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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)
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)
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)
Building on the recovery approach: the development of a conceptual model of service design for carers in mental health
- Author:
- FOX Joanna
- Journal article citation:
- Research Policy and Planning, 32(3), 2016/17, pp.183-196.
- Publisher:
- Social Services Research Group
Carers’ views about their role in recovery are under-researched, and studies investigating their needs are underdeveloped. In this study, participatory action research was used; the researcher was supported by a steering group of eight stakeholders to co-produce a training programme on recovery and data collection methods to explore the meaning of recovery for carers. The programme was delivered by the researcher, an expert-by-experience with a diagnosis of schizophrenia, and a carer of her son with a similar diagnosis, to a group of eleven participants. Mainly qualitative data was collected together with supplementary quantitative socio-demographic data from the participants. Selected findings based on the carers’ discussions are presented which focus on how the relationship between carers and professionals can most effectively facilitate service user recovery. Issues of information exchange between carers and professionals and the impact of patient confidentiality are highlighted, the nature of recovery practice is considered, and the participants’ need to be regarded as ‘experts’ is addressed. A conceptual model of service design based on a recovery-oriented ‘triangle of care’ is presented. The potential implementation of this model in the current UK mental health service context is considered with the need for co-production between all stakeholders to ensure its development. (Edited publisher abstract)
Child protection, social work and the media: doing as well as being done to
- Author:
- JONES Ray
- Journal article citation:
- Research Policy and Planning, 29(2), 2012, pp.83-94.
- Publisher:
- Social Services Research Group
2008-2010 was an exceptional time of considerable media coverage of child protection and social work in the United Kingdom, much of it negative, and some of it personally targeted on individual social workers. The cluster of media stories included the deaths of ‘Baby Peter Connelly’ and Khyra Ishaq, the kidnapping of Shannon Matthews, and the extreme assaults on two young boys in Edlington, Doncaster. Based on the author’s personal engagement with the media, this article illustrates that the clustering of stories also gave the opportunity to seek to shape the media and editorial coverage and to explain the realities and complexities of seeking to protect children and of social work. (Edited publisher abstract)
The state of adult social care research: findings from an online survey
- Authors:
- REHILL Amritpal, KING Derek, KNAPP Martin
- Journal article citation:
- Research Policy and Planning, 29(2), 2012, pp.115-134.
- Publisher:
- Social Services Research Group
This paper describes the findings from an online survey that asked about the status of social care research in 2010. Some questions reflected concerns raised at a 2005 seminar, organised by the Department of Health, that had discussed social care research. Notwithstanding the difficulties of collecting this kind of information through an online survey, the findings offer some useful insights. A number of improvements were described over the period from 2005 to 2010, including a more strategic approach to research, greater emphasis on interdisciplinarity, a greater practice focus, better accessibility to findings, some influences on policy and practice, and greater involvement of people who use services and carers. On the other hand, there were strong concerns about the future funding of social care research, with associated concerns about the effectiveness of care and support. Concerns were also expressed about ethics and governance arrangements, and research careers. (Publisher abstract)