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Choice and independence over the lifecourse: final report to the Department of Health
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2011
- Pagination:
- 43p.
- Place of publication:
- York
Between 2006 and 2011 the Social Policy Research Unit (SPRU) at the University of York carried out a programme of research on choice for disabled and older people who need social care support, and their family carers, called ‘Choice and Independence over the Lifecourse’. This final report for the Department of Health (DH) provides an overview of this programme of research. The account of the research is divided into 3 sections: projects funded from the main DH programme grant; projects funded through SPRU’s ‘responsive mode’ capacity; and other projects linked to the DH programme. An account of the relevance of the research programme to DH policy and its implementation at local levels is also provided. The research conducted by SPRU within its DH-funded programme has, for the most part, been concerned with issues of choice, from the perspectives of users, carers, service providers and managers. At the heart of the programme was a major long-term study of disabled young people, working age adults and older people as their health and other circumstances changed. The report concludes with a list of the published outputs (peer reviewed journal articles, books and reports, research summaries, professional press, and presentations) emerging from this research programme.
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.
Personalisation and partnership: competing objectives in English adult social care? The individual budget pilot projects and the NHS
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- Social Policy and Society, 10(2), April 2011, pp.151-162.
- Publisher:
- Cambridge University Press
This paper discusses inter-sectoral and service partnerships alongside personalised approaches in delivering health and social care in England, where improving collaboration between care services is a long-established objective of social policy. A recent example has been the personalisation of social care for adults and older people through the introduction of individualised funding arrangements. This article examines interviews with lead officers responsible for implementing individual budgets (IBs). It shows how the contexts of local collaboration created problems for the implementation of the personalisation pilots, jeopardised inter-sectoral relationships and threatened some of the collaborative arrangements that had developed over the previous decade. Personal budgets for some health services have subsequently also been piloted. In conclusion, the authors suggest that these will need to build upon the experiences of the social care IB pilots, so that policy objectives of personalisation do not weaken other collaborative accomplishments.