Good practice in social care for disabled adults and older people with severe and complex needs: evidence from a scoping review

Purpose – The purpose of this paper is to draw attention to the potential and limits of the Multi-Agency Risk Assessment Conferences (MARACs) in supporting adults with social care needs who also experience domestic violence. Design/methodology/approach – The paper reports on a scoping review as part of a wider research project entitled: to identify and assess the effectiveness of social care's contribution to the development of MARAC and the protection of adults facing domestic violence. Findings – An understanding of the workings of MARAC could support social care practice with high-risk victims of domestic violence. However, the conception of risk assessment and management central to the process also poses ethical dilemmas for practitioners. Practical implications – Social care is ideally placed to support, in an holistic manner, a group of vulnerable service-users with complex needs. However, the current climate of austerity could jeopardise this work. Originality/value – There is little in the professional and academic press on the MARAC process and particularly in relation to adults and older people. This paper alerts the practice community to the process, its historical development and characteristics and implications for practice.

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What Skills Do Older Self-Funders in England Need to Arrange and Manage Social Care? Findings from a Scoping Review of the Literature

The British Journal of Social Work ◽

10.1093/bjsw/bcaa102 ◽

2020 ◽

Author(s):

Kate Baxter ◽

Mark Wilberforce ◽

Yvonne Birks

Keyword(s):

Older People ◽

Scoping Review ◽

Social Care ◽

Personal Attributes ◽

Implicit Assumption ◽

Local Council ◽

Business Skills ◽

Manage Care ◽

Published Evidence ◽

Tailored Approach

Abstract Older people in England who pay for social care from their own funds (‘self-funders’) receive little help in seeking and arranging care compared to older people funded by their local council. This suggests an implicit assumption that people funded by local councils need help to manage their care whereas self-funders do not. This article reports findings from a scoping review of published evidence from England, Scotland and Wales on the skills that older people need, and the help they get, to seek, arrange or manage use of social care, and how this help affects outcomes. Searches undertaken in October 2018 resulted in the inclusion of thirty-six empirical papers and seven reviews. Thematic analysis identified the importance of everyday life and specific business skills, and personal attributes including objectivity when evaluating options. The review identified two significant gaps in the evidence: first, how help in seeking and arranging care compensated for lack of, or complemented existing, skills; and secondly, how outcomes for people receiving help in arranging care compared with those not receiving help. The article concludes that a tailored approach to supporting older people arrange and manage care, irrespective of funding, should be considered.

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Building a system-wide approach to community relationships with the findings of a scoping review in health and social care

Journal of Health Organization and Management ◽

10.1108/jhom-01-2016-0018 ◽

2016 ◽

Vol 30 (7) ◽

pp. 1047-1062 ◽

Cited By ~ 1

Author(s):

Paul Grimshaw ◽

Linda McGowan ◽

Elaine McNichol

Keyword(s):

Older People ◽

Health Systems ◽

Scoping Review ◽

Review Process ◽

Social Care ◽

Time Budget ◽

Content Type ◽

Care Community ◽

Health And Social Care ◽

Quality Relationships

Purpose For leadership and management of Western health systems, good quality relationships are a fundamental cornerstone of organising health and social care (H&SC) delivery, delivering benefits across organisations and communities. The purpose of this paper is to explore the extant management, H&SC literature, grounded in older people care, reveal behaviours, processes and practices that if readily identified across a context will support healthy relationships across the “whole system” of stakeholders. Design/methodology/approach An academic/practitioner group designed and guided a scoping literature review of the H&SC and broader management literature to identify and extract important behaviours, processes and practices underlying the support of high-quality relationships. A search strategy was agreed and key health and management databases were interrogated and 51 papers selected for inclusion. Working with the practitioners, the selected papers were coded and then organised into emergent themes. Findings The paper outlines the relational behaviours, processes and practice elements that should be present within an older peoples care community, to support a healthy relational environment. These elements are presented under the five emergent literature themes of integrity, compassion, respect, fairness and trust. These five topics are examined in detail. A way forward for building statements using the review material, that may be applied to reveal relational patterns within older people care, is also explored and outlined. Research limitations/implications All literature reviews are subject to practical decisions around time, budget, scope and depth restraints. Therefore potentially relevant papers may have been missed in the review process. The scoping review process adapted here does not seek to make any major considerations with regards to the weighting of evidence behind the primary research. Originality/value This paper contributes to a growing need for designers of health systems to more fully understand, measure and draw on the value of relationships to help bridge the gap between diminishing resources and the expanding demand on H&SC services.

