University of Leicester. Nuffield Community Care Studies Unit
Publication year:
2000
Pagination:
69p.
Place of publication:
Leicester
This literature review was undertaken to provide a background for the research, inform the selection of local authorities and aid the formulation of research tools. The review outlines the policy background to current community care provision, identifies the effect that this policy has had on services and community care practice, and reviews what little is known about the impact on older people. Throughout the emphasis is those issues which are most relevant to access to social care.
This literature review was undertaken to provide a background for the research, inform the selection of local authorities and aid the formulation of research tools. The review outlines the policy background to current community care provision, identifies the effect that this policy has had on services and community care practice, and reviews what little is known about the impact on older people. Throughout the emphasis is those issues which are most relevant to access to social care.
Extended abstract:
Author
PARKER Gillian; PHELPS Kay; FRANCIS Jenny; Title
Access to social care for older people: literature review.
Publisher
University of Leicester. Nuffield Community Care Studies Unit, 2000.
Summary
This review outlines the policy background to current community care provision, identifies the effect that this policy has had on services and community care practice, and reviews what little is known about the impact on older people.
Context
This literature review was undertaken to provide a background for the research, inform the selection of local authorities and aid the formulation of research tools. Throughout the emphasis is those issues which are most relevant to access to social care.
Contents
The introduction explains that overall objective of the research project of which this review is a part is to examine the policies and practices that local authority social services departments use to determine access to social care, either overtly or covertly, and understand the impact these have on older people. The aims of the research are to identify the policies and practices that exist within individual local authorities in respect of the allocation of resources for community care services for older people; to identify the policies and practices that are having an effect on the welfare and quality of life of older clients, and to estimate how widespread these may be elsewhere; and to describe the outcomes of these policy and practice decisions by examining in depth their impact on the quality of life of older people who are at home, or in residential or nursing home care. This literature review was undertaken to provide a background for the research, inform the selection of local authorities and aid the formulation of research tools. It outlines the policy background to current community care provision, identifies the effect that this policy has had on services and community care practice, and reviews what little is known about the impact on older people. Throughout the emphasis is on those issues which are most relevant to access to social care. The review used three main techniques to identify relevant material: electronic searching of relevant databases from 1985, use of web sites of relevant research organisations and registers, and hand-searching of relevant periodical publications that are not indexed in the electronic databases. Community care policy documents were, of course, also used. The review is divided into three areas: policy, practice and outcomes. Chapter 1 supplies contextual information by reviewing community care policy since the reforms of the 1990s. This concentrated particularly on the financial background to the changes and the emphasis put on care management as a model for delivering ‘needs-led' and cost-effective care. Changes in the health service which have affected social care are also covered. Chapter 2 outlines the impact that the 1990 community care changes have had on local authority budgets, including their charging policies, and examines what little is known about the way in which the different elements of care management are being delivered.
Conclusion
Keeping people in their own homes was one of the main aims of the NHS and Community Care Act 1990, and the evidence reviewed suggests this is happening to a greater degree than before the 1993 changes. The financial raison d'etre was that it could be cheaper to keep the frail, disabled elderly at home, based largely on evidence that this cost about two-thirds of residential care. But two necessary conditions were breached in introducing the reforms: there should be no perverse effect giving local authorities an incentive to use long-term care rather than home support; and it must be possible to replicate the success of the care management experiments across the whole country. Urgent research is needed that focuses on understanding how given local authorities respond to financial pressures on services, interpret their duties and make decisions that may affect users or potential users in predictable and unpredictable ways; explores the outcomes for older people of changes resulting from these decisions; and attempts to elucidate the link between them. This review forms the first part of a project aiming to do just that.
105 references
Subject terms:
literature reviews, older people, social care, social care provision, access to services;
International Journal of Geriatric Psychiatry, 36(3), 2021, pp.393-402.
Publisher:
Wiley
Objectives: The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia. Methods: A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being. Results: Five hundred and sixty‐nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X2‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future.
