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St. Monica Trust: domiciliary care services report
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2011
- Pagination:
- 55p.
- Place of publication:
- Oxford
Demand for domiciliary based services for older people is growing in response to population demand and to policy demands for effective alternatives to residential and hospital based care. In addition, the client-provider relationship is changing, with local authorities and, to some extent, health authorities being removed from the contracting transaction, and more direct choice and control for service users. This report was prepared for St Monica Trust with the aim of: identifying the different forms of domiciliary service which can be provided, from home help to intensive rehabilitative services and end of life care; describing key approaches and business models, and consideration of their cost and business development implications; and identifying examples of existing services. The research comprised an analysis of existing published materials, and telephone conversations with a few existing services to explore the financial costing and employment issues. The report concludes by considering future marketing and business strategies, especially in relation to: local authority and GP consortia; personal budget and individual budget holders; and self-funders.
Oxfordshire County Council: support to the early intervention and prevention services for older people and vulnerable adults programme: report on study of care pathways
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2010
- Pagination:
- 37p.
- Place of publication:
- Oxford
This project examined the care pathways of older people moving into a care home in order to determine the critical characteristics, circumstances and events which lead to a care home admission. The aim was to identify areas to develop services to prevent or delay care home admission. This study comprised an audit of the files of 115 people admitted to care homes in 2008-2009 in Oxfordshire. Qualitative interviews were also held with 7 older people, 8 of their informal carers and 8 care managers. The older people and carers were asked about the older person’s circumstances prior to entering the care home, including: the previous living arrangements; their health and need for care; the circumstances around the decision to go into care; and whether there were any services or support that could have enabled them to continue living in their own home. The key characteristics identified were the proportion of women (71%), people who live alone (64%), aged 85 and over (58%), with difficulty in walking (56%), urinary incontinence (45%), bowel incontinence (34%), dementia (40%), experiencing a fall in the last 12 months (41%) and admitted from hospital (61%). Some issues were identified that indicate that care home admission may not have been inevitable: the number of people who were not receiving intensive care prior to admission; the limited use and application of specialist services despite the relevance of older people’s conditions; and the lack of earlier follow up to falls and strokes.
Charging in extra care housing
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- DH Care Networks. Housing Learning and Improvement Network
- Publication year:
- 2010
- Pagination:
- 16p.
- Place of publication:
- London
This report considers approaches to charging people living in Extra Care Housing for the various services provided, with a particular focus on social care. It draws on existing research and materials and the experience of a small number of authorities gained through telephone interviews. The report considers how the contractual arrangements for social care within Extra Care Housing can vary, and how this impacts on the charging arrangements. It discusses the various approaches to charging, and how these approaches meet the potentially competing requirements of fairness and choice for the individual, and an ability to provide flexible and responsive care and support services. The report considers key policy initiatives such as the personalisation agenda and mixing tenure within schemes. Case studies in Cheshire, Hartlepool and East Sussex are described. The report concludes that developing a charging policy for social care provided within Extra Care Housing presents commissioners with a complex set of issues to consider including: being clear about the strategic vision for Extra Care Housing; the affordability of the service for residents; developing the most efficient and accountable procurement approaches; and maintaining value for money and equity for residents.
Anticipating future needs
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Care Services Improvement Partnership. Care Services Efficiency Delivery Programme
- Publication year:
- 2007
- Pagination:
- 42p.
- Place of publication:
- London
Increasing the current service provision in line with the projected population growth is unaffordable and early evidence from the Anticipating Future Needs studies shows that it would not meet the changing expectations of older people. Configuring Future Services explores service configuration options to support people's preferred lifestyle, in their own homes, as long as possible. These exist at the health and social care interface and represent opportunities to build on Joint Strategic Needs Assessment with specific, practical joint projects. This paper provides the evidence for service reconfiguration for 7 conditions based on the current literature and an implementation planning approach. A second paper, in December 2007, will discuss lessons learnt from work with two pilot authorities and make recommendations for wider implementation including the building of a knowledge base for local authorities to access.
