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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.
Patterns of commissioning, contracting and care management in social care services for older people in England
- Authors:
- CHESTER Helen, HUGHES Jane, CHALLIS David
- Journal article citation:
- British Journal of Social Work, 40(8), December 2010, pp.2523-2537..
- Publisher:
- Oxford University Press
A current objective of social care policy in England is to provide more personalised care services. This has implications for the provision of community based care for frail older people. Using data from a national postal survey of local authorities in England, this paper explores whether a typology of commissioning, contracting and care management arrangements, key components in the delivery of social care, can be discerned through the analysis of a series of indicators. Over two thirds of local authorities responded and arrangements were categorised on an empirical basis, resulting in the formulation of seven categories of authority. These were found to vary in the level of activity in three domains: commissioning and contracting arrangements; employment practices; and flexibility in service provision at the level of the service user. The extent to which the typology constitutes a viable ideal type is explored, together with its relevance to the emergent policy agenda.
Case management for long-term conditions: implementation and processes
- Authors:
- REILLY Siobhan, HUGHES Jane, CHALLIS David
- Journal article citation:
- Ageing and Society, 30(1), January 2010, pp.125-155.
- Publisher:
- Cambridge University Press
This literature review focused on comprehensive case management by nurses for adults with long-term conditions living in the community. Twenty-nine studies were included; the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. Three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.