(Edited publisher abstract)
Objectives: The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia. Methods: A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being. Results: Five hundred and sixty‐nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X2‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future.
(Edited publisher abstract)
Subject terms:
older people, Covid-19, dementia, carers, access to services, social care;
Summary: This article reviews the evidence available on the treatment of older prisoners within England and Wales who are the fastest growing group within prisons. It concentrates on the lack of available social care facilities for older prisoners. Many older prisoners have special needs that are not met within prison, mainly because of the ‘sameness’ principle that is applied. Social care is as important to older prisoners as their health care. Although some social care may be available to older prisoners, it is not provided within the legal framework that applies to older people outside of prison. This article argues that the general legal obligation to provide social care (imperfect though it may be), should also be applied within the prison setting.
Findings: Based on the evidence available, older prisoners are often unable to access social care services within prison. This is a breach of international obligations entered into by the United Kingdom. It may also breach the European Convention of Human Rights. The article argues that existing legislation does not prevent older prisoners from accessing social care services. The sameness principle discriminates against older prisoners. Mental health, physical disability, and incontinence are all areas where older prisoners lack access to services available to older people outside of prison.
Applications: Considerable progress has been made in raising the profile of older prisoners. However, more needs to be done to embed the social care needs older prisoners may have into the prison system. The ordinary residence rule, the National Service Framework and the Fair Access to Care guidance must be adapted to meet the needs of serving prisoners as well as those preparing for release. Attitudes need to change. There needs to be a willingness to meet the international and domestic legal obligations towards older prisoners.
(Publisher abstract)
Summary: This article reviews the evidence available on the treatment of older prisoners within England and Wales who are the fastest growing group within prisons. It concentrates on the lack of available social care facilities for older prisoners. Many older prisoners have special needs that are not met within prison, mainly because of the ‘sameness’ principle that is applied. Social care is as important to older prisoners as their health care. Although some social care may be available to older prisoners, it is not provided within the legal framework that applies to older people outside of prison. This article argues that the general legal obligation to provide social care (imperfect though it may be), should also be applied within the prison setting.
Findings: Based on the evidence available, older prisoners are often unable to access social care services within prison. This is a breach of international obligations entered into by the United Kingdom. It may also breach the European Convention of Human Rights. The article argues that existing legislation does not prevent older prisoners from accessing social care services. The sameness principle discriminates against older prisoners. Mental health, physical disability, and incontinence are all areas where older prisoners lack access to services available to older people outside of prison.
Applications: Considerable progress has been made in raising the profile of older prisoners. However, more needs to be done to embed the social care needs older prisoners may have into the prison system. The ordinary residence rule, the National Service Framework and the Fair Access to Care guidance must be adapted to meet the needs of serving prisoners as well as those preparing for release. Attitudes need to change. There needs to be a willingness to meet the international and domestic legal obligations towards older prisoners.
(Publisher abstract)
Subject terms:
social care, older people, prisoners, treatment, needs, access to services;
Purpose – The aim of this paper is to provide an overview of the Achieving Age Equality Toolkit, to give the background to its development, and to advise readers of the ways in which it has already been successful in the health and social care arena.
Design/methodology/approach – The subject of this paper is the ban on age discrimination in goods and services that came into force on 1 October 2012. The objectives of the paper are achieved by setting out the policy context, and by detailing how the age equality recommendations were made through an independent review.
Findings – Older people have different experiences of health and social care services, but most want to be able to access support when they need it. Age as a barrier to treatment and screening in areas such as mental health and cancer continue to give cause for concern. Organisations need to ensure they are working in an “age equal” way across services.
Research limitations/implications – Implications for further research could include an assessment of the extent of “institutional ageism” in services after the ban on age discrimination in goods and services on 1 October 2012.
Practical implications – The article illustrates through case studies how use of the toolkit enables one organisation to better identify where changes are needed towards embedding anti age discrimination practice.
