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Funding long-term care for older people: lessons from other countries
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2004
- Pagination:
- 35p., bibliog.
- Place of publication:
- York
An evaluation of how other countries are devising fair and sustainable ways of funding long-term care for older people. Like the UK, many other countries are facing challenges in devising fair and sustainable ways of funding the long-term care needed by new generations of older people. While the challenges are similar, their responses are sometimes very different from our own. Nevertheless, their experiences can provide valuable lessons for the UK. This report draws on the experiences of long-term care funding – both the raising of revenue and the mechanisms by which it is allocated to services and allowances – in Australia, Austria, Denmark, France, Germany, Japan, Netherlands, Scotland and the United States.
Declaration of independence
- Author:
- GLENDINNING Caroline
- Journal article citation:
- Community Care, 8.5.03, 2003, pp.40-41.
- Publisher:
- Reed Business Information
Discusses a new study by the Audit Commission in partnership with the Better Government for Older People Network which examines what independence really means to older people. To ensure the research was shaped by the views of older people, focus groups were organised by Age Concern in eight urban and rural areas across England. The study found that independence often meant having choice and control, rather than doing everything for yourself.
Caring for a relative with dementia: the perceptions of carers and CPNs
- Authors:
- PICKARD Susan, GLENDINNING Caroline
- Journal article citation:
- Quality in Ageing, 2(4), December 2001, pp.3-11.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Older people with dementia living in the community are most likely to be cared for by other older people, predominantly spouses, who will be at increased risk of stress-related health problems themselves. Appropriate support of such carers is crucial if carer breakdown and consequent care-receiver admission to residential homes is to be avoided. This paper examines the experience of older carers of frail older people with dementia and examines the kind of support that is provided to such carers. In practice, the sole source of professional support received by older people in this study was from community psychiatric nurses (CPNs). CPN' s role did not comprise hands-on care-giving and family carers carried out most personal/physical and health care tasks themselves, aided in some cases by care workers. The paper concludes by suggesting that lack of support for carers in these activities requires redress.
Women and poverty in Britain
- Editors:
- GLENDINNING Caroline, Millar Jane
- Publisher:
- Wheatsheaf Books
- Publication year:
- 1987
- Pagination:
- 302p., bibliog.
- Place of publication:
- Brighton
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.
Choice and control for older people using home care services: how far have council-managed personal budgets helped?
- Authors:
- RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Quality in Ageing and Older Adults, 15(4), 2014, pp.210-219.
- Publisher:
- Emerald
Purpose: This paper reports the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise. Design/methodology/approach: Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face. Findings: Areas discussed include choice and flexibility over care agency, care workers, tasks, and timing and duration of visits. Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the 'ideal' of user choice and the 'reality of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to 'exit' from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs. Originality/value: The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider. (Edited publisher abstract)
Managed personal budgets for older people: what are English local authorities doing to facilitate personalized and flexible care?
- Authors:
- BAXTER Kate, RABIEE Parvaneh, GLENDINNING Caroline
- Journal article citation:
- Public Money and Management, 33(6), 2013, pp.399-406.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper explores how three local authorities in England have tried to facilitate personalized home care for older people through changes in commissioning and market development activities; and how these changes have been experienced by support planners and home care agency managers. Two borough council and one county council were selected. One council offered Individual Service Funds (IFS) and one offered 'virtual budgets'. Overall, it appears that changes are well intended, but the practicalities of implementing them raise some challenges that mean desired objectives may not always be achieved. (Edited publisher abstract)
Choice and independence over the lifecourse: final report to the Department of Health
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2011
- Pagination:
- 43p.
- Place of publication:
- York
Between 2006 and 2011 the Social Policy Research Unit (SPRU) at the University of York carried out a programme of research on choice for disabled and older people who need social care support, and their family carers, called ‘Choice and Independence over the Lifecourse’. This final report for the Department of Health (DH) provides an overview of this programme of research. The account of the research is divided into 3 sections: projects funded from the main DH programme grant; projects funded through SPRU’s ‘responsive mode’ capacity; and other projects linked to the DH programme. An account of the relevance of the research programme to DH policy and its implementation at local levels is also provided. The research conducted by SPRU within its DH-funded programme has, for the most part, been concerned with issues of choice, from the perspectives of users, carers, service providers and managers. At the heart of the programme was a major long-term study of disabled young people, working age adults and older people as their health and other circumstances changed. The report concludes with a list of the published outputs (peer reviewed journal articles, books and reports, research summaries, professional press, and presentations) emerging from this research programme.
A survey of access to medical services in nursing and residential homes in England
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- British Journal of General Practice, 52(480), July 2002, pp.545-548.
- Publisher:
- Royal College of General Practitioners
A survey was conducted within the 72 English primary care groups/trusts (PCG/Ts) used in the National Tracker Survey of PCG/Ts to investigate patterns of access to medical services for residents in homes for older people. A structured questionnaire was used to investigate home characteristics, numbers of general practitioners (GPs) or practices per home, homes' policies for registering new residents with GPs, existence of payments to GPs, GP services provided to homes, and access to specialist medical care. Wide variations in the numbers of GPs providing services to individual homes were found and this was not entirely dependent on home size. Eight percent of homes paid local GPs for their services to residents; these were more likely to be nursing homes than residential homes and larger homes. Homes paying local GPs were more likely to receive one or more additional services, over and above GPs' core contractual obligations. Few homes had direct access to specialist clinicians. These extensive variations in homes' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community.
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.