Recent Submissions

  • Older people as victims and perpetrators of crime

    Di Lorito, Claudio (2020)
    Older people are at a higher risk of becoming the victims of crime than of being the perpetrators of it, given the added vulnerability that comes with aging. This chapter examines crime in relation to old age. The first section presents data around older people as victims of crime, and further discusses different types of abuse against older people, which, in the presence of intensive care needs and carer burden, may be perpetrated within the family or in residential and institutional settings. The second section of the chapter examines older people as the perpetrators of crime. In particular, it describes how older offenders are dealt within the justice system. It presents data on the growing population of older offenders in prisons and in forensic psychiatric services and reports on whether the unique needs of older offenders are being met in these settings.
  • Development and preliminary testing of a framework for quantifying local service provision for people with dementia

    Hughes, Jane; Challis, David (2020)
    Purpose: It was hypothesised that there were variations in health and social care services available for older people with dementia and their carers, and that measurement of this between localities was possible. The purpose of this paper is to present a framework for examining this. Design/methodology/approach: Using a case study approach, data from national surveys of local authorities providing social care and National Health Services Trusts providing old age mental health services conducted in 2014/2015 in England were used. From these, indicators of variation in services for people with dementia and their carers in different geographical areas were created. Measurement of the presence/absence of each service permitted the creation of a service mix score for each area. Findings: The framework comprised 16 attributes each with indicators describing the characteristics of the organisations providing the services; the skill mix of community mental health teams for older people; and the health care and social care services available in localities. Variation was evident, confirmed by quartile analysis and exemplars, suggesting that older people with dementia and their carers in different localities are likely to experience differences in the range of provision available, particularly social care services. Originality/value: The case study approach used achieved its objectives, and the resultant framework has potential for generalisability and utility, given acceptable ecological validity and discriminant validity in identifying variations in service mix. It could be used in both research and practice. © 2020, Emerald Publishing Limited.
  • Complex care needs and devolution in Greater Manchester: A pilot study to explore social care innovation in newly integrated service arrangements for older people

    Hughes, Jane; Challis, David (2020)
    Objective: The aim of this study was to describe emergent approaches to integrated care for older people with complex care needs and investigate the viability of measuring integrated care. Methods: A case study approach was used. Sites were recruited following discussion with senior staff in health and social care agencies. Service arrangements were categorised using a framework developed by the researchers. To investigate joint working within the sites, the development model for integrated care was adapted and administered to the manager of each service. Data were collected in 2018. Results: Six case study sites were recruited illustrating adult social care services partnerships in services for older people with home care providers, mental health and community nursing services. Most were established in 2018. Service arrangements were characterised by joint assessment and informal face-to-face discussions between staff. The development of an infrastructure to promote partnership working was evident between adult social care and each of the other services and most developed with home care providers. There was little evidence of a sequential approach to the development of integrated working practices. Conclusion: Components of partnerships promoting integrated care have been highlighted and understanding of the complexity of measuring integrated care enhanced. Means of information sharing and work force development require further consideration. What is known about the topic?: The devolution of health and social care arrangements in Greater Manchester has aroused considerable interest in much wider arenas. Necessarily much of the focus in available material has been upon strategic development, analysis of broader trends and mechanisms and a concern with changes in the healthcare system. What does this paper add?: The findings from this study will enable emerging approaches to be described and codified, and permit the specific social care contribution to the new arrangements to be discerned. The findings are relevant beyond the immediate context of Greater Manchester to wider integrated care. The evidence can be used by commissioners and services, providing a sound basis for further work as service systems develop. What are the implications for practitioners?: This research is important because it is one of the first pieces of work to examine the new integrated care arrangements in Greater Manchester. By providing guidance to promote evidence-based practice, this study contributes to service development in Greater Manchester and the achievement of the broad national service objectives of improving user and carer experiences and ensuring value for money. © 2020 AHHA.
  • Home-care providers as collaborators in commissioning arrangements for older people

    Hughes, Jane; Chester, Helen; Challis, David (2020)
    In England, care to support people living at home is largely commissioned by local authorities (statutory organisations with responsibility for social care in specific localities) from non-statutory home-care providers (for-profit, not-for-profit, voluntary). This paper explores how managers of these services perceive commissioning arrangements and their impact on home-care providers, the care workforce and service users. Little formal research of providers' experiences of working with local authorities in a commissioning model is available. A qualitative study employed semi-structured telephone interviews with 20 managers of for-profit home-care providers from 10 selected local authority areas in England. Data were analysed using thematic analysis to identify main and subsidiary themes. Home-care providers reported operating in a complex and changeable partnership with commissioners, characterised by: (a) relationships ranging from transactional to collaborative, (b) providers expressing a strong sense of public service motivation, (c) commissioning practices that were complex to negotiate, time-consuming and overly prescriptive, (d) frequent changes in commissioning practices and a perceived lack of strategic planning, which were reported as contributing to uncertainty and tension for providers and confusion for service users. Attempting to operate a market model with tightly prescribed contracts is likely to be unsustainable. An alternative approach based on a collaborative model of joint responsibility for providing home care is recommended drawing on a conceptual framework of principal-steward relationships in contracting.
  • What do service users want from mental health social work? A best-worst scaling analysis