Social implications – As well as obeying legal requirements, ending age discrimination in health and social care requires a change in hearts and minds towards encouraging society to think differently about the ways in which older people are supported by health and social care services.
Originality/value – Since the review, there have been repeated cases of age discrimination in goods and services, illustrating the need for change.
(Publisher abstract)
Purpose – The aim of this paper is to provide an overview of the Achieving Age Equality Toolkit, to give the background to its development, and to advise readers of the ways in which it has already been successful in the health and social care arena.
Design/methodology/approach – The subject of this paper is the ban on age discrimination in goods and services that came into force on 1 October 2012. The objectives of the paper are achieved by setting out the policy context, and by detailing how the age equality recommendations were made through an independent review.
Findings – Older people have different experiences of health and social care services, but most want to be able to access support when they need it. Age as a barrier to treatment and screening in areas such as mental health and cancer continue to give cause for concern. Organisations need to ensure they are working in an “age equal” way across services.
Research limitations/implications – Implications for further research could include an assessment of the extent of “institutional ageism” in services after the ban on age discrimination in goods and services on 1 October 2012.
Practical implications – The article illustrates through case studies how use of the toolkit enables one organisation to better identify where changes are needed towards embedding anti age discrimination practice.
Social implications – As well as obeying legal requirements, ending age discrimination in health and social care requires a change in hearts and minds towards encouraging society to think differently about the ways in which older people are supported by health and social care services.
Originality/value – Since the review, there have been repeated cases of age discrimination in goods and services, illustrating the need for change.
(Publisher abstract)
Subject terms:
age discrimination, older people, social care, health care, access to services, case studies;
SOCIAL CARE INSTITUTE FOR EXCELLENCE, SHARIF Nadira, BROWN Walt, RUTTER Deborah
Publisher:
Social Care Institute for Excellence
Publication year:
2008
Pagination:
86p., bibliog.
Place of publication:
London
Systematic maps aim to describe the existing research literature on a broad topic area and also highlight any gaps. This systematic map includes research on the experience of depression in various BME older populations and the use of services in the UK. In particular, it provides an overview of and access to research on: the main ethnic groups assessed for depression; the factors associated with the incidence of depression; the languages used by different BME communities to describe depression, and the meanings attached to depressive symptoms; the screening tools for depression used by healthcare and other professionals some types of interventions available to older BME people. Despite the coverage of broad issues on depression in BME older people, the map highlights considerable gaps particularly around the issue of social care provision.
Systematic maps aim to describe the existing research literature on a broad topic area and also highlight any gaps. This systematic map includes research on the experience of depression in various BME older populations and the use of services in the UK. In particular, it provides an overview of and access to research on: the main ethnic groups assessed for depression; the factors associated with the incidence of depression; the languages used by different BME communities to describe depression, and the meanings attached to depressive symptoms; the screening tools for depression used by healthcare and other professionals some types of interventions available to older BME people. Despite the coverage of broad issues on depression in BME older people, the map highlights considerable gaps particularly around the issue of social care provision.
