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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)
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)
James' Place model: application of a novel clinical, community-based intervention for the prevention of suicide among men
- Authors:
- HANLON Claire Anne, et al
- Journal article citation:
- Journal of Public Mental Health, 21(1), 2022, pp.82-92.
- Publisher:
- Emerald
Purpose: High suicide rates among men presents a global challenge for commissioners and clinicians. Innovative approaches towards suicide prevention interventions designed for men are needed. The James' Place (JP) service opened in 2018, and its model of practice is a clinical, community-based intervention for men experiencing suicidal crisis. This paper aims to describe the implementation framework within which the JP model is applied. Design/methodology/approach: Fostering a public health case study approach, this paper provides a description of how the JP service operates, including the referral pathways, key components of this innovative model and its impact upon the men who receive the intervention. Illustrative case studies derived from semi-structured interviews from men and therapists are reported. Findings: The JP model is dynamic and flexible, allowing the tailoring of a suicidal crisis intervention to suit the needs and priorities of the individual and the wider local community. Clinical and practical implications, such as reduction in suicidality, are discussed. Originality/value: Rapidly accessible, effective community-based interventions for men experiencing suicidal crisis are required. Yet, while widely advocated in policy, there remains a dearth of evidence illustrating the real-world application and value of such services within a community-setting. To the best of the authors' knowledge, the JP model is the first of its kind in the UK and an example of an innovative clinical, community-based suicide prevention intervention offering support for men experiencing suicidal crisis. (Edited publisher abstract)
What are the priorities for the future development of integrated care? A scoping review
- Authors:
- BURKE Corey, et al
- Journal article citation:
- Journal of Integrated Care, early cite August 2021,
- Publisher:
- Emerald
Purpose: “Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue. Design/methodology/approach: A scoping review was conducted using Arksey and O'Malley's framework to determine IC priority areas. Findings: Twenty-one papers relevant to the research question were identified. These included studies from many geographical regions, encompassing several study designs and a range of populations and sample sizes. The findings identified four priority areas that should be considered when designing and implementing IC models: (1) communication, (2) coordination, collaboration and cooperation (CCC), (3) responsibility and accountability and (4) a population approach. Multiple elements were identified within these priorities, all of which are important to ensuring successful and sustained integration of care. These included education, efficiency, patient centredness, safety, trust and time. Originality/value: The study's findings bring clarity and definition to what has become an increasingly extensive and wide-ranging body of work on the topic of IC. Future research should evaluate the implementation of these priorities in care settings. (Edited publisher abstract)
Homelessness and integrated care: an application of integrated care knowledge to understanding services for wicked issues
- Authors:
- CLARK Michael, et al
- Journal article citation:
- Journal of Integrated Care, 30(1), 2022, pp.3-19.
- Publisher:
- Emerald
Purpose: People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness. Design/methodology/approach: The paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area. Findings: Supporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state. Research limitations/implications: The data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context. Practical implications: Integration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice. Social implications: Addressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions. Originality/value: This paper examines an application of integrated care knowledge to a key complex, or wicked policy issue. (Edited publisher abstract)
Theoretical approaches to elder abuse: a systematic review of the empirical evidence
- Authors:
- FUNDINHO Joao Filipe, PEREIRA Diana Cunha, FERREIRA-ALVES Jose
- Journal article citation:
- Journal of Adult Protection, 23(6), 2021, pp.370-383.
