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Discriminatory abuse: time to revive a forgotten form of abuse?
- Authors:
- MASON Karl, et al
- Journal article citation:
- Journal of Adult Protection, 24(2), 2022, pp.115-125.
- Publisher:
- Emerald
Purpose: Discriminatory abuse has been a distinct category of abuse in safeguarding adults policy since 2000, but it is rarely used in practice, according to recent official statistics. As part of a larger project, the authors undertook a literature review to clarify the concept, explore reasons for low reporting and consider recommendations for practice. The purpose of this paper is to present the findings of this literature review. Design/methodology/approach: This literature review comprises 35 sources, which were identified using three academic databases, reference harvesting and sector-specific websites. Findings were developed through thematic analysis of the data. Findings: The literature review demonstrates that definitions of discriminatory abuse stretch from an interpersonal emphasis in policy documents to a more structural approach. There are open questions about the status of discriminatory abuse as a category of abuse due to the complicated interface between discriminatory motivations and the abusive acts through which they are experienced. A range of factors can obscure its identification, particularly the hidden, stigmatised and normalised nature of discriminatory abuse. Some recommendations for practice are identified, but more work is needed to develop the practice vocabulary and required skills. Originality/value: This study brings together existing research on discriminatory abuse to argue that it is time to revive this understanding of abuse and develop safeguarding practice with adults who have protected characteristics. (Edited publisher abstract)
Learning from safeguarding adult reviews about Transitional Safeguarding: building an evidence base
- Authors:
- PRESTON-SHOOT Michael, COCKER Christine, COOPER Adi
- Journal article citation:
- Journal of Adult Protection, 24(2), 2022, pp.90-101.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to set out the evidence base to date for Transitional Safeguarding to support authors of Safeguarding Adult Reviews (SARs) where Transitional Safeguarding is a key theme in the review. Design/methodology/approach: This paper draws on key evidence from several published sources about Transitional Safeguarding in England. This evidence is presented in this paper as a framework for analysis to support SAR authors. It follows the same four domains framework used in other adult safeguarding reviews: direct work with individuals; team around the person; organisational support for team members; and governance. This framework was then applied to two SARs written by two of the article's authors. Findings: The framework for analysis for Transitional Safeguarding SARs was applied as part of the methodology of two separate SARs regarding three young people. Key reflections from applying the framework to both SARs are identified and discussed. These included: providing an effective framework for analysis which all participants could use and a contribution for developing knowledge. Whilst many issues arising for safeguarding young people are similar to those for other adults, there are some unique features. The ways in which the gaps between children and adults systems play out through inter-agency and multi-professional working, as well as how "lifestyle choices" of young people are understood and interpreted are key issues. Practical implications: This paper presents an evidence base regarding Transitional Safeguarding for SAR authors who are tasked with completing a SAR where Transitional Safeguarding is a key theme. Originality/value: This paper draws together key literature and evidence about Transitional Safeguarding practice with young people. This paper argues that this framework for analysis provides SAR authors with a useful tool to support their analysis in this complex area of practice. (Edited publisher abstract)
Personal health budgets: a mechanism to encourage service integration?
- Authors:
- WELCH Elizabeth, et al
- Journal article citation:
- Journal of Integrated Care, 30(3), 2022, pp.251-262.
- Publisher:
- Emerald
Purpose: Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the centre of decision-making and are part of a wider long-term initiative working towards personalised and integrated care. Personal budgets began in social care with the national pilot programme of individual budgets, which aimed to incorporate several funding streams into one budget, but in practice local authorities limited these to social care expenditure. Personal budgets then moved into the health care sector with the introduction of a three-year personal health budgets pilot programme that started in 2009. The purpose of the paper is to explore the post-pilot implementation of personal health budgets and explore their role in facilitating service integration. We examine this through the RE-AIM framework. Design/methodology/approach: During 2015 and 2016, eight organisational representatives, 23 personal health budget holders and three service providers were interviewed, 42 personal health budget support plans were collected and 14 service providers completed an online survey. Findings: Overall, personal health budgets continued to be viewed positively but progress in implementation was slower than expected. Effective leadership, clear communication and longer-term implementation were seen as vital ingredients in ensuring personal health budgets are fully embedded and contribute to wider service integration. Originality/value: The paper highlights the importance of policy implementation over the longer-term, while illustrating how the venture of personal health budgets in England could be a mechanism for implementing service integration. The findings can serve to guide future policy initiatives on person-centred care and service integration. (Edited publisher abstract)
Social work's contribution to integrated primary health care teams in the UK for older adults with complex needs
- Authors:
- BAILEY Di, MUTALE Gabriella Jennifer
- Journal article citation:
- Journal of Integrated Care, 30(3), 2022, pp.263-275.
