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Outcomes-focused services for older people
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, GLENDINNING Caroline, et al
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2006
- Pagination:
- 134p.
- Place of publication:
- London
This project was commissioned by the Social Care Institute for Excellence (SCIE), to form the basis of practice guidance published by SCIE to support the implementation of proposals in the health and care White Paper, Our Health, Our Care, Our Say. It helped to strengthen the evidence base on how to deliver outcomes-focused services for older people and carers. The project aimed to identify: the service outcomes that were valued by older people and their carers; the organisational and other factors that helped or hindered the delivery of desired outcomes; and examples of good practice in outcomes-focused, person-centred services for older people and their carers. Outcomes' are defined as the impact, or end-results, of services on a person's life; therefore outcomes-focused services are those that aim to achieve the priorities that service users themselves identify as important. The project had two stages. The first covered research on the outcomes valued by older people and their carers; and examples of outcomes-focused practices, including changes in ways of funding, organising or commissioning services, assessment or review arrangements, or the activities of service provider organisations. A postal survey was undertaken to find out how widely outcomes-focused approaches were being developed in services for older people and carers across England and Wales, and the range of different projects or approaches involved. The study then focused on six localities in more depth, examining what changes had been made to the organisation and delivery of services; and the impact of those changes, from the perspectives of service users and carers, managers and front-line staff. The project was supported by an Advisory Group of Service Users, that met at key stages during the project. The Outcomes Network established by SPRU also contributed advice throughout the project.
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.