Social care, service users and user involvement

This article aims to clarify the meaning of the much-used term ‘empowerment’ in order to contribute to a more theoretically coherent development of policy and practice aimed at facilitating the empowerment of health and social care service users. The liberational and consumerist models of empowerment are highlighted, with the former having a broader emphasis on people's roles within society than the latter. The concept of ‘empowerment as professional practice’ is also critically explored, with the conclusion that professionals can work with people in empowering ways if they recognise and work to address the structural causes of oppression.

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Beyond Modernisation? Social Care and the Transformation of Welfare Governance

Journal of Social Policy ◽

10.1017/s0047279408002201 ◽

2008 ◽

Vol 37 (4) ◽

pp. 531-557 ◽

Cited By ~ 63

Author(s):

JANET NEWMAN ◽

CAROLINE GLENDINNING ◽

MICHAEL HUGHES

Keyword(s):

Social Care ◽

Care Service ◽

Research Programme ◽

Service Users ◽

Social Care Service ◽

England And Wales ◽

Distinctive Features ◽

Care Services ◽

Department Of Health ◽

The Future

AbstractThis article reflects on the process and outcomes of modernisation in adult social care in England and Wales, drawing particularly on the recently completed Modernising Adult Social Care (MASC) research programme commissioned by the Department of Health. We begin by exploring the contested status of ‘modernisation’ as a descriptor of reform. We then outline some of the distinctive features of adult social care services and suggest that these features introduce dynamics likely to shape both the experiences and outcomes of policy ambitions for modernisation. We then reflect on the evidence emerging from the MASC studies and develop a model for illuminating some of the dynamics of welfare governance. Finally, we highlight the emerging focus on individualisation and on user-directed and controlled services. We argue that the current focus of modernisation involves a reduced emphasis on structural and institutional approaches to change and an increased emphasis on changes in the behaviours and roles of adult social care service users. This focus has implications for both the future dynamics of welfare governance and for conceptions of citizenship.

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‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

BMC Health Services Research ◽

10.1186/s12913-021-06243-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heidi Snoen Glomsås ◽

Ingrid Ruud Knutsen ◽

Mariann Fossum ◽

Kristin Halvorsen

Keyword(s):

Qualitative Study ◽

Home Care ◽

Health Care Quality ◽

Care Service ◽

User Involvement ◽

Home Care Services ◽

Care Quality ◽

Service Users ◽

Care Services ◽

Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

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Providing gender-affirming hormone therapy through primary care: Service users' and health professionals' experiences of a pilot clinic

10.26686/wgtn.12693110.v1 ◽

2020 ◽

Author(s):

A Ker ◽

Gloria Fraser ◽

Antonia Lyons ◽

C Stephenson ◽

T Fleming

Keyword(s):

Primary Care ◽

Health Care ◽

New Zealand ◽

Hormone Therapy ◽

Health Care Providers ◽

Health Professionals ◽

Care Service ◽

Gender Diversity ◽

Service Users ◽

Care Providers

© 2020 CSIRO Publishing Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a. INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.

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End of life care for people with dementia: The views of health professionals, social care service managers and frontline staff on key requirements for good practice

PLoS ONE ◽

10.1371/journal.pone.0179355 ◽

2017 ◽

Vol 12 (6) ◽

pp. e0179355 ◽

Cited By ~ 13

Author(s):

Richard Philip Lee ◽

Claire Bamford ◽

Marie Poole ◽

Emma McLellan ◽

Catherine Exley ◽

...

Keyword(s):

Health Professionals ◽

End Of Life Care ◽

Social Care ◽

Care Service ◽

Good Practice ◽

Life Care ◽

Social Care Service ◽

Frontline Staff ◽

People With Dementia ◽

Service Managers

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Impact of occupational therapy in an integrated adult social care service: Audit of Therapy Outcome Measure Findings

Journal of Integrated Care ◽

10.1108/jica-04-2021-0020 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Sharon J. Davenport

Keyword(s):

Occupational Therapy ◽

Social Care ◽

Outcome Measure ◽

Care Service ◽

Data Gathering ◽

Sampling Bias ◽

Therapy Outcome ◽

Social Care Service ◽

Content Type ◽

Health And Social Care

PurposeHealth and social care services should demonstrate the quality of their interventions for commissioners, patients and carers, plus it is a requirement for occupational therapists to measure and record outcomes. Use of the “Therapy Outcome Measure” (TOMs) standardised tool was implemented by an occupational therapy adult social care service to demonstrate outcomes from April 2020, following integration to a community NHS Trust.Design/methodology/approachThe aim was to demonstrate occupational therapy outcomes in adult social care through a local audit of the TOMs. The objective was to determine if clients improved following occupational therapy intervention in the four domains of impairment, activity, participation and wellbeing/carer wellbeing. 70 cases were purposively sampled over a 2-month timeframe, extracting data from the local electronic recording system.FindingsOccupational therapy in adult social care clearly makes an impact with their client group and carers. Evidence from the dataset demonstrates clinically significant change, as 93% of clients seen by adult social care occupational therapy staff showed an improvement in at least one TOMs domain during their whole episode of care. 79% of activity scores, 20% of participation scores and 50% of wellbeing scores improved following intervention. 79% of carer wellbeing scores improved following occupational therapy.Research limitations/implicationsThe audit did not collect data on uptake from the separate teams (equipment, housing, STAR and adult social care work) in occupational therapy adult social care. Potential sampling bias occurred as cases with completed scores only were purposively sampled. Sampling was not random which prevented data gathering on uptake of TOMs across the separate teams. Additionally, the audit results can only be applied to the setting from which the data was collected, so has limited external validity.Originality/valueThese novel findings illustrate the valuable and unique impact of occupational therapy in this adult social care setting. The integration of adult social care into an NHS Community Trust has supported the service to measure outcomes, by utilising the same standardised tool in use by allied health professions across the Trust.

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