- Publisher:
- Emerald
Purpose: This study examined the contribution of adult social work in integrated teams in the UK. Design/methodology/approach: The study design was realist, evaluation research using a mixed methods approach. Data collection methods included interviews and focus groups. Types of social work activities were extracted from older adults' case records and used to calculate costs of care. The presence or absence of indicators of care quality was recorded using the same sample of case records. Data were collected from three primary care teams in which social work was integrated. They were compared with data from three social-work-only teams in the same districts. Narrative data was analysed thematically. Inferential and descriptive statistics were used to compare costs and care quality. Findings: When social work was embedded or attached to a primary care team, costs of care delivery were lower than in their social-work-only team and more indicators of good quality care outcomes were recorded. Results suggest that embedding social work in integrated primary care teams contributes to cost-effective, quality care for older people if certain conditions for integration are met. Originality/value: This is the first study to triangulate three data sources to quantify the social work contribution to integrated primary health care teams for older adults. (Edited publisher abstract)
Enablers and barriers in adopting a reablement model of domiciliary care
- Authors:
- KING Erin, YOUNG Alys
- Journal article citation:
- Journal of Integrated Care, 30(2), 2022, pp.123-133.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the effectiveness of reablement as an outcome-focussed commissioning model within the English domiciliary care market from the perspective of two private domiciliary care agency (PDCA) managers/owners within one local authority (LA) in the North West of England. Specifically, it focusses on owner/managers' perceived ability to effect change from a dependency to a reablement model within the English domiciliary care market. Design/methodology/approach: Qualitative interviews with two contrasting owners/managers of PDCAs within one LA in the North West of England were carried out. Explorative analysis followed a constructionist grounded theory methodology. Findings: Findings revealed how two main factors interacted to effect change from a dependency model to a reablement model of domiciliary care: internal organisational structure and individual emotional investment of the owners/managers. Additionally, fiscal and external organisational systems impact on these drivers, and are perceived to act as potential barriers to the adoption of a reablement model of domiciliary care by PDCAs. Originality/value: Although based on only two idiographic accounts, the findings shed light on the policy and practice of commissioning models of domiciliary care within England and suggest further studies in this area of practice. (Edited publisher abstract)
Transferable learning about patient and public involvement and engagement in gambling support services from health and social care: findings from a narrative review and workshop with people with lived experience
- Authors:
- NORRIE Caroline, et al
- Journal article citation:
- Journal of Integrated Care, 30(2), 2022, pp.189-202.
- Publisher:
- Emerald
Purpose: The involvement of patients or members of the public within public health, health and social care and addictions services is growing in the UK and internationally but is less common in gambling support services. The purpose of this study was to explore Patient and Public Involvement (PPI) infrastructures and engagement channels used in health and care services and debate their transferability to the gambling support sector (including research, education and treatment). Design/methodology/approach: A narrative review examined data from six English language electronic databases, NHS evidence and grey literature covering the period 2007-2019. We identified 130 relevant items from UK literature. A workshop was held in London, England, with people with lived experience of gambling harm to seek their views on and applicability of the review findings to gambling services. Findings: Synthesis of literature and workshop data was undertaken. Main themes addressed "What works" in relation to: building infrastructures and organising involvement of people with lived experience; what people want to be involved in; widening participation and sustaining involvement and respecting people with lived experience. Practical implications: Examination of the literature about involvement and engagement of patients, service users and the public in public health, health and social care and addiction services provides potentially useful examples of good practice which may be adopted by gambling services. Originality/value: The involvement of people with lived experience of gambling harms in gambling support services is under-explored, with little published evidence of what constitutes good practice amongst self-organising groups/networks/grassroots organisations or rights-based/empowerment-based approaches. (Edited publisher abstract)
Access to and use of health and social care services for people with learning disabilities during COVID-19: a longitudinal study
- Authors:
- FLYNN Samantha, et al
- Journal article citation:
- Tizard Learning Disability Review, 27(1), 2022, pp.57-66.