Subject terms:
literature reviews, older people, social care, social care provision, access to services, black and minority ethnic people, depression, mental health problems;
This report presents the findings from a survey conducted by Ipsos on behalf of the Care Quality Commission (CQC). The survey was undertaken via telephone with 4,013 people aged 65 and over living in England in May and June 2022 who have used health and social care services in the last six months. In addition to demographics, the questionnaire covered use of health and social care services, experience when accessing these, waiting lists for health services or a care assessment, as well as social networks. Overall, people aged 65 and over who have used health and social care services in the last six months tend to describe the care and support they have received as good and feel they have received the care and support they thought they needed, at least to some extent. Although positive at an overall level, the findings highlight that there are risks to health inequalities. some groups of people consistently report poorer experiences of care and support than others (for example of being listened to or treated fairly): women, disabled people and those with multiple long-term conditions, people living in more deprived areas, people in social grades D and E, and people with caring responsibilities. Overall, people aged 65 and over who have used health or social care services in the last six months find it easy to get help from a close family member or friends / neighbours if it is needed, demonstrating strong social networks. However, those most likely to need help (for example, due to old age, a disability, being on a waiting list) find it comparatively harder to get help from family, friends and neighbours when they need it. Those who are currently waiting, either for health services or for a care assessment, are consistently more negative about health and social care services, in relation to access, the quality of care and the coordination of care. Significant minorities do not currently feel well supported, and/or find that their ability to carry out day-to-day activities is getting worse in comparison with when they were first referred to health services or requested a care assessment
(Edited publisher abstract)
This report presents the findings from a survey conducted by Ipsos on behalf of the Care Quality Commission (CQC). The survey was undertaken via telephone with 4,013 people aged 65 and over living in England in May and June 2022 who have used health and social care services in the last six months. In addition to demographics, the questionnaire covered use of health and social care services, experience when accessing these, waiting lists for health services or a care assessment, as well as social networks. Overall, people aged 65 and over who have used health and social care services in the last six months tend to describe the care and support they have received as good and feel they have received the care and support they thought they needed, at least to some extent. Although positive at an overall level, the findings highlight that there are risks to health inequalities. some groups of people consistently report poorer experiences of care and support than others (for example of being listened to or treated fairly): women, disabled people and those with multiple long-term conditions, people living in more deprived areas, people in social grades D and E, and people with caring responsibilities. Overall, people aged 65 and over who have used health or social care services in the last six months find it easy to get help from a close family member or friends / neighbours if it is needed, demonstrating strong social networks. However, those most likely to need help (for example, due to old age, a disability, being on a waiting list) find it comparatively harder to get help from family, friends and neighbours when they need it. Those who are currently waiting, either for health services or for a care assessment, are consistently more negative about health and social care services, in relation to access, the quality of care and the coordination of care. Significant minorities do not currently feel well supported, and/or find that their ability to carry out day-to-day activities is getting worse in comparison with when they were first referred to health services or requested a care assessment
(Edited publisher abstract)
Subject terms:
surveys, user views, health care, social care, access to services, waiting lists, older people, adult social care, health inequalities, inequalities;
Fifteen years after the Special Eurobarometer 283 on Health and long-term care in the European Union, the results of the cross-national InCARE survey bring to light significant changes in the attitudes, expectations and long-term care experiences of Europeans. As momentum for reform is building both at national and European level, we find the policy discourse has not kept up with dynamic preferences and attitudes towards care, especially among younger cohorts. Overwhelming support for increasing the role of the State in long-term care organization, provision and financing and shifting the burden of care away from families and individuals, is improperly reflected in current policies. What is more, a failure to do so is negatively affecting trust in care systems, as well as increasing the reliance on informal carers at the detriment of their health and wellbeing. Since 2007, the ability of care systems to adequately address evolving care needs has declined: residential care is unaffordable for many, and the supply of community-based services is falling considerably behind a rising demand. Rural communities and poorer individuals bear the brunt of growing capacity gaps, while women are disproportionately affected by the burden of frequent, intensive and undesired informal caregiving spells. A reorientation towards person-centered, participatory, equitable and accessible care models is urgently needed to rebuild declining public trust in the ability of care systems to respond to the preferences and expectations of individuals and communities.
(Edited publisher abstract)
Fifteen years after the Special Eurobarometer 283 on Health and long-term care in the European Union, the results of the cross-national InCARE survey bring to light significant changes in the attitudes, expectations and long-term care experiences of Europeans. As momentum for reform is building both at national and European level, we find the policy discourse has not kept up with dynamic preferences and attitudes towards care, especially among younger cohorts. Overwhelming support for increasing the role of the State in long-term care organization, provision and financing and shifting the burden of care away from families and individuals, is improperly reflected in current policies. What is more, a failure to do so is negatively affecting trust in care systems, as well as increasing the reliance on informal carers at the detriment of their health and wellbeing. Since 2007, the ability of care systems to adequately address evolving care needs has declined: residential care is unaffordable for many, and the supply of community-based services is falling considerably behind a rising demand. Rural communities and poorer individuals bear the brunt of growing capacity gaps, while women are disproportionately affected by the burden of frequent, intensive and undesired informal caregiving spells. A reorientation towards person-centered, participatory, equitable and accessible care models is urgently needed to rebuild declining public trust in the ability of care systems to respond to the preferences and expectations of individuals and communities.
