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Improving personal budgets for older people: a review: phase one report
- Authors:
- ROUTLEDGE Martin, CARR Sarah
- Publisher:
- Think Local Act Personal
- Publication year:
- 2013
- Pagination:
- 21p.
- Place of publication:
- London
This project explores the challenges, identifies positive practice and makes recommendations for central and local government action with respect to improving personal budgets. Think Local Act Personal (TLAP) published, Personal Budgets: Taking Stock and Moving Forward (2011) which reviewed progress, challenges and possibilities with PBs and has initiated a National Self-Directed Support Forum. This brings together relevant groups and individuals to identify challenges and agree actions to achieve improvements. Approaches to making personal budgets work well for older people emerged as a high priority and TLAP has committed to do more work in this area. This report is the first stage. It draws on two key surveys: the ADASS personalisation survey (2012); and the TLAP National Personal Budgets Survey (2011). It reviews the literature and research on key challenges to successful implementation of personal budgets for older people, reviews data on numbers and outcomes including from ADASS and Personal Budgets Outcomes Evaluation Tool (POET) surveys. It also gives an initial overview of promising practice responding to the challenges from literature and the ADASS survey. Relatively strong average progress with numbers for people aged 65 and over is being made. The recent significant increase in numbers has been via more managed personal budgets with direct payment numbers steady but significantly lower for older people than for under 65s. There is very significant variation in direct payment numbers across councils and regions.
The effectiveness of local authority social services' occupational therapy for older people in Great Britain: a critical literature review
- Authors:
- BONIFACE Gail, et al
- Journal article citation:
- British Journal of Occupational Therapy, 76(12), 2013, pp.538-547.
- Publisher:
- Sage
This literature review systematically selected, critically appraised, and thematically synthesized the post 2000 published and unpublished evidence on the effectiveness and cost effectiveness of occupational therapy interventions for older people in social care services. Identified themes established: the localized nature of social care services for older people; organizational and policy impacts on services, and factors influencing effectiveness and cost effectiveness. Although occupational therapists are increasingly involved in rehabilitation and reablement, there is a continuing focus on equipment and adaptations provision. A high level of service user satisfaction was identified, once timely occupational therapy services were received. Overall, occupational therapy in social care is perceived as effective in improving quality of life for older people and their carers, and cost effective in making savings for other social and healthcare services. However, the complex nature of social care services makes it difficult to disaggregate the effectiveness of occupational therapy from other services. (Edited publisher abstract)
A realistic evaluation of integrated health and social care for older people in Wales, to promote independence and wellbeing: interim report
- Authors:
- CHICHLOWSKA S.Carnes, et al
- Publisher:
- Welsh Government Social Research
- Publication year:
- 2013
- Pagination:
- 123
- Place of publication:
- Cardiff
Researchers at the Centre for Innovative Ageing, Swansea University provide a critical overview of each of a range of integration projects or services across Wales, comparing them to an idealised ‘testable theory’ of how integration should work. The aim is that older people are able to maintain their wellbeing and independence whilst being able to live with a range of care needs extending to complex and chronic conditions, preferably in their own homes and their own communities. The first section of the report is a summary of the literature review related to policy strategy and provision of integrated health and social care services for older people, using literature sourced nationally across Britain and locally in Wales. The second section comprises information on the models of care of the projects and services selected, based on a small number of interviews with stakeholders. The information will be used to develop a conceptual model of integrated care that can be used to assess the impact of services to older people. The report observes the emergence of several unintended and undesirable outcomes of developing integrated care, including competition between services and alienation of GPs and other health and service professionals. Assessment, patient notes and data collection is still largely paper based, creating difficulties in sharing and disseminating information across services. Further work is required to evaluate integrated health and social care. (Original abstract)
An evaluation of mixed methods (diaries and focus groups) when working with older people
- Authors:
- KOOPMAN-BOYDEN Peggy, RICHARDSON Margaret M.
- Journal article citation:
- International Journal of Social Research Methodology, 16(5), 2013, pp.389-401.
- Publisher:
- Taylor and Francis
This paper considers the advantages and limitations of using mixed methods, diaries and focus groups in research with older people, specifically research investigating the interaction experiences of older individuals as customers, members and workers with public-, private- and community-based organisations. Drawing on the literature on mixed method integration, five distinct advantages were identified: development, completeness, expansion, offsetting and initiation. Two limitations were also noted: demands of the data collection on the participants and insufficient depth. Each is discussed in the context of the particular research project, with the suggestion that mixed methods be used in future research with older people. (Publisher abstract)
Preventing social isolation in later life: findings and insights from a pilot Queensland intervention study
- Authors:
- BARTLETT Helen, et al
- Journal article citation:
- Ageing and Society, 33(7), 2013, pp.1167-1189.
- Publisher:
- Cambridge University Press
This paper reports on the challenges of attempting to undertake a rigorous evaluation of three demonstration pilot projects targeting older people at risk of social isolation, conducted within different social settings in Queensland, Australia. The demonstration projects were part of the Queensland Cross-Government Project to Reduce Social Isolation in Older People (CGPRSIOP) led by the Office for Seniors within the Queensland Department of Communities. The programme incorporated validated psychological measures to evaluate the effectiveness of interventions. While use of these measures suggested some promising results, the focus of this paper is on the methodological and practical challenges associated with utilising evaluation measures in community-based interventions. The detailed consideration of the methodological issues involved in this programme highlights some key lessons and offers new insights into evaluating interventions for reducing social isolation. (Edited publisher abstract)
On the track of evaluated programmes targeting the social participation of seniors: a typology proposal
- Authors:
- RAYMOND Émilie, et al
- Journal article citation:
- Ageing and Society, 33(2), 2013, pp.267-296.
