Search results

This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers.

An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England.

This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement.

The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field.

This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support.

Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.

The purpose of this paper is to explore the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators.

Data are presented from the Adult Social Services Environments and Settings project which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews.

Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public.

This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.

Data were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.

The integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.

The study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.

The study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.

This paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.

This paper examined the significance of the built environment for shaping inclusion and social connections in housing with care (HwC) schemes for older people (50+ years) in England and Wales. The purpose of this study was to develop a better understanding of how the availability, absence and use of communal spaces impacts social connections with other residents within HwC schemes.

Longitudinal and cross-sectional qualitative interviews were conducted with 72 residents across three HwC providers in England and Wales. Data were analysed using a thematic framework approach to examine how residents experienced their living environments.

Whilst the presence of communal shared spaces helps facilitate social connections and the development of friendships, full and equal access to these spaces remains challenging for residents with minority characteristics, and/or physical impairments. Building designers need to ensure they are complying with building regulations and the Equalities Act. The presence of on-site staff may also help to manage the impact of discriminatory attitudes.

A key strength of this study is its design, both in using longitudinal and cross-sectional interviews and in recruiting respondents with marginalised characteristics, whose voices have often been excluded in gerontological research. Another strength, albeit unexpected, is that this study was able to capture perspectives across the onset of the COVID-19 pandemic. The pandemic, however, may also have generated some limitations in this study. COVID-19 restrictions limited the ability to engage face-to-face within housing schemes whose residents were predominantly from different ethnic minoritised groups, and it therefore limits the inclusion of the voices and experiences of these groups. Responses in later interviews may also have been influenced by the changes in social engagement stimulated by lockdowns and may only be specific to the context of the pandemic. However, the findings reported here focus on the role and use of the built environment, and much of the interview content would feasibly apply regardless of the pandemic.

This research offers some key insights and implications for housing providers and policy. Housing providers and architects must ensure that the design of HwC schemes affords all residents access to every area of the built environment to maintain independence, autonomy and to adopt the ethos of the ageing in place agenda. If communal areas are to function as “third” or social spaces – if they are to remain equally accessible to all members of the community – then building providers must ensure that all areas are accessible to all residents in line with building regulations and the Equality Act (2010).

Housing staff need to balance the natural development of friendship groups with the potential of the formation of exclusionary “cliques” within HwC schemes. Such cliques threaten the accomplishment of communal areas as “third” or social spaces and, as such, impact the quality of life for residents.

This study offers insights into how built environments support the development of social connections and friendships in HwC schemes. It also identifies ways that housing managers can ensure that all residents feel equally valued and included.

The purpose of this paper is to document the influence of policy transfer on integrated care development, its global occurrence and shifts towards integrated care. It highlights the influence of supranational forces, and the roles and relevance of policy transfer and policy translation in the development of integrated care.

This paper presents the findings of an international review of the policy transfer of integrated care, and the relevance of policy translation in integrated care development.

The global occurrence in integrated care, as evinced in this paper, can be seen in the global shift towards integrated care in various countries. However, studies exploring the actual mechanism of policy transfer and policy translation in relation to integrated care across countries are limited. The study of integrated care through the lens of policy transfer is important, as it for example, explores the structural elements, including environmental and cognitive obstacles in the policy transfer process. Policy translation offers a social constructivist approach to explore the travel of ideas, and considers the multiple spatial and scalar contexts in which integrated care policy is implemented.

This paper aims to advance policy transfer and policy translation as complementary frameworks to explain integrated care development. Second, it seeks to make novel and useful contributions to the debate about the development of integrated care, and to the wider arguments on policy transfer and policy translation and integrated care in other parts of the world.

This article reports the findings of a systematic review of the factors promoting and obstacles hindering joint working at the NHS/social services interface. The review provides robust, research‐based evidence about different models of joint working across the interface at the strategic, commissioning and operational levels and describes the factors known to have an impact on the success of joint working.

The fundamental role of housing in community care has long been acknowledged. However, progress in achieving any real integration of housing and social care has been slow. This article reports the findings from the Crossing the Housing and Care Divide programme, which was jointly sponsored by the Housing Corporation and Anchor Trust. The programme aimed to stimulate developments in services for older people that would enable housing to become part of community care, lead to greater inter‐agency working, enhance the involvement of users in the planning, monitoring and delivery of services and deliver a high quality of service more cost‐effectively. The programme offers many practical lessons for the effectiveness of services.

A better understanding of experiences of the end of life in old age is important for practitioners, but there are considerable methodological and ethical challenges to research in this area. An interdisciplinary team at the University of Bristol conducted a pilot study of 100 people aged over 80, over the course of a year. The study focused on significant events in the lives of participants, the vast majority of whom were living ordinary lives in the community. Data were gathered from participants and their relatives and, where relevant, from health and social care professionals. In this paper key findings are presented and the implications for research and practice considered.

The purpose of this paper is to provide an update to a review of the joint working literature in the field of health and social care for adults, with particular emphasis given to the experiences of users and carers.

The aims of the literature review remained largely the same as those of the original, they were to identify: models of joint working, evidence of effectiveness and cost-effectiveness and the factors promoting or hindering the models. However, to reflect the growing interest in the experiences of users and carers a fourth aim was added to map these experiences. Given their prominence in terms of policy debates about integration, the review focused on jointly organised services for older people and people with mental health problems in the UK only.

The review demonstrates tentative signs that some initiatives designed to join-up or integrate services can deliver outcomes desired by government. Importantly some studies that report the experiences of users of services and carers suggest that they perceive benefits from efforts to join-up or integrate services. However it is our contention that the evidence is less than compelling and does not justify the faith invested in the strategy by current or previous governments.

The study updates our knowledge of the impact of joint working in the field of health and social care for adults. Importantly the paper highlights what is known about the experiences of users and carers of joint/integrated services.