Market shaping in adult social care
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2017
- Pagination:
- 18
- Place of publication:
- Oxford
This paper analyses changes in the care home market in England over the past five years, and whether the Care Act 2014 market shaping duty has influenced the market. The analysis shows that the total number of care home beds has reduced across England, but that the number of beds specifically for older people has increased. There has also been a reduction in the number of residential and nursing homes operating in England over the past five years and a trend for care homes to be larger. The analysis found smaller homes that are closing, whilst new larger care homes are often targeted at self-funders. The analysis highlights the fragility of the care home market. It makes suggestions to councils on what they should do to fulfil their market shaping duty and ensure there is a diverse and sustainable care home market. (Edited publisher abstract)
A carer's life: implications and considerations for commissioning
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2017
- Pagination:
- 11
- Place of publication:
- Oxford
This paper discusses the finding of a study on the impact of caring on the quality of life and emotional aspects of carers’ lives. The study looked across adult carer groups to identify common themes that are relevant to carers and commissioners of services. A total of 18 carers, including 15 women and 3 men participated in three focus groups for the study. Three main themes were identified: the scale of the caring role, in terms of the range of tasks and time spent; adopting the role of the skilled helper, resulting in the loss of other rolls and identity; and the hidden care, who becomes more isolated. The paper looks at the implications of the findings for commissioners across four stages of the commissioning cycle: undertaking needs analysis; planning services and support; ensuring good services are delivered; and reviewing and monitoring services. The paper highlights the importance of recognising, valuing carers and supporting carers in their role. (Edited publisher abstract)
Money matters: reviews of cost-effective initiatives
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University. Institute of Public Care
- Publication year:
- 2011
- Pagination:
- 48
- Place of publication:
- Oxford
A set of eight case studies, produced by the Institute of Public Care on behalf of the Institute for Research and Innovation in Social Services (IRISS), providing detailed analysis of the cost-effectiveness of a series of recent social care initiatives, ranging from nationwide and relatively high-profile schemes such as individual budgets to those thus far unique to one country, city or local authority area in the UK. In each case, the report provides an overview of the initiative – its origins, including previous variants of the scheme, who it is intended to help, and how it works in practice – before justifying claims of cost-effectiveness by reference to detailed comparative costings, using one illustrative implementation of the scheme where the initiative is nationwide. Based on the analysis, the report sets out the initiative’s applicability to other settings as well as potential impediments to broader implementation. (Edited publisher abstract)
Local area economic impact assessment: report
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Oxford Brookes University
- Publication year:
- 2014
- Pagination:
- 40
- Place of publication:
- Oxford
The report assesses the impact of Retirement Living and Assisted Living Extra Care developments across England, Wales and Scotland. In particular, it considers the benefits generated by the schemes in terms of health and social care, social capital, capital investment in the area, including planning gain and employment and the additional expenditure likely to be generated in the local area. Each chapter reviews the existing published research evidence where appropriate, and presents the survey and interview data from a sample of 10 retirement living and assisted living schemes run by the McCarthy and Stone. The study found that both Retirement Living and Assisted Living Extra Care schemes facilitate the health and well-being of owners; that the schemes make significant contributions to the local economy both during the construction stage and the operational stage, providing capital investment and employment in local communities and that there is strong evidence of significant additional expenditure, compared to a hypothetical conventional housing development on a similar site, contributing to the viability and sustainability of local shops and services. (Edited publisher abstract)
Minority groups in extra care housing
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- DH Care Networks. Housing Learning and Improvement Network
- Publication year:
- 2010
- Pagination:
- 17p.
- Place of publication:
- London
This report explores the issues facing commissioners and providers in meeting the needs of minority groups of older people within the community through Extra Care Housing services. It draws on existing research and materials and the experience of a small number of authorities gained through telephone interviews. It looks at how minority groups are being defined, how their needs are being met by mainstream services, and when specialist services are appropriate. Part 1 of the report looks at populations and policies across a number of types of minority groups (black and minority ethnic groups; lesbian gay and bisexual people; people with disabilities including sight loss, learning disabilities and mental health problems; and homeless people) and draws conclusions about the overall approaches needed by commissioners. Part 2 looks explicitly at the black and minority ethnic community, looking at understanding the needs of these groups and designing services to meet needs. Case studies in Birmingham, Tower Hamlets, and Suffolk are described.
Day care and outreach in extra care housing
- Author:
- OXFORD BROOKES UNIVERSITY. Institute of Public Care
- Publisher:
- Care Services Improvement Partnership. Housing Learning and Improvement Network
- Publication year:
- 2008
- Pagination:
- 9p.
- Place of publication:
- London
This factsheet explores the national policy context and key issues for commissioners of day services, the benefits of providing such services within an extra care housing scheme both for the scheme's residents and the local communities, and provides descriptions of a number of schemes and the kinds of additional care and support services which they offer.