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Handovers in care homes for older people – their type, timing and usefulness. Findings from a scoping review

Ageing and Society ◽

10.1017/s0144686x17001301 ◽

2017 ◽

Vol 39 (4) ◽

pp. 851-871 ◽

Cited By ~ 5

Author(s):

JO MORIARTY ◽

VALERIE LIPMAN ◽

CAROLINE NORRIE ◽

REKHA ELASWARAPU ◽

JILL MANTHORPE

Keyword(s):

Older People ◽

Scoping Review ◽

English Language ◽

Care Home ◽

Good Practice ◽

Care Quality ◽

Care Homes ◽

Regulatory Body ◽

Health And Social Care ◽

Care Quality Commission

ABSTRACTThere is a considerable body of literature on the importance of effective shift handovers in hospitals and other health-care settings but less is known about the transfer of information between staff starting and completing stints of paid work in care homes. In the first of two articles considering this under-explored topic, we report findings from a scoping review examining what is known about shift-to-shift handovers in care homes for older people and their equivalents. It is based on systematic searches of electronic databases of English-language journals on ageing and internet searches for material published between January 2005 and October 2016. Guidance from the regulatory body for health and social care in England, the Care Quality Commission, highlights the importance of handovers in care homes but the degree to which they are embedded into care home routines appears to be variable, influenced by factors such as workplace culture, shift patterns and the extent to which they involve all those on duty or just those with professional qualifications. Staffing shortages and whether or not members of staff are paid for their time attending handovers appear to be further constraints on their use. We conclude that there is considerable scope for further research in this field to identify and develop good practice.

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Pursuing collaborative advantage in Swedish care for older people: stakeholders' views on trust

Journal of Integrated Care ◽

10.1108/jica-01-2020-0001 ◽

2020 ◽

Vol 28 (3) ◽

pp. 231-241

Author(s):

Inger Kjellberg ◽

Stefan Szücs

Keyword(s):

Older People ◽

Social Care ◽

Content Type ◽

Complex Needs ◽

Collaborative Advantage ◽

Care Services ◽

Health And Social Care ◽

Swedish Experience ◽

Coordination And Collaboration ◽

Care For Older People

PurposeThe purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy.Design/methodology/approachThe study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used.FindingsThis study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people.Research limitations/implicationsAlthough the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies.Originality/valueSweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.

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Unmet care needs of older people: A scoping review

Nursing Ethics ◽

10.1177/0969733020948112 ◽

2020 ◽

pp. 096973302094811

Author(s):

Dominika Kalánková ◽

Minna Stolt ◽

P Anne Scott ◽

Evridiki Papastavrou ◽

Riitta Suhonen

Keyword(s):

Older People ◽

Nursing Care ◽

Scoping Review ◽

Ethical Issues ◽

Empirical Studies ◽

Point Of View ◽

World Health ◽

Organizational Level ◽

Care Needs ◽

Complex Needs

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons.

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Biomedical nemesis? Critical deliberations with regard to health and social care integration for social work with older people

International Social Work ◽

10.1177/0020872816651698 ◽

2016 ◽

Vol 61 (5) ◽

pp. 651-664 ◽

Cited By ~ 2

Author(s):

Malcolm Carey

Keyword(s):

Social Work ◽

Older People ◽

Social Care ◽

Positive Role ◽

Complex Needs ◽

The United Kingdom ◽

Care Integration ◽

Health And Social Care ◽

Ageing Populations

This article questions ongoing moves towards integration into health care for social work with older people in the United Kingdom. While potentially constructing clearer pathways to support, integration risks reducing welfare provisions for a traditional low priority user group, while further extending the principles of privatisation. Integration models also understate the ideological impact of biomedical perspectives within health and social care domains, conflate roles and undermine the potential positive role of ‘holistic’ multi-agency care. Constructive social work for older people is likely to further dilute within aggressive integrated models of welfare, which will be detrimental for meeting many of the complex needs of ageing populations.

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