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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.
Increasing choice and control for older and disabled people: a critical review of new developments in England
- Author:
- GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 42(5), October 2008, pp.451-469.
- Publisher:
- Wiley
This paper critically examines new policies currently being implemented in England aimed at increasing the choice and control that disabled and older people can exercise over the social care support and services they receive. The development of these policies, and their elaboration in three policy documents published during 2005, are summarized. The paper then discusses two issues underpinning these proposals: the role of quasi-markets within publicly funded social care services; and the political and policy discourses of consumerism and choice within the welfare state. Despite powerful critiques of welfare consumerism, the paper argues that there are nevertheless very important reasons for taking choice seriously when considering how best to organize and deliver support and other services for disabled and older people. A policy discourse on consumerism, however, combined with the use of market mechanisms for implementing this, may be highly problematic as the means of creating opportunities for increased choice and, on its own, risks introducing new forms of disadvantage and social exclusion.
Improving equity and sustainability in UK funding for long-term care: lessons from Germany
- Author:
- GLENDINNING Caroline
- Journal article citation:
- Social Policy and Society, 6(3), July 2007, pp.411-422.
- Publisher:
- Cambridge University Press
This paper argues for a transformation of arrangements for accessing and allocating public resources for long-term care in the UK. Currently these arrangements are fragmented, inequitable and not always well targeted. Different arrangements exist in Scotland and England; Wales has also debated the introduction of free personal care. While not necessarily advocating a social insurance approach, the experience of Germany nevertheless shows how simplicity, transparency and equity of access can be combined with strong cost control levers and political sustainability. An opportunity to transform ways of accessing and distributing public resources for long-term care arises with the piloting of ‘individual budgets’ in 13 English local authorities from 2006. The paper argues that the principles underpinning individual budgets should be extended, with the UK government taking a strong national lead.
Carers' roles in personal budgets: tensions and dilemmas in front line practice
- Authors:
- MITCHELL Wendy, BROOKS Jenni, GLENDINNING Caroline
- Journal article citation:
- British Journal of Social Work, 45(5), 2015, pp.1433-1450.
- Publisher:
- Oxford University Press
Adult social care in England emphasises the service and support preferences of disabled and older people. Personal budgets play a central role in this development. Carers in England have also secured rights to assessment and support in their care-giving roles. However, these policies have developed largely separately, with little consideration of the interdependencies between disabled and older people and their carers. There is limited evidence detailing current practice. This paper explores current practice, particularly how far social care practitioners recognise and balance the needs and interests of service users and carers, especially those with cognitive and/or communication impairments. The paper reports findings from nine qualitative focus groups (forty-seven participants) conducted in 2012 with practitioners involved in service user personalisation and carer assessments from older people and learning disability teams across three English authorities. Findings indicate inconsistencies in practice. Although practitioners felt they sought to involve carers, practices varied between authorities, teams and colleagues in the same team. Clear and timely links between processes for service users and carers were absent. Practice was discussed most frequently around service user assessments; other stages of personalisation appeared ad hoc. Areas of confusion and tension are identified. Future policy and practice developments and challenges are also considered. (Publisher abstract)
Buying Independence: using direct payments to integrate health and social services
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- National Primary Care Research and Development Centre
- Publication year:
- 2000
- Pagination:
- 58p.
- Place of publication:
- Bristol
Shows how disabled people do not make clear distinctions between 'health' and 'social' care. Through direct payments, they are able to control and integrate into their daily routines a wide range of health-related activities, such as physiotherapy and nursing tasks, in ways which offer increased independence and better quality of life, compared with conventional health services. Is extending direct payments to older people and disabled children a shift in the boundary between 'health' and 'social' services? This book explores how direct payments can improve further the integration of services from the perspectives of the users and providers involved.