- Publisher:
- Emerald
Purpose: This paper aims to present data about access to and use of health and social care services by adults with learning disabilities during the COVID-19 pandemic in England, Northern Ireland, Scotland and Wales. Design/methodology/approach: Data were collected in three waves between December 2020 and September 2021 and concerned the use of health and social care services during the COVID-19 pandemic. Data were collected at one or more time-points directly from 694 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 447 adults with learning disabilities. Findings: Many people with learning disabilities who reported regularly accessing services/supports pre-pandemic were not receiving them during the timeframe of this study. There were indications of increasing access to some services and supports between Wave 2 and 3, but this was not universal. Practical implications: People in Cohort 2, who were likely to have severe/profound learning disabilities, were less frequently reported to access online community activities than people in Cohort 1, which is likely to exacerbate existing social isolation for this cohort and their family carers. Service providers should seek to ensure equitable access to services and activities for all people with learning disabilities in the event of future lockdowns or pandemics. Originality/value: This is the largest longitudinal study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. We primarily collected data directly from adults with learning disabilities and worked with partner organisations of people with learning disabilities and family members throughout the study. (Edited publisher abstract)
Adapted guided self-help booklets for supporting the well-being of people with intellectual disabilities during the COVID-19 pandemic: an evaluation of impact
- Authors:
- MAGUIRE Roseann, et al
- Journal article citation:
- Tizard Learning Disability Review, 27(1), 2022, pp.17-25.
- Publisher:
- Emerald
Purpose: The COVID-19 pandemic meant that it became impossible for many individuals with intellectual disability to access specialist mental health support. The purpose of this study was to evaluate a set of guided self-help resources adapted for delivery on an outreach basis. Design/methodology/approach: The use and impact of the resources were evaluated through: data about downloads and requests for printed materials; interviews with individuals who used the resources; webinars with organisations; family members and support workers who had delivered the resources and an online survey with individuals who had delivered the resources. Findings: The resources had considerable reach, with over 12,555 printed copies requested from across Scotland. The materials were perceived to be relevant and useful, helping individuals to talk about difficulties and to be aware that others were facing similar challenges. Originality/value: The findings highlight the potential long-term value of guided self-help resources to help promote well-being that can be delivered on an outreach basis by family members and social care organisations. (Edited publisher abstract)
'I don't want my face on the front page of The Sun': the 'Baby P effect' as a barrier to social worker discretion
- Author:
- MURPHY Ciaran
- Journal article citation:
- Journal of Children's Services, 17(1), 2022, pp.45-58.
- Publisher:
- Emerald
Purpose: The backdrop to the Munro Review of Child Protection was a narrative propagated in the British national press, and perpetuated particularly by the then opposition Conservative Party, that the case of "Baby P" evidenced the English child protection system was "failing" and in need of reform. Subsequently, the review asserted that the system had become "over-bureaucratised" and "defensive" at the expense of social worker discretion in the interests of the individual child, highlighting the need for "radical reform". This paper aims to report on the extent of, and continued barriers to, social worker discretion within the contemporary English child protection. Design/methodology/approach: As an ethnographic case study of a single English child protection team, the study used a sequential and iterative mixed method design, encompassing observation, document analysis, focus groups, questionnaire, interviews and "Critical Realist Grounded Theory". Findings: The study found that social worker discretion was continuing to be undermined by the "Baby P effect"; not only in the sense of increasing numbers of children within the system but also by the perpetual fear of being "named", "blamed" and "shamed", akin to Peter Connelly's social workers. Originality/value: The paper considers how discretion is manifested in contemporary child protection, especially in the context of the "child-centred" system envisaged by the Munro Review. It concludes that the British media and politicians have a continued role to play in reducing the risk associated with the social worker's discretionary space. (Edited publisher abstract)
Missing links: safeguarding and disability hate crime responses
- Authors:
- HEALY Jane C., DRAY Rosslyn
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.43-53.
- Publisher:
- Emerald
Purpose: This paper aims to consider the relationship between disability hate crime and safeguarding adults. It critically considers whether safeguarding responses to disability hate crime have changed following the implementation of the Care Act 2014. Historically, protectionist responses to disabled people may have masked the scale of hate crime and prevented them from seeking legal recourse through the criminal justice system (CJS). This paper investigates whether agencies are working together effectively to tackle hate crime. Design/methodology/approach: The research presented draws on semi-structured interviews with key informants who work with disabled people and organisations as part of a wider study on disability hate crime. Findings: Prior to the Care Act, safeguarding practice often failed to prioritise criminal justice interventions when responding to reports of disability hate crimes. Improving engagement within multi-agency safeguarding hubs and boards has the potential to increase hate crime awareness and reporting. Research limitations/implications: This research was limited in scope to 15 participants who worked in England within safeguarding teams or with victims of hate crime. Practical implications: Raising the profile of disability hate crime within safeguarding teams could lead to achieving more effective outcomes for adults at risk: improving confidence in reporting, identifying perpetrators of hate crimes, enabling the CJS to intervene and reducing the risk of further targeted abuse on the victim or wider community. Originality/value: This paper is original in its contribution in this field as there is a dearth of research on the relationship between safeguarding and disability hate crime. (Edited publisher abstract)