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Book

Decentralised budgeting and care for the elderly

Authors:
CHALLIS David, DAVIES Bleddyn
Publisher:
University of Kent. Personal Social Services Research Unit
Publication year:
1988
Pagination:
24p., tables.
Place of publication:
Canterbury

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Book

Case management in community care: an evaluated experiment in the home care of the elderly

Authors:
CHALLIS David, DAVIES Bleddyn
Publisher:
Gower
Publication year:
1986
Pagination:
289p., tables, diags., bibliog
Place of publication:
Aldershot
Journal article

A new approach to community care for the elderly

Authors:
CHALLIS David, DAVIES Bleddyn
Journal article citation:
British Journal of Social Work, 10(1), 1980, pp.1-18.
Publisher:
Oxford University Press

Argues that only a limited number of service innovations can be introduced into an organisation at one time. Innovation in community care of the elderly is an urgent necessity, and the Kent Community Care Scheme is such an innovation.

Journal article

Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England

Authors:
CHALLIS David, et al
Journal article citation:
Ageing and Society, 30(7), October 2010, pp.1115-1134.
Publisher:
Cambridge University Press

In the United Kingdom, the quality of assessment of older people with health and social care needs has been a concern of policy makers and others. This paper examined a key aspect of these concerns – whether sufficient expertise is deployed when an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their complex and multiple problems. The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005/06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. Results revealed that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing. Also, a systematic multi-disciplinary approach was absent. The authors concluded that policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.

Journal article

Factors associated with higher quality assessment tools in care homes

Authors:
WORDEN Angela, CHALLIS David
Journal article citation:
Journal of Care Services Management, 2(1), October 2007, pp.79-91.
Publisher:
Taylor and Francis

This paper investigates the relationship between the quality of assessment tools used in care homes and the different characteristics of care homes in part of North-West England. Using both single variable comparisons and multivariate analyses there were several home characteristics associated with the use of higher-quality assessment tools. Higher-quality assessment process were associated with homes being larger, part of a group or chain, provision of staff training and run by non-for-profit organisation or local authority. Poorer quality of assessment was associated with inspection reports indicating lower standards of management and staffing and generally poorer quality of the home. The findings raise the question as to whether government initiatives to improve assessment of older people should be extended to care homes, with a need to focus on certain types of home where assessment is less likely to be well developed.

Journal article

Care management for older people: does integration make a difference?

Authors:
CHALLIS David, et al
Journal article citation:
Journal of Interprofessional Care, 20(4), August 2006, pp.335-348.
Publisher:
Informa Healthcare

England and Northern Ireland provide examples of different degrees of integration of health and social care within broadly similar administrative and funding frameworks. This paper examines whether integrated structures appear to impact upon the operation of care management, a key approach to providing coordinated care for vulnerable older people. It draws on a study undertaken by the Personal Social Services Research Unit (PSSRU) and funded by the Department of Health to evaluate the different forms and types of care management that have emerged since the NHS and Community Care Act for two user groups: older people and people with mental health problems. Results found there appeared to be more evidence of integrated practice between health and social care in Northern Ireland than England, although some key features, such as intensive care management, were no more evident. It is concluded that further investigation is required as to the extent to which integrated structures have impacted upon patterns of professional working and underlying beliefs about roles.

Journal article

Assessing care home quality using routine regulatory information

Authors:
WORDEN Angela, CHALLIS David
Journal article citation:
Quality in Ageing, 7(3), September 2006, pp.33-44.
Publisher:
Pier Professional
Place of publication:
Brighton

Quality is an essential criterion by which care homes for older people are judged. However, the measurement of quality is both challenging and potentially costly. This article examines the potential of using routinely generated data from inspection processes as quality indicators. Eight key areas are identified: leadership, activity, meals services, health, staffing, size of homes, environment and quality of life. It indicates that generation of such information is possible, providing material that may be used in research and also for more general guidance.

Journal article

Community care for the frail elderly: an urban experiment

Authors:
CHALLIS David, et al
Journal article citation:
British Journal of Social Work, 18(Supplement), 1988, pp.13-42.
Publisher:
Oxford University Press

Describes the development of the Gateshead project, outcomes, measures of quality of life and adequacy of care.

Journal article

An examination of factors influencing delayed discharge of older people from hospital

Authors:
CHALLIS David, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 29(2), 2014, pp.160-168.
Publisher:
Wiley-Blackwell

Methods: To examine factors influencing delayed discharge of older people from hospital data were collected retrospectively from inpatient records and adult social care services on older patients referred to the latter prior to hospital discharge. Results: Data on two related measures, delayed discharge and length of stay, were analysed separately within a four-stage sequential framework. Using bivariate analysis, cognitive impairment and dependency were found to be significantly associated with delay. Patients admitted to trauma and orthopaedics specialties were significantly more likely to be delayed on discharge. Respiratory illness was negatively associated with delay. Factors related to care received as an inpatient associated with delayed discharge from hospital were not being in the responsible consultant's bed for part of their stay, two or more moves between specialties and receipt of rehabilitation services. Admission to a care home and receipt of domiciliary care if returning to a private dwelling on discharge were associated with delay. In the multivariate analysis, dependence and cognitive impairment impacted differently on delay and length of stay . Hospital variables were the most important predictors of length of stay and social care variables in respect of delayed discharge. Conclusion: Patient characteristics and especially the organisation of care in hospital and the provision of services on discharge are related to the likelihood of delayed discharge and LOS. Improved services and structures to systematically assess and treat patient needs in hospital, together with the timely provision of services providing post-discharge services tailored to individual circumstances, are required. (Edited publisher abstract)

Journal article

Towards understanding variations in social care for older people in England

Authors:
BRAND Christian, HUGHES Jane, CHALLIS David
Journal article citation:
Social Policy and Administration, 46(7), December 2012, pp.705-726.
Publisher:
Wiley-Blackwell

Drawing on multiple data sources, this article investigates the relationship between different indicators of public provision of old age social care. The study used the Performance Indicators Analytic Framework model, and explored process indicators of operational practice and how social services are organised and run, structural factors such as the characteristics of local authorities and populations, and indicators of performance. The analysis was based on selected factors within local authority social care services for older people in England in 2006/7. The article describes the study background, methodology, analysis and statistical modelling. It reports on the findings and discusses factors captured by area performance measures, the potential benefits of greater understanding of indicators, and interpretation of and response to area level performance. It concludes that structural factors beyond the control of local authorities play a major role in determining service outcomes, and explain a considerable share of observable variation between local authorities, and that the findings suggest that caution is necessary when aggregate indicators of service provision are used for performance monitoring purposes.

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