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Good practice in social care for disabled adults and older people with severe and complex needs: evidence from a scoping review
- Authors:
- GRIDLEY Kate, BROOKS Jenni, GLENDINNING Caroline
- Journal article citation:
- Health and Social Care in the Community, 22(3), 2014, pp.234-248.
- Publisher:
- Wiley
This article reports findings from a scoping review of the literature on good practice in social care for disabled adults and older people with severe and complex needs.The review formed part of a larger study to identify social care service models with characteristics desired by people with severe and complex needs and scope the evidence of effectiveness. Systematic database searches were conducted for literature published between January 1997 and February 2011 on good practice in UK social care services for three groups: young adults with life-limiting conditions; adults who had suffered a brain injury or spinal injury and had severe or complex needs; and older people with dementia and complex needs. Five thousand and ninety-eight potentially relevant records were identified through electronic searching and 51 by hand. Eighty-six papers were selected for inclusion, from which 29 studies of specific services were identified. However, only four of these evaluated a service model against a comparison group and only six reported any evidence of costs. Thirty-five papers advocated person-centred support for people with complex needs, but no well-supported evaluation evidence was found in favour of any particular approach to delivering this. The strongest evaluation evidence indicated the effectiveness of a multidisciplinary specialist team for young adults; intensive case management for older people with advanced dementia; a specialist social worker with a budget for domiciliary care working with psycho-geriatric inpatients; and interprofessional training for community mental health professionals. The dearth of robust evaluation evidence identified through this review points to an urgent need for more rigorous evaluation of models of social care for disabled adults and older people with severe and complex needs. (Edited publisher abstract)
Good support for people with complex needs: what does it look like and where is the evidence?
- Authors:
- GRIDLEY Kate, BROOKS Jenni, GLENDINNING Caroline
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2012
- Pagination:
- 4p.
- Place of publication:
- London
The population of adult social care users is changing. Advances in medicine are enabling more children with life-threatening conditions to live into adulthood, more adults to survive major injuries or illnesses with on-going needs, and growing numbers of older people to live longer, often with long-term conditions. These developments present new challenges for adult social care and require new responses. This study aimed to explore good practice in social care for disabled and older people with severe and complex needs, find out what this group consider to be key features of good support, and identify examples of potential good practice. The study was conducted between June 2010 and February 2012 and had 3 stages: consultation with 22 people with severe and complex needs, 23 carers and 22 members of specialist organisations; identification of service examples that demonstrate key features of good practice; and a scoping review of the UK literature since 1997 on good practice in social care for people with severe and complex needs. The findings demonstrate that people with complex needs value person-centred support, typified by the availability of time to get to know a person and flexibility to manage changes in circumstance. The document concludes that there is an urgent need for rigorous evaluation of models of support for people with severe and complex needs.