- Publisher:
- Emerald
Purpose: The study of theoretical models explaining elder abuse has been one of the main gaps in the literature of the field. The extent of support of each theory is not clear. This study aims to conduct a systematic review to examine research supporting or opposing six theories of elder abuse: caregiver stress theory, social exchange theory, social learning theory, bidirectional theory, dyadic discord theory and the psychopathology of the caregiver. Design/methodology/approach: This study conducts a systematic review of the literature. Seven databases were searched six times using different keywords about each theory. Findings: This paper finds 26,229 references and then organised and analysed these references using pre-established criteria. In total, 89 papers were selected, which contained 117 results of interest; these papers were summarised and assessed for conceptual, methodological and evidence quality. The results showed evidence in favour of all the explored theories, except for social learning theory, whose results indicate multiple interpretations of the theory. This study finishes this paper by proposing that each of these theories might explain different facets of elder abuse and that more research is necessary to understand how the predictions of these different theories interact. Originality/value: This paper presents an extensive review of the literature on theoretical explanations of elder abuse. The findings can be of value for selecting theories for prevention programmes or providing a summary of the evidence for researchers and practitioners interested in the theoretical explanation of elder abuse. (Edited publisher abstract)
A logic model of the implementation of a regional workforce strategy in positive behavioural support
- Authors:
- NOONE Steve, BRANCH Alison, SHERRING Melissa
- Journal article citation:
- Tizard Learning Disability Review, 26(4), 2021, pp.185-193.
- Publisher:
- Emerald
Purpose: Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach: A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings: This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications: A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value: This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework. (Edited publisher abstract)
Commentary on “a logic model for the implementation of a regional workforce strategy in positive behavioural support”",
- Author:
- TOMLINSON Serena Rose Louisa
- Journal article citation:
- Tizard Learning Disability Review, 26(4), 2021, pp.194-198.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide a commentary on “A logic model for the implementation of a regional workforce strategy in Positive Behavioural Support”. Design/methodology/approach: This commentary provides a discussion of the importance of evaluating positive behaviour support (PBS) training and key issues relating to this. This provides a springboard from which researchers/practitioners may consider these issues when designing and evaluating PBS training courses. Findings: Three main issues are explored: the necessary diversity and breadth of PBS training approaches, the outcome domains to be evaluated and wider systemic issues that may influence PBS training and evaluation of its effectiveness. Originality/value: Effective PBS implementation requires robust training. To achieve this, it will be important for the field to overcome issues relating to the evaluation of training approaches. (Edited publisher abstract)
Servant leadership informed trauma peer support
- Author:
- MAHON Daryl
- Journal article citation:
- Mental Health and Social Inclusion, 25(4), 2021, pp.366-377.
- Publisher:
- Emerald
Purpose: Peer support has gained increasing attention within the mental health literature, including the trauma informed approaches research where peer support is a key principle. The purpose of this paper is to outline a servant leadership model of trauma peer support. Design/methodology/approach: A targeted literature search that incorporated systematic reviews, meta-analyses and randomised control trials in the areas of servant leadership, peer support and trauma informed approaches were sourced. Findings: Servant leadership can be used to provide a theoretical model of trauma peer support. All three constructs share the idea of empowerment as a core principle. An ideographic model of servant leadership trauma peer support is put forward based on eight characteristics from the extant literature. Research limitations/implications: As with all conceptual papers, a lack of empirical data means the findings need to be investigated using primary data. Future research may wish to use this theoretical model to test effectiveness in equivalence studies. Practical implications: A theoretical model of trauma informed peer support based on servant leadership theory, with a clear guide to its utilisation. (Edited publisher abstract)
From lived experience to experiential knowledge: a working model
- Authors:
- GRUNDMAN Shimri Hadas, EDRI Neta, ELRAN Renana Stanger
- Journal article citation:
- Mental Health and Social Inclusion, 25(1), 2021, pp.23-31.
- Publisher:
- Emerald
Purpose: This paper aims to present a working model for using experiential knowledge in the work of lived experience practitioners within the mental health field. Design/methodology/approach: The working model is constructed from three key elements, namely, components of lived experience, the Library of Life Experiences and the NISE technique for sharing experiential knowledge (NISE: need identification; inner identification; sharing experiential knowledge and interpersonal encounter). Findings: The model will be described, followed by central themes that emerged from a pilot course that was taught in Israel in 2019 to a group of peers working in the mental health system. The central themes were: developing peer identity; sharing peer language; internalizing the working model; understanding the peer role; and awakening social consciousness. Originality/value: The original working model and training course were co-produced and co-conducted by peer specialists and mental health professionals, for the use of lived experience practitioners. (Edited publisher abstract)