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Widening choices for older people with high support needs: summary
- Author:
- BOWERS Helen
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2013
- Pagination:
- 8p.
- Place of publication:
- York
This brief paper summarises the findings of a two- year study of support options available to older people with high support needs. It sets out the potential for viable alternatives to traditional forms of long-term care, how to widen support at a local level and how to overcome cultural and structural barriers that older people face. Older people with high support needs want greater choice and control over their lives and a wider range of options. The study identifies the benefits and potential of options based on mutuality (people supporting each other) and/or reciprocity (people contributing to individual and group well-being). Formal (e.g. Shared Lives, Homeshare, Time Banks) and informal (e.g. mutually supportive relationships) models and arrangements can be found throughout the UK, but they usually operate under the radar of public sector commissioners and on a very small scale. The study identifies five priorities to make change happen: communicating and demonstrating benefits, raising public awareness and engagement, tackling interfaces with other services, replication and scaling out, and mobilising resources.
Widening choices for older people with high support needs: report
- Authors:
- BOWERS Helen, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2013
- Pagination:
- 95p.
- Place of publication:
- York
This paper reports the findings of Not A One Way Street, a collaborative research project designed to better understand the various ways in which older people with high support needs take up active roles within support arrangements based on mutuality and reciprocity. It describes the benefits and outcomes achieved for individuals, families, communities and providers based on a typology of mutual support that describes the options such as: Shared Lives, Homeshare, cohousing, time banks, mutually supportive relationships, self-help/peer support networks, and mutually supportive communities. More than 100 people across the UK shared their experiences of and outcomes achieved by these models. Ten characteristics or conditions for successful support are highlighted. The study concludes that such options work best when they are locally focused, personally delivered and connected to other services and networks. However it is noted that significant change will be needed in the way that services are commissioned and delivered if current options for support are to be widened to include these models. Barriers include negative attitudes about and narrow perceptions of older age, professional scepticism, and the need for clear outcomes. The report concludes with priorities for action.
Not a one way street: research into older people's experiences of support based on mutuality and reciprocity: interim findings
- Authors:
- BOWERS Helen, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2011
- Pagination:
- 34p.
- Place of publication:
- York
This paper outlines emerging findings and key messages from the first 2 stages of an action research project called 'Not A One-Way Street', which is part of the Better Life programme. The project focuses on the various ways in which older people with high support needs take up active roles within different support arrangements based on 'mutuality and reciprocity'. Mutuality and reciprocity refers to arrangements designed to enable those involved to both give and receive support. Research activities have involved: a call for information which has led to useful case studies and leads for follow-up work; a literature search; a mapping exercise of known reciprocal schemes; and a public meeting. Drawing on the findings of this research, this paper explores alternative approaches to planning, funding and providing long term care for older people with high support needs, particularly focusing on the ways older people take up active roles based on mutuality and reciprocity. It provides stories and situations where those involved are giving and receiving support, rather than more traditional services provided by professionals or organisations. The aim is that this work will contribute to emerging discussions and developments associated with mutuality and reciprocity.
A funding settlement that works for people, not services
- Authors:
- STONE Emma, WOOD Claudia
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 9p., bibliog.
- Place of publication:
- York
This paper was written in advance of the Comprehensive Spending Review in October 2010 and the coalition Government's new vision for social care, expected in early November. It is hoped that together these will form the foundations of a permanent settlement for how we all will contribute towards our care in later life and the system that delivers it. The paper considers the question regarding whether the proposed funding settlement and statute will be aligned with each other, and, critically, with a vision for social care that is designed around people’s lives, rather than around services. It argues that only a funding system acceptable in principle and in practice to those who contribute to it will survive over time. It considers four key principles for a future funding settlement, arguing that it should be: fair; transparent; sustainable; and capable of supporting self-defined outcomes. The importance of an outcome-based funding system, which is compatible with how people live their lives, and what they want and value from life, is discussed. The paper considers what a settlement enshrining these principles would look like. It concludes by examining the challenges of an outcome-based model.
