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Patterns of commissioning, contracting and care management in social care services for older people in England
- Authors:
- CHESTER Helen, HUGHES Jane, CHALLIS David
- Journal article citation:
- British Journal of Social Work, 40(8), December 2010, pp.2523-2537..
- Publisher:
- Oxford University Press
A current objective of social care policy in England is to provide more personalised care services. This has implications for the provision of community based care for frail older people. Using data from a national postal survey of local authorities in England, this paper explores whether a typology of commissioning, contracting and care management arrangements, key components in the delivery of social care, can be discerned through the analysis of a series of indicators. Over two thirds of local authorities responded and arrangements were categorised on an empirical basis, resulting in the formulation of seven categories of authority. These were found to vary in the level of activity in three domains: commissioning and contracting arrangements; employment practices; and flexibility in service provision at the level of the service user. The extent to which the typology constitutes a viable ideal type is explored, together with its relevance to the emergent policy agenda.
Home care services for older people: findings from a national survey of social care commissioners
- Authors:
- HUGHES Jane, CHESTER Helen, CHALLIS David
- Journal article citation:
- Research Policy and Planning, 30(1), 2013, pp.51-64.
- Publisher:
- Social Services Research Group
This paper explores local authority commissioning and contracting arrangements for home care, staff training opportunities and the range of services provided for older people utilising data from a national postal survey with a 74 per cent response rate. Local authority provision focused on intermediate care services. Joint commissioning of this with health was common but less likely for specialist mental health services. Most home care was commissioned from and provided by independent sector providers with contractual requirements identified as a means of influencing and monitoring training opportunities. A range of services were provided for users, additional to personal care. Local authority training was sometimes available to independent providers, focused on statutory requirements rather than user needs. Implications for the development of high quality services are discussed in terms of user need, service flexibility and training for staff providing direct care. It is suggested that within the commissioning process key drivers of the development of more personalised high quality home care services are: regular dialogue with service providers; greater health and social care involvement in a joint commissioning process; alignment of contracting arrangements to reflect service outcomes; and specification of training requirements within the setting and monitoring of home care contracts. (Publisher abstract)
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)