Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 8 of 8
Choice and control for older people using home care services: how far have council-managed personal budgets helped?
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Quality in Ageing and Older Adults, 15(4), 2014, pp.210-219.
- Publisher:
- Emerald
Purpose: This paper reports the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise. Design/methodology/approach: Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face. Findings: Areas discussed include choice and flexibility over care agency, care workers, tasks, and timing and duration of visits. Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the 'ideal' of user choice and the 'reality of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to 'exit' from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs. Originality/value: The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider. (Edited publisher abstract)
Managed personal budgets for older people: what are English local authorities doing to facilitate personalized and flexible care?
- Authors:
- BAXTER Kate, RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Public Money and Management, 33(6), 2013, pp.399-406.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper explores how three local authorities in England have tried to facilitate personalized home care for older people through changes in commissioning and market development activities; and how these changes have been experienced by support planners and home care agency managers. Two borough council and one county council were selected. One council offered Individual Service Funds (IFS) and one offered 'virtual budgets'. Overall, it appears that changes are well intended, but the practicalities of implementing them raise some challenges that mean desired objectives may not always be achieved. (Edited publisher abstract)
Exploring the relationships between choice and independence: experiences of disabled and older people
- Author:
- RABIEE Parvaneh
- Journal article citation:
- British Journal of Social Work, 43(5), 2013, pp.872-888.
- Publisher:
- Oxford University Press
Extending choice and control to the users of publicly funded services is a cornerstone in the personalisation agenda. It is assumed that giving service users greater choice and control will promote users' independence. As service users are increasingly given the responsibility to determine their support, social work practitioners need to work differently with service users in order to provide personalised support in exercising choice. This requires practitioners having a nuanced understanding of people's concepts of independence, how people make choices about support services and how those choices can impact on their perceived independence in the longer term. This paper reports new findings from a longitudinal qualitative study of choice and control over the life course in England. Semi-structured interviews were carried out with fifty adults and older people experiencing fluctuating support needs and/or a sudden deterioration in health. The paper discusses the relationships between choice and independence as experienced by disabled and older people. The findings show that independence is not a fixed concept, but is relative and multidimensional. There are multiple relationships between the choices people make and the consequences of those choices for people's subjective views of their independence. The paper concludes by highlighting the implications of findings for the role of social work practitioners. (Publisher abstract)
Organisation and delivery of home care re-ablement: what makes a difference?
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Health and Social Care in the Community, 19(5), September 2011, pp.495-503.
- Publisher:
- Wiley
Re-ablement services are a cornerstone of preventive services in England, where many local authorities provide intensive, short-term re-ablement. This study examined the organisation and content of re-ablement services that have the potential to enhance or detract from their effectiveness. Semi-structured interviews were held with senior service managers in five sites with well-established re-ablement services, the observation of 26 re-ablement visits to service users, and a focus group discussion with 37 front-line staff in each site. Contributing factors to the effectiveness of re-ablement services included: service user characteristics and expectations; staff commitment, attitudes and skills; flexibility and prompt intervention; thorough and consistent recording systems; and rapid access to equipment and specialist skills in the team. Factors external to the services which had implications for their effectiveness included: a clear, widely understood vision of the service; access to a wide range of specialist skills; and capacity within long-term home-care services. The authors concluded that more inclusive intake services suggested that outcomes would be considerably lower for service users who have more limited potential for independence.
Choice and change: disabled adults' and older peoples' experiences of making choices about services and support
- Authors:
- BAXTER Helen, RABIEE Parvaneh, GLENDINNING Caroline
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2011
- Pagination:
- 4p.
- Place of publication:
- York
This study explored the experiences of disabled people of working age and older who were likely to have to take frequent decisions because of their changing health status. Thirty working age and older people with fluctuating conditions and twenty with the recent sudden onset of severe impairments were recruited to the study from diverse backgrounds across England; around two-thirds remained in the study after three years. Participants were interviewed on at least three occasions between 2007 and 2010, to explore recent experiences of making choices about services including: the information and advice people sought; the options considered; the factors taken into account; the outcomes of these choices over time; and the roles played by family, friends and professionals in the choices that were made. Fifteen ‘significant others’, reported as having played an important role in a particular choice, were also interviewed. Data were analysed to identify common and contrasting patterns. Analysis addressed specific questions and drew wherever possible on data from all interview rounds to maximise the longitudinal dimension of the study. Key findings include that choice is important in maintaining health, independence and identity, but that exercising choice can be limited by lack of information or acceptable options. Implications for professionals are summarised.
Community-based vision rehabilitation provision in England
- Authors:
- RABIEE Parvaneh, et al
- Journal article citation:
- British Journal of Visual Impairment, 34(3), 2016, pp.248-261.
- Publisher:
- Sage
Sight loss is more common among older than younger people. With an ageing population and increasing pressure on health and social care services, preventive and rehabilitation services are being prioritised. However, evidence around community-based vision rehabilitation services is underdeveloped. The focus of this article is on the prevalence, organisational models and capacity of community-based vision rehabilitation services in England that are wholly or partly funded by local authorities (LAs). In all, 89 of the 152 (57%) LAs responded to an online survey about vision rehabilitation services. Services vary widely in the type of provider, type of support offered, structure and skills of the team delivering interventions, caseloads and waiting times. Voluntary organisations appear to experience more pressure on budgets and staffing ratios than LA in-house services. The article discusses implications for practice. (Publisher abstract)
Council-managed personal budgets for older people: improving choice through market development and brokerage?
- Authors:
- BAXTER Kate, RABIEE Parvaneh
- Journal article citation:
- Journal of Care Services Management, 7(4), 2013, pp.136-145.
- Publisher:
- Taylor and Francis
This paper presents findings from interviews with social care service development managers and brokers in three local authorities. It follows an earlier study exploring choice and flexibility in home care services for older people using council-managed personal budgets. That study found that local authorities were limiting the number of providers on framework agreements for home care services so that there were sufficient to encourage competition but not so many that providers risked having insufficient business to remain financially viable. It also found that communication issues were affecting the proper functioning of brokerage systems. The current study therefore revisited the same three local authorities to investigate changes in framework agreements and developments in brokerage systems. The findings showed little change in the number of providers on framework agreements and remaining communication challenges for brokers. However, lessons had been learned from unforeseen consequences of framework agreements, and progress was being made towards encouraging market development and diversification of service provision. (Publisher abstract)
Choice: what, when and why? Exploring the importance of choice to disabled people
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Disability and Society, 25(7), December 2010, pp.827-839.
- Publisher:
- Taylor and Francis
This paper reports evidence from an ongoing qualitative longitudinal study into the realities of exercising choice about support and related services as experienced by disabled and older people and their families. Findings are reported from the first round of interviews, conducted in 2007-08, with 27 young people (aged 13-21) with degenerative/progressive conditions and 34 of their parents, 30 adults and older people with fluctuating support needs, and 20 adults and older people who had recently experienced the sudden onset of a disabling condition. There was considerable diversity among each of these groups in terms of gender, ethnicity and household composition. Key findings are discussed under the headings of healthcare, equipment, housing and adaptations, education/training, social care, employment, and leisure and transport. Almost all respondents felt that having choice was important, however, this is only meaningful if the choices are ‘real’. The choices considered to be important and the way choice was prioritised was shaped by the respondents age and the nature and severity of their condition and also by previous experience of services, future expectations, the availability of information, individual preferences, family responsibilities and the role of others providing support. The importance of learning over time and how this can shape experiences of choice making was also highlighted. Implications of the findings for policy and practice are discussed.