Funding care: can each generation pay its fair share?
- Authors:
- HIRSCH Donald, SPIERS Philip
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 7p.
- Place of publication:
- York
There is now wide agreement, accepted by government, that the present system of paying for care needs replacing. The big sticking point is finding extra funding which both covers the growing needs of an ageing population and shares the cost fairly between generations. A new settlement needs to be fair, transparent and sustainable. This viewpoint proposes a two-track approach where each generation contributes to the costs of its own care in later life. Today’s older people have not put aside funds to cover these costs, but have built up other assets. A first part of the Care Levy taxing these assets at a modest rate on inheritance could meet the funding gap in caring for this generation. Younger people could start to build up funds through additional National Insurance contributions as part of the Care Levy. Each successive age cohort would have the inheritance part of the levy reduced to reflect this, with people aged 30 or less when the scheme was introduced having no levy on inheritance. In addition to these 2 parts of the Care Levy, funding could also come from general taxation and small charges to users. Such a broad sharing of costs among different generations, linked to ability to pay, could be presented as a fair and equitable settlement.
The impact of devolution: long-term care provision in the UK
- Author:
- BELL David
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 41p., bibliog.
- Place of publication:
- York
This report on long-term care provision policies, from a series on the impact of 10 years devolved government in the United Kingdom, considers the constraint that tax and benefit structure (control of which remains centrally within the Departmental Expenditure Limits (DEL) system), has on Scotland, Northern Ireland, Wales and England. The importance of having secondary social care, funded from Annually Managed Expenditure by the Department for Work and Pensions (DWP) and less bound to annual budgets than DEL, in minimising diversity of delivered care is discussed. The inability of devolved governments to steer DWP, due to weak intergovernmental relations, is highlighted and in section 2 Scottish attendance allowances and Welsh domiciliary care charges are contrasted. Section 3 details demand for care varies more within countries than between them, while section 4 highlights divergence in older people’s ability to pay. A current snapshot of care provision across the UK in section 5, is followed by a focus on free personal care, personalisation and charging in Section 6. Section 7 reiterates that policies can be constrained as well as enhanced by devolution. Other reports, in this series, detail area based regeneration, indicators of poverty and social exclusion, employment and employability and housing and homelessness.
Older people's vision for long-term care
- Authors:
- BOWERS Helen, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 56p., bibliog.
- Place of publication:
- York
The research project explored the voice, choice and control of older people living with high support needs. The research involved a scoping study exploring the current role of long term care; a series of discussions with older people, their families and professionals; synthesis of key messages with a diverse advisory group; local feedback; and a national ‘sounding board’ event to identify the key messages to be shared. Those involved in the study emphasised the need for all sectors to work to ensure that older people's vision for their own future is widely owned and used to move from the current default model of residential care towards a range of more flexible options.
Identifying a fairer system for funding adult social care
- Authors:
- KEEN Justin, BELL David
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 11p., bibliog.
- Place of publication:
- York
This briefing sets out a framework for identifying a fairer system of adult social care. It discusses five key questions that form a framework for identifying a fairer system. What is the scope of the reform programme? What is to be distributed? What distributive principle should be used? What are the priorities? and Who are the loosers in the care lottery? It then uses these questions evaluate the Green Paper Shaping the future of care together. This analysis shows that the Paper represents an advance on previous government statements on adult social care, but lacks important detail, particularly on funding options.
Options for care funding: what could be done now?
- Author:
- COLLINS Sue
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 7p.
- Place of publication:
- York
This overview draws on JRF’s research from its ‘Paying for long-term care’ programme to examine other funding alternatives and improvements to the current system. It also draws on the practical experience of the Joseph Rowntree Housing Trust care services to provide innovative examples from practice.
Care and support - a community responsibility?
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2008
- Pagination:
- 12p.
- Place of publication:
- York
In this Viewpoint the author asserts that demographic and societal changes mean there will be a growing shortfall of family carers. It is argued that the wider community must therefore expect to play a growing role. This will also provide an opportunity to end social care's marginalisation.