(Edited publisher abstract)
Subject terms:
older people, social care, long term care, attitudes, government policy, service provision, user views, person-centred care, user participation, access to services;
This second State of the Nation report explores the increasing need that people have for social care advice, highlights the external factors which may have driven some of this increased need, and details the complexities of some of the issues that those in need are now facing. The report draws together over 74,000 separate data points through a bespoke processing pipeline. We have matched over 1,200 separate organisational data categories to a set of harmonised group categories ('universal themes'). These universal themes match similar group member queries into one category, allowing us to derive greater collective insight across the sector. We categorise member data into group types: 'carers', 'older people', 'sensory disability' and 'learning disability'. We explore key social care trends, investigate the changing pattern of advice provision and detail some examples of the impact this has had on people with social care needs and their families. We observe an unprecedented level of advice provision over and above what we reported in our 2021 State of the Nation report. People continue to struggle in accessing care and support and the increases in advice provision in many of our universal theme areas are stark. Key findings include: our members have provided advice on more social care advice queries in the year 2021/22 compared to 2019/20, a rise of 74%; our members processed 88% more enquiries that were identified as needing specialist legal advice in the year 2021/22 compared to 2019/20; the number of enquiries about social care needs assessments has risen by 229% in the year 2021/22 compared to 2019/20; the number of people contacting our members about problems or concerns about existing social care and support rose by 43% in the year 2021/22 compared to 2019/20.
(Edited publisher abstract)
This second State of the Nation report explores the increasing need that people have for social care advice, highlights the external factors which may have driven some of this increased need, and details the complexities of some of the issues that those in need are now facing. The report draws together over 74,000 separate data points through a bespoke processing pipeline. We have matched over 1,200 separate organisational data categories to a set of harmonised group categories ('universal themes'). These universal themes match similar group member queries into one category, allowing us to derive greater collective insight across the sector. We categorise member data into group types: 'carers', 'older people', 'sensory disability' and 'learning disability'. We explore key social care trends, investigate the changing pattern of advice provision and detail some examples of the impact this has had on people with social care needs and their families. We observe an unprecedented level of advice provision over and above what we reported in our 2021 State of the Nation report. People continue to struggle in accessing care and support and the increases in advice provision in many of our universal theme areas are stark. Key findings include: our members have provided advice on more social care advice queries in the year 2021/22 compared to 2019/20, a rise of 74%; our members processed 88% more enquiries that were identified as needing specialist legal advice in the year 2021/22 compared to 2019/20; the number of enquiries about social care needs assessments has risen by 229% in the year 2021/22 compared to 2019/20; the number of people contacting our members about problems or concerns about existing social care and support rose by 43% in the year 2021/22 compared to 2019/20.
(Edited publisher abstract)
Subject terms:
social care, learning disabilities, adult social care, disabilities, older people, carers, access to information, advice services, access to services, service uptake;
This State of the Nation report looks at the extent to which social care advice demand and provision has changed due to the COVID-19 health crisis as well as ongoing chronic underfunding in the social care sector. Access Social Care have worked with Mencap, Age UK, Carers UK and Independent Age for over a year on analysing the key challenges facing people who need social care and their families. Data is presented by categorising into group types: 'carers', 'older people' and 'learning disability'. We compare key social care trends across England and investigate the changing pattern of advice demand and provision on these group types. We detail some examples of the impact this has had on people with social care needs and their families. The findings indicate sharp and alarming rises in demand in many areas. The rate of growth is extremely concerning, particularly against the backdrop of known and imminent cost efficiency targets within some adult social care budgets from 2021/22 onwards. Specifically, the findings show: significant increase in overall demand for carers advice - advice for carers rose by 394% in April 2021 compared to March 2019; social care needs assessment enquiries rise by 84%; social care charging queries rise by 45%; safeguarding concerns about disabled people continue, peaking in easing of national restrictions.
