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Equipment and adaptations used for self-care activities: suggestions for good practice to maximise successful uptake
- Author:
- McLAGGAN Joy
- Journal article citation:
- Research Policy and Planning, 33(3), 2020, pp.115-130.
- Publisher:
- Social Services Research Group
It has been five years since the publication of ‘Decisions about equipment and adaptations used for bathing and showering’ (McLaggan, 2015). That article explored the issues which influence whether people use or abandon the equipment and adaptations for bathing and showering prescribed or recommended to them, usually by a professional, such as an Occupational Therapist (OT). It drew on original research from 2010, and also explored other literature. The need to better understand the experiences, preferences and needs of users of equipment and adaptations remains important, both for those involved in recommending and prescribing these items, and for commissioners of these services. Since 2015 the Care Act 2014 has been enacted, and its impact on practice is now better known. Alongside this there has been the emergence of new research which adds to knowledge, along with new insights and considerations for practice. This present paper revisits the findings from the earlier paper (McLaggan, 2015) in the light of new published findings, and the implications for practice and for further research. (Edited publisher abstract)
An idea whose time has not yet come: Government positions on long term care funding in England since 1999
- Authors:
- POWELL Martin, HALL Patrick
- Journal article citation:
- Research Policy and Planning, 33(3), 2020, pp.137-150.
- Publisher:
- Social Services Research Group
This article seeks to explore ideas in Government Green Papers, and the Government appointed Commissions on Long Term Care funding since 1997 through the lens of the agenda-setting model of the Multiple Streams Approach. In particular, we examine the roles of ideas in the five major concepts of the model: the problem stream; the politics stream; the policy stream; the policy window; and the policy entrepreneur, for three key ‘moments’: the 1999 Royal Commission on Long Term Care for the Elderly, the 2009-10 Green and White Papers proposing a ‘National Care Service’, and the 2010-14 Dilnot Commission, White Paper, and the Care Act (Part 2). It is found that most of the documents discuss similar problems, similar policy options (although with different favoured options), and the need for some measure of political cross-party agreement (which has been undermined by cross-party sniping). However, the main obstacle seems to be perceived affordability. The efforts of the policy entrepreneurs have not, as yet, resulted in the policy window, ajar for over twenty years, being fully opened. In short, Long Term Care funding represents an idea whose time has not yet come, with discussions dominated by cost, meaning that the ideas have been on the agenda – but not seriously on the agenda. (Edited publisher abstract)
“But can things only get better?” Older people’s social care before, during and after austerity
- Author:
- KERSLAKE Andrew
- Journal article citation:
- Research Policy and Planning, 33(3), 2020, pp.151-168.
- Publisher:
- Social Services Research Group
In 2006 the then Labour Government published a significant, two hundred plus pages, White Paper, ‘Our Health, Our Care, Our Say’. Endorsed by Prime Minister Tony Blair and backed by the Secretary of State Patricia Hewitt, it was designed to outline a new and lasting approach to improving community-based health and social care services. In particular, it recognised the need to better manage the increased demand for care based on the anticipated growth in the numbers of older people within the UK population. Fourteen years later we still await that ‘new and lasting approach to community-based health and social care’. This paper explores why the aspirations of that original White Paper remain to be achieved and what strategic direction social care for older people should take in the future. (Edited publisher abstract)
Toward a new start and a sustainable future for adult social care
- Authors:
- SLASBERG Colin, BERESFORD Peter
- Journal article citation:
- Research Policy and Planning, 33(3), 2020, pp.169-184.
- Publisher:
- Social Services Research Group
The social care system in England is widely seen to be suffering from a sustained period of underfunding as a result of a decade of austerity. Less well observed is that it is also suffering from a chronic lack of direction. The evidence leaves little room for debate that the high transformative ambitions of the personalisation strategy have failed. The ambitions remain ones that have universal support – a service that responds to each individual, enables wellbeing and good quality of life and makes best use of public resources. The question, therefore, is how to achieve this? This paper explores the predominant thinking of the sector’s leadership, highlighting its inability to fill the present intellectual vacuum. It goes on to explore how the thinking from the service user movement, notably the idea of independent living, holds the promise of authentic and sustainable change. (Edited publisher abstract)
What is (Adult) Social Care in England? Its origins and meaning
- Authors:
- SMITH Randall, et al
- Journal article citation:
- Research Policy and Planning, 33(2), 2018/19, pp.45-56.
- Publisher:
- Social Services Research Group
The term ‘social care’ emerged in both official and academic publications in England in the 1990s but has not been defined in legislation. How the phrase has varied in usage over the last 20 plus years is outlined in this article. Whilst the element of ‘personal care’ has been present in the range of descriptions of ‘social care’, the policy context has changed dramatically, affecting the broader debate about priorities in public support for vulnerable adults. What ‘social care’ means as a policy rather than a practice has changed over time. The notion of indeterminacy provides a plausible explanation of changes in terminology and meaning in policies and practices. (Edited publisher abstract)
Personal Health Budgets: a critical analysis of the NHS vision
- Author:
- POZZOLI Francesca
- Journal article citation:
- Research Policy and Planning, 33(2), 2018/19, pp.69-84.
