Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 17
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.
Organisation and delivery of home care re-ablement: what makes a difference?
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Health and Social Care in the Community, 19(5), September 2011, pp.495-503.
- Publisher:
- Wiley
Re-ablement services are a cornerstone of preventive services in England, where many local authorities provide intensive, short-term re-ablement. This study examined the organisation and content of re-ablement services that have the potential to enhance or detract from their effectiveness. Semi-structured interviews were held with senior service managers in five sites with well-established re-ablement services, the observation of 26 re-ablement visits to service users, and a focus group discussion with 37 front-line staff in each site. Contributing factors to the effectiveness of re-ablement services included: service user characteristics and expectations; staff commitment, attitudes and skills; flexibility and prompt intervention; thorough and consistent recording systems; and rapid access to equipment and specialist skills in the team. Factors external to the services which had implications for their effectiveness included: a clear, widely understood vision of the service; access to a wide range of specialist skills; and capacity within long-term home-care services. The authors concluded that more inclusive intake services suggested that outcomes would be considerably lower for service users who have more limited potential for independence.
Dartington review on the future of adult social care: what can England learn from the experiences of other countries?
- Author:
- GLENDINNING Caroline
- Publisher:
- Research in Practice for Adults
- Publication year:
- 2010
- Pagination:
- 24p., bibliog.
- Place of publication:
- Dartington
This paper examines the potential future funding and delivery of adult social care by investigating the experiences of other advanced welfare states, including Denmark, Netherlands and Japan. In 2008 the English Government announced consultation on the future funding and delivery of care and support for disabled adults and older people. A Green Paper was published which suggested a number of potentially radical changes to adult social care and a further period of consultation was announced. However, these debates are also much longer standing. Despite projections of demographic change, particularly future population ageing, this on-going consultation suggests that politically acceptable and economically sustainable solutions are hard to find. If central government becomes responsible for deciding on the levels of resources allocated to individual service users, then it would be unfair to expect local authorities to contribute resources from local council tax – central government would become responsible for raising all the resources for social care, from taxation and insurance mechanisms; a move entirely consistent with reform elsewhere in the world.
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.
Personalisation and partnership: competing objectives in English adult social care? The individual budget pilot projects and the NHS
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- Social Policy and Society, 10(2), April 2011, pp.151-162.
- Publisher:
- Cambridge University Press
This paper discusses inter-sectoral and service partnerships alongside personalised approaches in delivering health and social care in England, where improving collaboration between care services is a long-established objective of social policy. A recent example has been the personalisation of social care for adults and older people through the introduction of individualised funding arrangements. This article examines interviews with lead officers responsible for implementing individual budgets (IBs). It shows how the contexts of local collaboration created problems for the implementation of the personalisation pilots, jeopardised inter-sectoral relationships and threatened some of the collaborative arrangements that had developed over the previous decade. Personal budgets for some health services have subsequently also been piloted. In conclusion, the authors suggest that these will need to build upon the experiences of the social care IB pilots, so that policy objectives of personalisation do not weaken other collaborative accomplishments.
Choice: what, when and why? Exploring the importance of choice to disabled people
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Disability and Society, 25(7), December 2010, pp.827-839.
- Publisher:
- Taylor and Francis
This paper reports evidence from an ongoing qualitative longitudinal study into the realities of exercising choice about support and related services as experienced by disabled and older people and their families. Findings are reported from the first round of interviews, conducted in 2007-08, with 27 young people (aged 13-21) with degenerative/progressive conditions and 34 of their parents, 30 adults and older people with fluctuating support needs, and 20 adults and older people who had recently experienced the sudden onset of a disabling condition. There was considerable diversity among each of these groups in terms of gender, ethnicity and household composition. Key findings are discussed under the headings of healthcare, equipment, housing and adaptations, education/training, social care, employment, and leisure and transport. Almost all respondents felt that having choice was important, however, this is only meaningful if the choices are ‘real’. The choices considered to be important and the way choice was prioritised was shaped by the respondents age and the nature and severity of their condition and also by previous experience of services, future expectations, the availability of information, individual preferences, family responsibilities and the role of others providing support. The importance of learning over time and how this can shape experiences of choice making was also highlighted. Implications of the findings for policy and practice are discussed.
Reforming long-term care: recent lessons from other countries
- Authors:
- GLENDINNING Caroline, MORAN Nicola
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2009
- Pagination:
- 51p., bibliog.
- Place of publication:
- York
This paper reports on a review that explored the experiences of a number of countries in reforming their arrangements for funding and delivering long term care. It aimed to: describe the key features of social care funding and service delivery in a number of countries; examine the current debates and reforms in arrangements for funding and delivery in these countries; discuss the implications and lessons for reform in England. In doing so, three issues were of particular interest: the promotion of choice through individual budgets; sustainability of current arrangements; the extent to which funding and delivery arrangements apply equally to older and younger people with care and support needs. The paper concludes with a number of lessons for the reform of care and support in England.
Progress and problems in developing outcomes-focused social care services for older people in England
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- Health and Social Care in the Community, 16(1), January 2008, pp.54-63.
- Publisher:
- Wiley
Social care services for adults are increasingly required to focus on achieving the outcomes that users aspire to, rather than on service inputs or provider concerns. This paper reports a study aimed at assessing progress in developing outcomes-focused services for older people and the factors that help and hinder this. It describes the current policy context and discusses the social care service outcomes desired by older people. It then reports on a postal survey that identified over 70 outcomes-focused social care initiatives across England and Wales, and case studies of progress in developing outcomes-focused social care services in six localities. The study found progress in developing outcomes-focused services was relatively recent and somewhat fragmented. Developments in intermediate care and re-ablement services, focusing on change outcomes, were marked; however, there appeared to be a disjunction between these and the capacity of home care services to address desired maintenance outcomes. Process outcomes were addressed across a range of re-ablement, day care and residential services. The paper concludes by discussing some of the challenges in developing outcomes-focused social care services.
Under strain? Exploring the troubled relationship between health and social care
- Authors:
- GLENDINNING Caroline, HUDSON Bob, MEANS Robin
- Journal article citation:
- Public Money and Management, 25(4), August 2005, pp.245-251.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Relationships between the NHS and social care services over the past 25 years have a poor history. This article examines the strategies that have been used by central government and by local NHS and social care organizations to overcome difficulties of service co-ordination in relation to services for older people and disabled adults. The article is written from the perspective of the NHS. The authors conclude that policies reflecting 'networked' modes of governance may stand the best chance of success, although evidence of improved impact and outcomes still remains scarce.
Progress in partnerships
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- British Medical Journal, 7.7.01, 2001, pp.28-31.
- Publisher:
- British Medical Association
Primary care groups and trusts are expected to develop partnerships with local authorities, particularly for commissioning services and developing services for older people. Reports on the results of a survey which showed that nearly half of the groups and trusts surveyed do not routinely consult with social services when commissioning community health services, and even fewer consult with social services about commissioning acute care. However, relationships between front line social services staff and community based and practice based health professionals are improving.