(Edited publisher abstract)
This State of the Nation report looks at the extent to which social care advice demand and provision has changed due to the COVID-19 health crisis as well as ongoing chronic underfunding in the social care sector. Access Social Care have worked with Mencap, Age UK, Carers UK and Independent Age for over a year on analysing the key challenges facing people who need social care and their families. Data is presented by categorising into group types: 'carers', 'older people' and 'learning disability'. We compare key social care trends across England and investigate the changing pattern of advice demand and provision on these group types. We detail some examples of the impact this has had on people with social care needs and their families. The findings indicate sharp and alarming rises in demand in many areas. The rate of growth is extremely concerning, particularly against the backdrop of known and imminent cost efficiency targets within some adult social care budgets from 2021/22 onwards. Specifically, the findings show: significant increase in overall demand for carers advice - advice for carers rose by 394% in April 2021 compared to March 2019; social care needs assessment enquiries rise by 84%; social care charging queries rise by 45%; safeguarding concerns about disabled people continue, peaking in easing of national restrictions.
(Edited publisher abstract)
Subject terms:
advice services, social care, adult social care, access to information, older people, carers, disabilities, access to services, service uptake;
This report presents the findings of a service user involvement exercise with older people in prison to understand their needs and experiences. Older people in prison (50 or over) currently make up 17% of the total prison population; that’s more than one in six and equates to 13,038 people. Of these, 3,281 are in their 60s and a further 1,638 people are 70 or older. 315 people in prison were aged 80 or over (as of 30 September 2020) – 311 were men and four were women. We engaged with older people in prison through forums in three prisons: HMP Wymott – one forum attended by six people; HMP Leyhill – two forums attended by four people (total eight); HMP Erlestoke – two forums attended by six people (total 12). In addition, we widened the reach of our engagement to a further four prisons (HMPs Preston, Manchester, Kirkham and Eastwood Park), collecting a total of 110 questionnaires from older prisoners. The study revealed the particular challenges older people in prison face and has highlighted the need for an overarching and consistent approach to meeting these needs. Four key themes were investigated: ensuring older people are placed in establishments which can meet their needs; access to age appropriate meaningful activity; access to health and care provision which meets multiple and complex health and social care needs; preparing for resettlement in the community upon release or end of life in prison.
(Edited publisher abstract)
This report presents the findings of a service user involvement exercise with older people in prison to understand their needs and experiences. Older people in prison (50 or over) currently make up 17% of the total prison population; that’s more than one in six and equates to 13,038 people. Of these, 3,281 are in their 60s and a further 1,638 people are 70 or older. 315 people in prison were aged 80 or over (as of 30 September 2020) – 311 were men and four were women. We engaged with older people in prison through forums in three prisons: HMP Wymott – one forum attended by six people; HMP Leyhill – two forums attended by four people (total eight); HMP Erlestoke – two forums attended by six people (total 12). In addition, we widened the reach of our engagement to a further four prisons (HMPs Preston, Manchester, Kirkham and Eastwood Park), collecting a total of 110 questionnaires from older prisoners. The study revealed the particular challenges older people in prison face and has highlighted the need for an overarching and consistent approach to meeting these needs. Four key themes were investigated: ensuring older people are placed in establishments which can meet their needs; access to age appropriate meaningful activity; access to health and care provision which meets multiple and complex health and social care needs; preparing for resettlement in the community upon release or end of life in prison.
(Edited publisher abstract)
Subject terms:
prisons, user views, older people, access to services, resettlement, prison service, social care, health care;