- Publisher:
- Social Services Research Group
Personal Health Budgets (PHBs) could prove to be a radical policy initiative for the National Health Service (NHS) in the UK because they represent changes to the way services are organised and delivered that, if extended, potentially challenge existing funding, commissioning and delivery of health care service arrangements. This paper aims to provide a critical analysis of the NHS vision for PHBs and a discussion of potential risks and negative effects should a wider roll-out of PHBs take place. To do this the paper explores ways in which PHBs are claimed to offer choice and control through the combination of documentary analysis of policy documents and guidelines and semistructured interviews conducted with PHBs specialists. The vision for PHBs emerging from these sources is discussed against the critical literature available on the topic. The paper suggests that for the promises of PHBs (choice and control) to be delivered, the concomitant radical shift in the way services are financed, commissioned and delivered may lead to the further privatisation of NHS services and the individualisation of care interventions. (Edited publisher abstract)
Multiple exclusion homelessness and adult social care in England: exploring the challenges through a researcher-practitioner partnership
- Authors:
- MASON Karl, et al
- Journal article citation:
- Research Policy and Planning, 33(1), 2018, pp.3-14.
- Publisher:
- Social Services Research Group
This paper describes the early progress that is being made to implement the Care Act 2014 in England with regard to the care and support needs of people who are homeless. It outlines exploratory discussions that were generated through a series of interprofessional ‘community of practice’ meetings. These meetings highlighted practice challenges and emerging strategies to overcome them, from the perspective of both local authority social workers and homelessness practitioners. Three main themes emerged and these are discussed under context related headings: (i) legal change, (ii) homelessness and (iii) the local authority as an organisation. In summary, homelessness practitioners spoke about efforts to become legally literate in order to support people who are homeless to access adult social care. They reported that they often encountered barriers or fragmented responses. Statutory social workers spoke about encountering homelessness as an atypical form of vulnerability and grappling with how their needs relate to the new eligibility framework alongside significant budgetary pressure. The findings link strongly with theoretical strands around the nature of legal literacy, constructions of vulnerability and the impact of austerity on ‘street level bureaucracies’. (Edited publisher abstract)
Will 2018 be the year the adult social care market in England collapses?
- Author:
- HUDSON Bob
- Journal article citation:
- Research Policy and Planning, 33(1), 2018, pp.27-34.
- Publisher:
- Social Services Research Group
The privatisation of adult social care has transformed the way in which these services are provided in the UK since the 1980s but has been the subject of relatively little critical examination. This article explores the nature and extent of privatisation and suggests that the model is reaching a tipping point in terms of funding, workforce, consumerism and market sustainability. An agenda for addressing these problems is outlined. (Edited publisher abstract)
The failure of the National Eligibility Criteria – what next?
- Author:
- SLASBERG Colin
- Journal article citation:
- Research Policy and Planning, 33(1), 2018, pp.15-25.
- Publisher:
- Social Services Research Group
Social care has traditionally managed the tension between demand and supply through strategies rooted on the demand side. The concept of ‘eligible need’ is used to limit spending so it matches budget. The strategy has been very successful in its primary objective. However, it has had seriously undesirable side effects. Fair Access to Care (FACS), the form given to the strategy from 2002, was held responsible by Government for persistent inequity. FACS was replaced with a single national set of criteria in 2015. The new strategy was built on the same core principles as FACS. Recent evidence, including new data generated through use of the Freedom of Information Act involving 30 councils, shows the inevitable failure of the national criteria. Persisting inequity is not the only price being paid. The eligibility process has been shown to be responsible for disempowerment and depersonalisation for service users and carers, waste of resources and concealment of information about the cost of meeting needs for wellbeing. The strategy of personal budgets through upfront allocations to nullify these ills is now shown to have failed and cannot succeed. The eligibility process remains dominant for all but a very small minority able to escape the mainstream system. Whilst many believe the most pressing issue is to adequately fund social care, it is hard to sustain this argument in the absence of credible information about what would actually be adequate. It will not be until social care switches from a demand side to a supply side approach to control spending, replicating the way demand and supply is managed in health, that it will be possible for social care to commence a journey toward a service that is both personalised and financially sustainable. Parliament, through the Care Act, has made the required change possible by replacing eligibility of need with affordability of need as the means to control spending. Government, through national policy, is ensuring the relevant provisions of the Care Act lie dormant. (Edited publisher abstract)
Role theory and family values: a conceptual framework for family and social work reciprocation
- Authors:
- RAPAPROT Joan, BAIANI Poirier
- Journal article citation:
- Research Policy and Planning, 32(3), 2016/17, pp.169-182.
- Publisher:
- Social Services Research Group
This article has two main parts. The first focuses on the theoretical and sociopolitical context surrounding the legal category of the nearest relative in England under the Mental Health Act 1983. It provides a brief overview of a study of the role’s functioning and the theoretical development of Reciprocal Role Valorization. The second concentrates on the Family Group Conference, its innovative developments in the New Brunswick, Canada and how the theory arising out of the nearest relative study relates to the province’s initiative. The importance of specialist postqualifying professional development and professional maturity to enable social workers to unlock family potential is also argued in the context of increasing interest in strengths based social work. (Edited publisher abstract)