so the need for residential and nursing homes and the numbers of people living in care homes is only likely to increase. Our ageing population also places additional demands on the NHS, with residents in care homes often spending time in A&E and lengthy spells in hospital. This paper highlights how CCGs and other health and social care organisations can work with care homes to improve the health and wellbeing of older residents in care homes and reduce pressures on other health services. Originality/value – Sutton CCG has put in place new arrangements for working with care homes that aim to support carers to improve the lives of their older residents. The paper shares practical examples of support that the CCG has provided which has successfully improved care and decision making in care homes; early indications show this has reduced 999 calls and conveyances to hospital. Sutton CCG, London Borough of Sutton and other statutory organisations with responsibility for care homes in Sutton have also set up a joint intelligence group to gain an overall picture of the quality of the borough’s care homes.

2015 ◽  
Vol 16 (4) ◽  
pp. 195-207 ◽  
Author(s):  
Trish Hafford-Letchfield ◽  
Peter Lavender

Purpose – Achieving meaningful participation and co-production for older people in care requires radical approaches. The purpose of this paper is to explore an innovation where learning interventions were introduced into care settings and older people matched to community-based learning mentors to develop partnerships. The authors explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship-based approach to promote wellbeing. Design/methodology/approach – A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement. Findings – Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support. Originality/value – Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes.


2015 ◽  
Vol 23 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Alison Taylor

Purpose – In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is described. The Scottish Parliament passed primary legislation in February 2014, which places requirements on Health Boards and Local Authorities to work together more closely than ever before. The paper aims to discuss these issues. Design/methodology/approach – This paper sets out the Scottish Government's legislative approach to integrating health and social care, based on previous experience of encouraging better partnership between health and social care working without legislative compulsion. Findings – The Scottish Government has concluded that legislation is required to create the integrated environment necessary for health and social care provision to meet the changing needs of Scotland's ageing population. Research limitations/implications – The paper is confined to experience in Scotland. Practical implications – Legislation is now complete, and implementation of the new arrangements is starting. Evaluation of their impact will be ongoing. Social implications – The new integrated arrangements in Scotland are intended to achieve a significant shift in the balance of care in favour of community-based support rather than institutional care in hospitals and care homes. Its social implications will be to support greater wellbeing, particularly for people with multimorbidities within communities. Originality/value – Scotland is taking a unique approach to integrating health and social care, focusing on legislative duties on Health Boards and Local Authorities to work together, rather than focusing on structural change alone. The scale of planned integration is also significant, with planning for, at least, all of adult social care and primary health care, and a proportion of acute hospital care, included in the new integrated arrangements.


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.


2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.


2014 ◽  
Vol 22 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Christopher Handy

Purpose – There are clear links between health, housing and social care. The homeless live much shorter lives as do those people living in poorer quality accommodation and areas of deprivation. Life expectancy and the quality of life in later years are both drastically affected by Marmot's (2010) social gradient, with people from poorer backgrounds often doing worse. A decent home is fundamental to a healthy and a good life. The paper aims to discuss these issues. Design/methodology/approach – The research approach reviewed existing articles, examples from the housing sector and analysis of a range of data from organisations including the NHS. Findings – Good housing helps to support better health but it is not the only answer – joined up working between agencies and Marmot's proposal of proportionate universalism are significant factors in finding solutions to this long-standing issue. Social implications – Costs to the government, health services and local authorities and other agencies could be reduced by wider thinking around the link between housing, health and other support. Originality/value – This paper focuses on the existing links between health, housing and social care.


2015 ◽  
Vol 16 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Richard Humphries

Purpose – The purpose of this paper is to describe the principal challenges facing the health and care system in England arising from an ageing population, assess the track record of the coalition government in addressing these and offer a perspective on the priorities likely to be faced by the next incoming government in relation to health and social care for older people. Design/methodology/approach – Assessment of key policy documents and legislation and interpretation of published data on trends in health and social care activity and expenditure. Findings – An ageing population requires a fundamental shift towards a new model of care that offers better coordinated care and promotes independence and healthy ageing. The Care Act 2014 is a significant achievement and NHS spending has been protected, but resulting cuts to local government budgets have since sharp reductions in social care for older people. The next incoming government will need to address a deepening financial crisis in health and care system; the increasingly unsustainability of means tested and rationed social care alongside universal free health care; and the need to make faster progress in developing a new models of integrated care closer to home. Originality/value – The issues raised in this paper affect older people as voters, tax payers and as existing or potential users of health and social care services. As a group they will attract significant attention from political parties in the next election campaign.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zoe Hodges

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.


