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Marketisation of Nordic eldercare: is the model still universal?
- Author:
- MOBERG Linda
- Journal article citation:
- Journal of Social Policy, 46(3), 2017, pp.603-621.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
The objective of this article is to analyse whether the increased reliance on marketisation in the provision of social care challenges the universality of eldercare in Sweden, Denmark, Finland and Norway. The study focuses on national reforms for contracting out and user choice of provider, analysing their consequences for four universalistic dimensions: (i) equal inclusion, (ii) public funding, (iii) public provision and (iv) comprehensive usage. The findings suggest that, although need-based inclusion and public funding remain key principles in all four countries, there is an increased reliance on private provision in Sweden, Denmark and Finland. In addition, the introduction of topping-up services challenges the dimension of comprehensive usage by enabling users with economic resources to turn to the private market to increase the comprehensiveness and quality of their care. (Publisher abstract)
Stoke-on-Trent: local system review report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 42
- Place of publication:
- Newcastle upon Tyne
One of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs. The reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This resulted in people finding it difficult to access GP appointments, older people being delayed in hospital, and needs and care packages in the community not being reviewed as regularly as they should be. The review also identifies areas for improvement. (Edited publisher abstract)
Halton: local system review report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 35
- Place of publication:
- Newcastle upon Tyne
One of 20 targeted reviews of local authority areas looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that there was a strong commitment and a shared vision across the local authority and the clinical commissioning group (CCG) to serve the people of Halton well. There was a positive approach in Halton to maintain people’s health and wellbeing in their own homes, with services designed for older people to keep them socially included, active and able to manage their long term conditions. There was good support for carers including those supporting people living with dementia. Halton had also recently introduced new services introduced to avoid hospital admissions, including a rapid seven-day re-ablement service and a rapid clinical assessment team. Transformation projects for care homes and domiciliary care were underway so that people’s individual needs could be met in a timely way. This had led to a reduction in the numbers of delayed transfers of care and improvements in performance. The review also identifies areas for improvement (Edited publisher abstract)
Bracknell Forest: local system review report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 42
- Place of publication:
- Newcastle upon Tyne
One of 20 targeted local system reviews looking at how older people move through the health and social care system, with a focus on how services work together. The review consideres how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that the health and social care system in Bracknell Forest was working effectively and using an integrated approach that was having positive outcomes for older people. Most older people were receiving good quality health and social care services in a timely way. Reviewers found evidence of strong strategic leadership between Bracknell Forest Council, Bracknell and Ascot Clinical Commissioning Group and providers, with a well-established, collaborative approach to designing and delivering services. Bracknell Forest service priorities included helping older people avoid unnecessary admissions to hospital, offering older people support to stay well, and improving the capacity of homecare agencies and care homes to manage the recruitment challenges. As a result, there had been reductions the numbers of people remaining in hospital while they waited for their ongoing care to be arranged. Performance had improved and was better than comparator and national averages. The review also identifies areas for improvement. (Edited publisher abstract)
A human rights based approach to self-directed support for older people
- Author:
- MILLER Carlyn
- Publisher:
- Scottish Care
- Publication year:
- 2017
- Pagination:
- 32
- Place of publication:
- Ayr
This report explores how using a human rights-based approach can help to implement self-directed support for older people in Scotland, using the experience of the Getting it Right for Older People Project. It explores how outcomes were met using a human rights based approach of participation, accountability, non-discrimination and equality, empowerment and legality alongside the Self-directed Support principles achieved. It shows how the PANEL and FAIR models can be used to address barriers to self-directed support implementation and ensure human rights are promoted. Case studies show how key challenges were addressed: the knowledge, awareness and understanding of self-directed support; availability of services, ownership and collaboration, and processes and timescales. The report concludes by reviewing the current barriers facing stakeholders in the implementation of self-directed support and human rights for older people and puts forward three calls to action if the Social Care (Self-directed Support) Scotland Act (2014) is to be fully realised. (Edited publisher abstract)
Social care: Government reviews and policy proposals for paying for care since 1997 (England)
- Author:
- JARRETT Tim
- Publisher:
- Great Britain. Parliament. House of Commons Library
- Publication year:
- 2017
- Pagination:
- 22
- Place of publication:
- London
This briefing considers the policy proposals of successive Governments since 1997 for how individuals should pay for their social care. Unlike health services through the NHS, social care is not universally free at the point of delivery – local authority support is means-tested, and those that receive funding such support are still expected to contribute their income towards the cost. While the issue of paying for social care has been considered in depth – by the Royal Commission in 1999, the independent King’s Fund in 2005, and the Dilnot Commission in 2011 – and some important changes have been made, the key features of the means-test remain broadly unchanged since 1997 while the issue of very high lifetime social care bills remains unresolved. This note sets out the key findings of the reviews as they relate to how individuals pay for their social care, Government policy responses, and the position of the current Conservative Government. Social care funding is a devolved matter – this note relates to England only, although it does provide information about the adaptation of free personal care in Scotland following the report of the Royal Commission. (Edited publisher abstract)
Support networks for Chinese older immigrants accessing English health and social care services: the concept of Bridge People
- Authors:
- LIU Xiayang, COOK Glenda, CATTAN Mima
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.667-677.
