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Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England
- Authors:
- CHALLIS David, et al
- Journal article citation:
- Ageing and Society, 30(7), October 2010, pp.1115-1134.
- Publisher:
- Cambridge University Press
In the United Kingdom, the quality of assessment of older people with health and social care needs has been a concern of policy makers and others. This paper examined a key aspect of these concerns – whether sufficient expertise is deployed when an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their complex and multiple problems. The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005/06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. Results revealed that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing. Also, a systematic multi-disciplinary approach was absent. The authors concluded that policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.
Towards understanding variations in social care for older people in England
- Authors:
- BRAND Christian, HUGHES Jane, CHALLIS David
- Journal article citation:
- Social Policy and Administration, 46(7), December 2012, pp.705-726.
- Publisher:
- Wiley
Drawing on multiple data sources, this article investigates the relationship between different indicators of public provision of old age social care. The study used the Performance Indicators Analytic Framework model, and explored process indicators of operational practice and how social services are organised and run, structural factors such as the characteristics of local authorities and populations, and indicators of performance. The analysis was based on selected factors within local authority social care services for older people in England in 2006/7. The article describes the study background, methodology, analysis and statistical modelling. It reports on the findings and discusses factors captured by area performance measures, the potential benefits of greater understanding of indicators, and interpretation of and response to area level performance. It concludes that structural factors beyond the control of local authorities play a major role in determining service outcomes, and explain a considerable share of observable variation between local authorities, and that the findings suggest that caution is necessary when aggregate indicators of service provision are used for performance monitoring purposes.
The assessment gap
- Authors:
- CLARKSON Paul, CHALLIS David
- Journal article citation:
- Community Care, 15.7.04, 2004, pp.38-39.
- Publisher:
- Reed Business Information
The single assessment process (SAP) is intended to overcome the difficulties with assessments of older people, avoid duplication, and promote and effective response to needs. This article examines the relevance of recent research for the debates leading up to the deadline for full implementation in April this year. The study, undertaken by the Personal Social Services Research Unit (PSSRU) at the University of Manchester, looked at 256 older people on the value of integrating the specialist assessments of secondary health care clinicians with those of care managers. Argues that integrating assessment practice between health and social care will require more than the breaking down of professional barriers. Joint structures, providing incentives for collaboration, are just as important.
A system for monitoring social work activity with the frail elderly
- Authors:
- CHALLIS David, CHESTERMAN John
- Journal article citation:
- British Journal of Social Work, 15(2), April 1985, pp.115-132.
- Publisher:
- Oxford University Press
Describes the development of a recording system for use by social workers in the long term care of elderly people at home. The system can be used by individual staff to plot their caseload activities and by management in considering problems of resource deployment. The system consists of: assessment document; periodic case reviews; a monitoring chart; and costing information. The analysis of a cohort of cases in the early phase of their care are discussed and the possible range of uses for such a recording system considered.
Commissioning social care for older people: influencing the quality of direct care
- Authors:
- CHESTER Helen, HUGHES Jane, CHALLIS David
- Journal article citation:
- Ageing and Society, 34(6), 2014, pp.930-950.
- Publisher:
- Cambridge University Press
The delivery of personalised support to vulnerable older people is largely contingent on those staff who provide direct care. These care workers play an invaluable role in supporting vulnerable older people that may have increasingly complex needs either at home or in care homes. Internationally, concern has been raised both about the recruitment and retention of care workers; and their skills and competencies because of their importance in the delivery of quality care services. Using both primary and secondary data, this paper explores commissioning and contracting arrangements for domiciliary care and care home provision in England and their influence on the recruitment and retention of staff in these services. The implications of the findings are discussed in the context of two factors which influence continuity of care, a proxy for quality services for older people: training opportunities for staff and factors affecting the supply of labour from which direct carers are traditionally recruited. It is suggested that some of the drivers of quality in the provision of care may not be susceptible to the influence of commissioners and providers. Nevertheless, training may aid the recruitment and retention of care workers and provide one way in which they can promote a higher standard of care for older people. (Publisher abstract)
Performance indicators in social care for older people
- Authors:
- CHALLIS David, CLARKSON Paul, WARBURTON Raymond
- Publisher:
- Ashgate
- Publication year:
- 2006
- Pagination:
- 350p.
- Place of publication:
- Aldershot
With growing focus upon performance review and monitoring, the awareness and use of performance indicators throughout a number of public services has increased. For social care organisations it is increasingly a requirement that data be available to make performance review possible. Set within a national context, this book reviews the historical development and measurement issues of performance indicators within social care and the public sector for older people. The book provides an approach to effective local performance measurement in services for older people and organising framework within which organisations can arrange their performance appraisal for older people's services. It examines the development of performance review in social care of older people; examines the process of developing local performance measures and engaging staff in enquiry and quality management; and reviews the process of development of performance indicators and their utilisation at an agency level.
Developing and implementing a local performance measurement system in older people's services
- Authors:
- CLARKSON Paul, CHALLIS David
- Journal article citation:
- Research Policy and Planning, 20(3), 2002, pp.3-16.
- Publisher:
- Social Services Research Group
Summarises work in developing and implementing a local performance measurement system within older people's services, drawing on work undertaken by the Personal Social Services Research Unit (PSSRU). Difficulties in developing such systems include central government demands for data that are not always appropriate to local concerns, technological problems and problems with interpretation. The work attempted to confront these difficulties by outlining a model of the most important domains for monitoring, devising a suite of indicators to comment on organisational objectives and using comparative analysis to formulate questions concerning key areas of variation. The system offers a number of benefits and focused implementation can overcome difficulties and increase co-operation from staff.
Community care, secondary health care and care management
- Editors:
- CHALLIS David, DARTON Robin, STEWART Karen
- Publisher:
- Ashgate
- Publication year:
- 1998
- Pagination:
- 178p.,diags.,bibliogs.
- Place of publication:
- Aldershot
Contains papers on: care management and community care; community care and health care for older people; findings and lessons for care management, health care and community care from the Darlington study; the Darlington service past, present and future; the Cornwall experience with assessment and rehabilitation teams in the community; standardised assessment in the community; social services departments, secondary health care and community care; cost opportunities and constraints in developing secondary health care in the community; and linking community and health care.
Performance indicators for community-based social care: From theory to practice
- Authors:
- CHALLIS David, WARBURTON Raymond
- Journal article citation:
- Care Plan, 2(4), June 1996, pp.19-24.
- Publisher:
- Positive Publications/ Anglia Polytechnic University, Faculty of Health and Social Work
Describes a framework for establishing local performance indicators for community-based social care, with an emphasise on care management. The framework has been developed by the Personal Social Services Research Unit (PSSRU) in collaboration with Cheshire Social Services Department. The framework is for services for older people and people with mental health problems, but can be readily modified to accommodate other groups of adult service users.
The work of a community mental health team for the elderly: referrals, caseloads, contact history and outcomes
- Authors:
- BROWN Pamela, CHALLIS David, VON ABENDORFF Richard
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(1), January 1996, pp.29-39.
- Publisher:
- Wiley
A random sample of open cases on the caseloads of two community and mental health teams for older people, operating an open access policy, were followed up over a period of 18 months. In comparison with referrals, caseloads had a higher proportion of patients with affective disorders and fewer with organic syndromes. Elderly patients with diagnoses of organic disorders tended to receive shorter episodes of intervention, more associated with assessment and diagnosis than continuing support, compared with those with affective disorders. A follow-up of those patients who were living at home at the point of sampling indicated that a higher proportion of those with affective disorders remained in their own homes compared with those with organic disorders.