2016 ◽  
Vol 20 (4) ◽  
pp. 214-218 ◽  
Author(s):  
Guy Robertson

Purpose The purpose of this paper is to provide a high-level overview of a substantial body of research on the impact that negative attitudes towards ageing have on the health and wellbeing outcomes of people in later life and to highlight the need for a more interdisciplinary approach towards older people’s wellbeing. Design/methodology/approach The paper draws from an initial analysis of over 70 peers reviewed and published studies on the psychosocial impact of negative stereotypes about ageing. Findings There is overwhelming evidence that the way in which people think about ageing can have a very significant adverse impact on a wide array of health and wellbeing outcomes. This research evidence is largely unknown, nor operationalised, within the field of health and social care policy or service development. Practical implications The fact that beliefs and attitudes can have such a profound impact on health and wellbeing outcomes suggests the possibility of psychosocial interventions to address them in order to improve older people’s experience of later life. There is a need for a much more interdisciplinary research agenda to take these findings forward. Social implications The evidence suggests the need for a much more rigorous and comprehensive approach to addressing the effects of socially constructed ageist attitudes. Originality/value Whilst the research itself is not new, the originality of this paper is its attempt to bring data from a different discipline into the health and social care ambit and thereby extend the knowledge base and create the possible conditions for the development and application of new psychosocial interventions to improve the lives of older people.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.160-e4
Author(s):  
Paul Morrish

Data collected by the Health and Social Care Information Centre and Public Health England is throwing light on the way neurology services are needed and delivered in England. GP recorded epilepsy prevalence varied between CCG's, from 456 to 1115 people with epilepsy per 100,000 population. Community spending on anticonvulsant drugs varied between £210,000 and £690,000 per 100,000 population. Percentage of epilepsy patients with 12 months seizure freedom varied between 45% and 74%. Admissions due to epilepsy ranged between 2 and 17 admissions per 100,000 residents. Community spending on headaches and migraine varied between £69,000 and £12,000 per 100,000 residents whilst admissions due to headache and migraine varied between 8 and 134 admissions in 2012–3. Admissions with Parkinson's disease varied between 2 and 21 per 100,000 residents whilst community spending on this illness varied between £183,000 and £36,000 per 100,000. In 2012–3 there was a sevenfold difference between CCG's in neurology appointments provided, from 809 to 5,633 appointments per 100,000 population. 46 CCG's provided no new neurology appointments in their own area, whilst 14 CCG's provided over 90% of new appointments in their own area. 4.86% of all neurology appointments in England were provided by one hospital trust.These sample headlines show how data are being collected and can be analysed to prompt questions and research, to inform commissioners and providers and to improve the quality of care for patients with neurological illness in England.


Author(s):  
Claire Ritchie

Purpose – The purpose of this paper is to inspire services to create Psychologically Informed Environments (PIEs) to support people experiencing homelessness, complex trauma and multiple exclusion. Design/methodology/approach – It outlines key elements of PIEs and how these have been implemented at the Waterloo Project; a 19 bed hostel and integrated health and social care partnership in Lambeth. It considers the importance of meeting individuals emotional and psychological needs to support them out of homelessness. Findings – The service review found a reliable reduction in residents’ mental distress and improved health and wellbeing. Repeat homelessness, anti-social and self-harming behaviour decreased whilst engagement with services, self-care and esteem increased. There are early indications of cost benefits to health and social care services. Staff reported professional development and an increase in their sense of personal accomplishment. Originality/value – The paper aims to share learning, good practice and the outcomes of a psychologically informed approach to working with individuals who have not had their needs met by existing services. It illustrates the actual and potential social and economic impact and value on both individuals and public services.


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