- Publisher:
- Wiley
As Chinese immigrants in the United Kingdom age, they experience an increasing need to access health and care services. It has, however, been reported that older Chinese immigrants have difficulties in accessing these services. This study explored the experiences of this population in using health and care services and the strategies that they adopted to address their difficulties. A grounded theory method with a two-staged research design was used. Stage 1 explored the participants’ experiences of ageing and use of health and social care services through focus group interviews. Stage 2 investigated the strategies individuals used to support access to and use of services through individual interviews. Forty-four older Chinese people and 15 supporters participated in interviews during August 2011 and May 2013. These older Chinese immigrants were challenged in knowing about and in accessing services. Their difficulties were attributed to language barriers, lack of information and instrumental support, and emotional and cultural issues regarding use of health and care services. Their supporters facilitated access to services and acted as a bridge between the service and the user; therefore, they were given the title ‘Bridge People’. Bridge People have different backgrounds: family and friends, public sector workers and staff from community-based Chinese organisations. The defining attributes of these supporters were: bilinguality, bicultural, multifunctionality and accessibility. There is no charge for this support; and the relationship between the Bridge Person and recipient involves trust and influence over decisions regarding use of health and care services. Bridge People should be recognised and identified by health, social care and housing services to promote engagement and use of services by older immigrant Chinese people. (Publisher abstract)
State of the nation: older people and malnutrition in the UK today
- Author:
- MALNUTRITION TASK FORCE
- Publisher:
- Malnutrition Task Force
- Publication year:
- 2017
- Pagination:
- 27
- Place of publication:
- London
Brings together information, statistics and evidence from across the health and social care system to provide a picture of what is happening to older people who are malnourished or at risk of malnutrition in England. It examines the causes and consequences of malnutrition in the UK. It discusses risk factors in three categories: medical and disease-related factors which are directly related to another on-going health condition, such as dementia; physical risk factors, which may be related to underlying health problems, such as mobility or sensory loss; and social factors, such as income and loneliness. The report shows that the prevalence of these risk factors is widespread and likely to increase as the population ages. It looks at older people at risk of malnutrition in hospitals and living in the community, and the support that could prevent malnutrition. The report also looks at economic costs and pressures, and whether the NHS and social care services are currently able to support older people at risk. The final section summarises existing good practice guidance and highlights the need for increasing public awareness, professional training, and an integrated system of health and social care in order to prevent and treat malnutrition. (Edited publisher abstract)
Health and social care needs assessments of the older prison population: a guidance document
- Authors:
- MUNDAY David, LEAMAN Jane, O'MOORE Eamonn
- Publisher:
- Public Health England
- Publication year:
- 2017
- Pagination:
- 59
- Place of publication:
- London
This document provides evidence-based guidance on how to carry out a health and social care needs assessment of older people in prisons. It can be used by commissioners of prison healthcare services and social care services to understand the needs of older people in prisons and commission and deliver services that meet their needs. The document is structured around 13 chapters which each address a key theme that should be considered. They include demographics, review of physical environment, risk factors for disease, prevalence of disease, medicines optimisation, prevalence of social care need, promoting health and wellbeing, palliative care services, user engagement, mapping services to meet need, and planning for release and continuity of care. Each chapter includes national level data on levels of need; data sources and indicators that can used to assess need; and examples from practice. (Edited publisher abstract)
Robotics in social care: a connected care ecosystem for independent living
- Author:
- UK-RAS Network
- Publisher:
- UK-RAS Network
- Publication year:
- 2017
- Pagination:
- 36
This discussion paper looks at the emerging crisis in UK social care due to both an ageing population and increasing numbers of people with long term conditions in need of support. It looks at the potential for technology, and in particular Robotics and Autonomous Systems (RAS), to provide long-term sustainable social care solutions. It proposes a role for robotics in supporting social care that connects together support at home, in residential care and in hospital. It outlines some of the robotic systems currently under development that can support independent living; technologies that can help people living with chronic conditions or disability; and also support people experiencing cognitive decline or dementia. The final section looks at some of the key research challenges for the future use of Robotics and Autonomous Systems (RAS) in social care. It also highlights the opportunities and ethical and societal issues for researchers, policy-makers and all social care stakeholders to work together. (Edited publisher abstract)