- Publisher:
- Cambridge University Press
A research review covering over 40 databases in the health and social sciences identified 32 programmes aimed at fostering the social participation of older people. The programmes were all both implemented and evaluated, and whose results were published between January 1970 and August 2011. Based on each programme's approach, a typology of social programmes is proposed. The programmes are grouped in five categories: social interaction in an individual context; social interaction in a group context; collective projects; volunteering and informal support; and socio-political programmes. Classification is based on the various ways the concept of social participation is defined and acted upon by the reviewed programmes. Far from being neutral, each category suggests a specific representation of the social roles of older people. The article also discusses how the proposed typology can guide both policy and practice, linking identity and agency issues to organisational and structural considerations. Three uses for the typology are suggested: as a policy-making support, as an evaluative framework, and as an experimental space for community practice. (Edited publisher abstract)
Integrated care pilot in north-west London: a mixed methods evaluation
- Authors:
- CURRY Natasha, et al
- Journal article citation:
- International Journal of Integrated Care, 13(3), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
This paper provides the results of a year-long evaluation of a large-scale integrated care pilot in north-west London. The pilot aimed to integrate care across primary, acute, community, mental health and social care for people with diabetes and/or those aged 75+ through care planning, multidisciplinary case reviews, information sharing and project management support. The evaluation team conducted qualitative studies of change at organisational, clinician and patient levels (using interviews, focus groups and a survey); and quantitative analysis of change in service use and patient-level clinical outcomes (using patient-level datasets and a matched control study). The pilot had successfully engaged provider organisations, created a shared strategic vision and established governance structures. However, the engagement of clinicians was variable and there was no evidence to date of significant reductions in emergency admissions. There was some evidence of changes in care processes. The paper concludes that it is critical that National Health Service managers and clinicians have realistic expectations of what can be achieved in a relatively short period of time. (Publisher abstract)
'When I get off the phone I feel like I belong to the human race': evaluation of the Silver Line Helpline pilots
- Author:
- CENTRE FOR SOCIAL JUSTICE
- Publisher:
- Centre for Social Justice
- Publication year:
- 2013
- Pagination:
- 61
- Place of publication:
- London
An evaluation of the Silver Line helpline and befriending service which was set up in response to loneliness and isolation of older people in the UK. The service has been piloted in the North West of the UK, and in the Isle of Man since the end of November 2012 and provides a helpline offering information, referrals to other organisations and someone to talk to 24 hours a day. The evaluation included a literature review, interviews by phone and in person, and fieldwork in the three call centres. The results found that the service was fulfilling its three key objectives of providing a referral service, delivering a befriending service to combat loneliness, and to help identify those who are vulnerable and may be suffering abuse or neglect. The evalution also highlights the skills and values that staff and volunteers considered to be essential when operating the service. Key recommendations for the future included extending the pilot across the country through partnership. (Original abstract)
Measuring the impact of Supporting People: a scoping review: research summary
- Author:
- WALES. Welsh Government
- Publisher:
- Welsh Government Social Research
- Publication year:
- 2013
- Pagination:
- 6
- Place of publication:
- Merthyr Tydfil
The Aylward Review of Supporting People (Welsh Assembly Government, 2010) recommended the review of outcomes measurement and monitoring of Supporting People projects in Wales. This scoping study was designed to inform the range, methodology and research questions of a large scale assessment of the impacts of Supporting People across Wales. The research was carried out between April and September 2012. The scoping study explored the Supporting People provision by contacting local authorities and also surveying service providers. Existing outcome monitoring and impact assessment systems developed both within and outside Wales were also reviewed. This research summary outlines key findings of the scoping review, including the drawbacks of and problems with the methodologies used. (Edited publisher abstract)
Gaps, disconnections, and discontinuities: the role of information exchange in the delivery of quality long-term care
- Journal article citation:
- Gerontologist, 53(5), 2013, pp.770-779.
- Publisher:
- Oxford University Press
Purpose of the Study: The smart use of information and communication technologies (ICT) is widely seen as a means of enhancing the quality of aged care services. One of the barriers to ICT diffusion in aged care is the failure to cater for the complex and interdisciplinary requirements of the aged care environment. The aim of this qualitative study was to identify the layers of information exchange and communication and produce a conceptual model that can help to inform decisions related to the design, implementation, and sustainability of ICT. Design and Methods : A qualitative study conducted in 2010 within seven Australian residential aged care facilities. It included 11 focus groups involving 47 staff and 54 individual interviews and observation sessions. Results : The analysis of work processes identified key information exchange components related to the type of information (residential, clinical, and administrative) that is collected, stored, and communicated. This information relies on a diverse number of internal and external communication channels that are important for the organisation of care. Implications : The findings highlight potential areas of communication dysfunction as a consequence of structural holes, fragmentation, or disconnections that can adversely affect the continuity and coordination of care, its safety, and quality. (Publisher abstract)