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‘The Billion Dollar Question’: embedding prevention in older people's services—Ten ‘High-Impact’ changes
- Authors:
- ALLEN Kerry, GLASBY Jon
- Journal article citation:
- British Journal of Social Work, 43(5), 2013, pp.904-924.
- Publisher:
- Oxford University Press
With ageing populations, social changes and rising public expectations, many countries are exploring ways of developing a more preventative approach within their health and social care services. In England, this has become a growing priority over time—made even more significant by recent economic change and by the urgent need to reduce public sector spending. However, a key dilemma for policy makers and managers is the patchy nature of the evidence base—with a lack of certainty over how to reform services or prioritise spending in order to develop a more genuinely preventative approach. Against this background, this commentary reviews national and international evidence around ten policy measures and interventions, highlighting some of the most promising approaches as well as the fragmented and contested nature of the evidence base. (Publisher abstract)
Achieving closure: good practice in supporting older people during residential care closures
- Authors:
- GLASBY Jon, ROBINSON Suzanne, ALLEN Kerry
- Publishers:
- Association of Directors of Adult Social Services, University of Birmingham. Health Services Management Centre
- Publication year:
- 2011
- Pagination:
- 30p., bibliog.
- Place of publication:
- London
Commissioned by the Association of Directors of Adult Social Services, this guide summarises emerging evidence about best practice when care homes for older people close and when residents need to be re-assessed and resettled. Its context is the mixed economy of care in the adult care home sector, the risk of increased ownership transfers and the impact this might have on older people. It is aimed at policy makers, managers and practitioners with responsibility for older people's services, and is intended to be read alongside the Social Care Association guidance Managing Care Home Closure. It draws on an overview of the literature, in-depth interviews with Directors of Adult Social Services with experience of overseeing care home closures, and emerging data from a detailed study of the outcomes of the modernisation of older people's services in Birmingham. Six key themes arose from the interviews: the importance of established policies and procedures, the importance of time, the role of assessment, the impact of closures, communication and information, and barriers and success factors. The report discusses the findings, with examples from the interviews. It notes the importance of following good practice for planned home closures or emergency closures.
“A game of two halves?” Understanding the process and outcomes of English care home closures: qualitative and quantitative perspectives
- Authors:
- GLASBY Jon, ALLEN Kerry, ROBINSON Suzanne
- Journal article citation:
- Social Policy and Administration, 53(1), 2019, pp.78-98.
- Publisher:
- Wiley
With care services increasingly delivered via a market there is always a risk that care homes could fail financially or struggle in terms of quality, ultimately having to close. When this happens, the received wisdom is that subsequent relocation can be detrimental to the health and well‐being of older residents (possibly even culminating in increased mortality). However, there is very little formal evidence in the United Kingdom (UK) or beyond to guide policymakers and local leaders when undertaking such sensitive work. Against this background, this article reports findings from an independent evaluation of what is believed to be the largest care home closure programme in the UK (and possibly beyond). This consisted of qualitative interviews with older people, families, care staff, and social work assessors during the closure process in one case study care home and one linked day centre, as well as self‐reported health and quality of life data for older people from 13 homes/linked day centers at initial assessment, 28 days after moving and at 12‐month follow up. The study is significant in presenting public data about such a contested topic from such a large‐scale closure process, in its focus on both process and outcomes, in its mixed‐methods approach, and in its engagement with older people, families, and care staff alongside the use of more formal outcome measures. Despite significant distress part‐way through the process, the article suggests that outcomes either stayed the same or improved for most of our sample up to a year after moving to new services. Care homes closures may thus be a “tale of two halves”, with inevitable distress during the closure but, if done well, with scope for improved outcomes for some people in the longer term. These findings are crucial for current policy and practice given that the risk of major closures seems to be growing and given that there is virtually no prior research on which to base local or national closure processes. While some of this research is specific to England, the underlying issue of care home closures and lessons learned around good practice will also apply to other countries. (Edited publisher abstract)
The (multi-) billion dollar question: embedding prevention and rehabilitation in English health and social care
- Authors:
- ALLEN Kerry, GLASBY Jon
- Journal article citation:
- Journal of Integrated Care, 18(4), August 2010, pp.26-35.
- Publisher:
- Emerald
As policy makers seek to develop a more preventative and rehabilitative approach to older people's services, new policies and integrated initiatives have made a positive contribution. This paper provides a critical review of English health and social care, exploring attempts to embed a more preventative and rehabilitative approach through multi-disciplinary and cross-organisational initiatives. Data for this article were collected between February and September 2009, as part of the European Commission Framework 7 Interlinks project. An English National Expert Panel (NEP) was created and took part in a consultation on the identification and discussion of key national strategy, policies and initiatives in prevention and rehabilitation and related literatures. A national report on English rehabilitation and prevention was then validated by each NEP member. The report considers: developments in English rehabilitation and prevention; hospital discharge; intermediate care; reablement; and the pilot project initiatives Health Action Zones, Partnerships for Older People Projects, and LinkAge Plus. The article concludes that, in spite of a stated commitment to prevention, there is a lack of clarify about what it means or how to do it in practice. It ends with a list of several outstanding questions for older people’s services in England.
'The billion dollar question': embedding prevention in older people's services: 10 'high impact' changes
- Authors:
- ALLEN Kerry, GLASBY Jon
- Publisher:
- University of Birmingham. Health Services Management Centre
- Publication year:
- 2010
- Pagination:
- 19p., bibliog.
- Place of publication:
- Birmingham
There is a need to invest more fully and strategically in both prevention and rehabilitation for older people, to help them stay healthier, more independent and more socially included for longer and to recover these capacities as fully as possible when they do require hospital treatment. While there is growing recognition that only a more preventative agenda will be sufficient to respond to current and future pressures, there is much less clarity about how to do this in practice. This paper seeks to identify the most promising ‘10 high impact changes’ with regards to prevention in older people’s services. The paper draws on two main sources. The first is an EU review of prevention and long-term care in older people’s services across 14 European counties known as Interlinks. The second key source is a recent review of the social and economic benefits of adult social care, commissioned by the Department of Health and Downing Street. This paper identifies and reviews the following 10 prevention strategies: promoting healthy lifestyles; vaccination; screening; falls prevention; housing adaptations and practical support; telecare and technology; intermediate care; reablement; partnership working; and personalisation.