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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)
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)
Self-funders and social care: findings from a scoping review
- Author:
- BAXTER Kate
- Journal article citation:
- Research Policy and Planning, 31(3), 2016, pp.179-193.
- Publisher:
- Social Services Research Group
This paper draws on a scoping review of the evidence base about adults in England who purchase social care services and support using their own money. It presents a selection of the review’s findings relevant to self-funders and key aspects of the Care Act 2014. The review covers the years 2000 to 2015. Searches of electronic databases were complemented by a focused search of the websites of key organisations. After applying inclusion/exclusion criteria, and removing duplicates, details were extracted from 76 references. The majority focused on residential care (33), domiciliary care (12), or both (23). Studies used a range of research methods. The overall numbers and percentages of self-funders of home care and care home places have increased. There are variations across regions but limited evidence about demographic or socio-economic characteristics of self-funders. Self-funders feel they lack advice from local authorities; local authorities have limited knowledge of self-funders in their areas. People struggle to understand fees and the financial implications of long-term care. Providers are beginning to realise the potential of the self-funding market but full use is not yet being made of e-marketplaces. Key gaps in knowledge remain at a time when the number and importance of self-funders is increasing. (Publisher abstract)
Satisfaction with adult social care assessment: the development of a measure
- Authors:
- ABENDSTERN Michele, et al
- Journal article citation:
- Research Policy and Planning, 29(2), 2012, pp.95-114.
- Publisher:
- Social Services Research Group
Seeking the opinions of service users is an important aspect of ensuring services are designed and adapted with their views in mind. The evaluation of social care assessment in the UK and elsewhere has to date been limited. This paper describes the development and implementation of The User Satisfaction Assessment Tool (USAT), validated by older people, designed specifically to measure older service users’ views of social care assessment, in particular their satisfaction with it. This was undertaken as part of an evaluation of the Single Assessment Process (SAP), introduced into England in 2004. The challenge was to create a tool that could be used by a broad range of people, be administered in a variety of ways, and be sensitive to variation in response. The paper considers the concept of satisfaction and its measurement, describes the administration of the USAT, and further explores a number of methodological issues arising from this. Following discussion of both its strengths and limitations, the paper concludes that the USAT is an appropriate and reliable satisfaction tool to collect baseline data from which more detailed and in-depth responses could be drawn. (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)
Citizenship, choice and care: an examination of the promotion of choice in the provision of adult social care
- Author:
- DALY Guy
- Journal article citation:
- Research Policy and Planning, 29(3), 2012, pp.179-189.
- Publisher:
- Social Services Research Group
Choice for service users in social care in the UK has been promoted by all governments over the last thirty years. However, there has been insufficient reflection on how this impacts on service users and citizens as a whole. In this article, the author suggests that when choice in social care is examined from economic, psychological and socio-political perspectives, doubts arise as to the extent it has empowered service users, promoted the rights of citizens and improved service delivery. Social care needs to be constructed less as a market or civil right and more as a social right since markets can be ineffective in coordinating the production, distribution and governance of social care. In addition, the promotion of choice in social care can have deleterious socio-political, psychological and economic consequences. The author argues that rather than concentrating on choice, a more appropriate way forward in the provision of social care and in the meeting of citizens’ rights to care would be to conceptualise choice as a ‘second order’ concern at most and, instead, to concentrate on establishing adequately funded, high quality universal social care services across the UK.
Toward a new eligibility framework that serves the interests of both service users and councils
- Author:
- SLASBERG Colin
- Journal article citation:
- Research Policy and Planning, 29(1), 2011, pp.45-59.
- Publisher:
- Social Services Research Group
The Dilnot Commission has called for an overhaul of the eligibility and assessment framework for adult social care. Any framework should ensure that the rationing of resources is carried out in a way that is fair, transparent and effective. However, continuing belief in some key, but flawed, concepts creates a risk that a review will perpetuate the worst, and not the best, aspects of current and past policies. This would condemn social care to continued confusion, unfairness and lack of transparency. This paper argues that if a review were to build from the best of what has so far been attempted, and accept the lessons of what has not worked, an approach can be created that enables the best possible realisation of the vision for social care for the greatest number of service users within existing funding, with the best hope in the longer term of bringing about a closer match of needs and funding. The paper discusses: the extent to which the current eligibility framework has failed and the reasons why; the vision of what an eligibility framework should achieve; the innovations required to deliver this vision; the resource allocation process and prioritisation of needs; and what needs to be in place to deliver the proposed approach.
Oxfordshire County Council’s research into preventing care home admissions and subsequent service redesign
- Authors:
- TAYLOR Rachel, CAIRNCROSS Liz, LIVADEAS Sara
- Journal article citation:
- Research Policy and Planning, 28(2), 2010, pp.91-102.
- Publisher:
- Social Services Research Group
Oxfordshire County Council worked in partnership with the Institute of Public Care on a study of the pathways of older people who had entered a care home in 2008-2009. The aim of the research was to identify the critical characteristics, circumstances and events which led to a care home admission in order to provide appropriate services to prevent or delay these admissions. The project comprised a literature review and a quantitative and qualitative analysis of a random sample of care home admissions across the county in 2008-9. Analysis of the case records of 115 care home admissions were carried out to identify common characteristics. This was followed up with interviews of people who had entered a care home, their carers and care managers, to explore more fully the circumstances and experiences prior to entering a home. These interviews covered the cases of 10 older people. The study found that certain conditions and experiences were particularly prevalent, including incontinence, dementia, falls and depression. Most people had been receiving social care support prior to entering the care home as well as informal care. However, despite common features, individual situations were both varied and complex. The article concludes by providing a short outline on the impact of this research on service design in Oxfordshire, including a co-ordinated continence service, and an outcomes-based holistic reablement service called ‘Turnaround’.
Challenges in evaluating a ‘think child, think parent, think family’ approach to adult mental health and children’s services
- Author:
- ROSCOE Hannah
- Journal article citation:
- Research Policy and Planning, 28(2), 2010, pp.103-114.
- Publisher:
- Social Services Research Group
In 2009, the Social Care Institute for Excellence (SCIE) published a guide on parental mental health and child welfare, which makes recommendations about how services can better support families in which there is a parent with a mental health problem. This guide is based on a ‘think family’ approach, which requires effective interagency working between adult mental health and children’s services. This article discusses how the recommendations of the guide might be implemented. In September 2009, a project team at SCIE began working with 5 sites in England and 5 Health and Social Care Trusts in Northern Ireland to implement the guide and gather further learning about good practice and solutions to some of the barriers identified. The article considers the challenges of designing methods of evaluation in these sites, particularly in terms of how to define and measure the impact of implementation. It suggests that the concept of a ‘complex intervention’ is helpful in thinking about implementation of the guide in terms of allowing local flexibility, targeting multiple parts of the health and social care system and the range of possible outcomes of the work. In line with the principles of realist evaluation, a key role of the evaluation is to help further understand and map the intervention rather than simply to provide a summation of success or failure.