    Challis, David; Hughes, Jane (2020)
    Despite being a profession dedicated to the empowerment of service users, empirical study of mental health social work appears dominated by the perspectives of social workers themselves. What service users value is less often reported. This study, authored by a mix of academics and service users/carers, reports a Best–Worst Scaling analysis of ten social worker ‘qualities’, representing both those highly specialist to social work and those generic to other mental health professionals. Fieldwork was undertaken during 2018 with 144 working-age service users, living at home, in five regions of England. Of specialist social work qualities, service users rated ‘[the social worker] thinks about my whole life, not just my illness’ particularly highly, indicating that person-centred approaches drawing on the social model of mental health are crucial to defining social work. However, service users did not value help accessing other community resources, particularly those who had spent the longest time within mental health services. Continuity of care was the most highly valued of all, although this is arguably a system-level feature of support. The research can assist the profession to promote the added value of their work, focusing on their expertise in person-centred care and the social model of mental health.
  • Perceptions of the social worker role in adult community mental health teams in England

    Hughes, Jane; Challis, David (2020)
    There is a growing recognition of the importance of the social work contribution within community mental health services. However, although many texts describe what the mental health social work contribution should be, little empirical evidence exists about their role in practice and the difference it might make to service users. This qualitative study sought to articulate this contribution through the voices of social workers and their multidisciplinary colleagues via focus group discussions across four English Mental Health Trusts. These considered the impact of the social worker on the service user. Thematic analysis resulted in the identification of three over-arching themes: social workers own perceptions of their contribution situated within the social model; the high value their colleagues placed on social work support and leadership in a range of situations and the concerns for service users if social workers were withdrawn from teams. Key findings were that social workers are the only professional group to lead on the social model; that this model enhances the whole teams’ practice and is required if service users are to be offered support that promotes long-term recovery and that without social workers, the community mental health team offer would be more transactional, less timely, with the potential for the loss of the service users’ voice. If social work is to make a full contribution to community mental health team practice, it must be clearly understood and provided with the support to enable social workers to operate to their full potential. © The Author(s) 2020.
  • Changes in commissioning home care: an English survey

    Hughes, Jane; Chester, Helen; Challis, David (2020)
    Purpose: The purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care. Design/methodology/approach: Data from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken. Findings: Findings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident. Originality/value: This paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity.
  • The challenges of commissioning home care for older people in England: Commissioners' perspectives

    Hughes, Jane; Chester, Helen; Challis, David (2020)
    Home care for older people in England is commissioned through local authorities working predominantly with independent providers of care. Commissioners operate in a market model, planning and procuring home care services for local populations. Their role involves 'managing' and 'shaping' the market to ensure an adequate supply of care providers. Another imperative, emerging from the principles of personalisation, is the drive to achieve user outcomes rather than 'time and task' objectives. Little formal research has investigated the way commissioners reconcile these different requirements and organise commissioning. This study investigated commissioning approaches using qualitative telephone interviews with ten commissioners from different local authorities in England. The characteristics of commissioning were analysed thematically. Findings indicated (a) commissioning involved complex systems and processes, uniquely shaped for the local context, but frequently changed, suggesting a constant need for reframing commissioning arrangements; (b) partnerships with providers were mainly transactional, with occasional examples of collaborative models, that were considered to facilitate flexible services more appropriate for commissioning for personalised outcomes; and (c) only a small number of commissioners had attempted to reconcile the competing and incompatible goals of tightly prescribed contracting and working collaboratively with providers. A better understanding of flexible contracting arrangements and the hallmarks of a trusting collaboration is required to move beyond the procedural elements of contracting and commissioning. © The Author(s), 2020. Published by Cambridge University Press.
  • Commissioning social care for people with dementia living at home: Findings from a national survey

    Hughes, Jane; Challis, David (2020)
    Objective To explore the complexities, circumstances, and range of services commissioned for people with dementia living at home. Methods A national survey was used to collect data from English local authorities in 2015. Commissioners of services for older adults were invited to complete a questionnaire. An exploratory cluster analysis of nominal data was conducted using a TwoStep procedure to identify distinct groups. Results A total of 122 authorities (83%) responded to the request. Four approaches to commissioning were identified, reflecting commissioning practices at the organisational, strategic, and individual service user levels. Commissioning at the service user level was most apparent. Bivariate analysis found that these configurations were not associated with the types of dementia specific services provided but were related to the number available. Authorities delivered a greater range of specialist services when joint commissioning between social care and health partners was undertaken. However, the joint commissioning of services was less observed in services specifically for people with dementia than in generic services for all older people. There was limited evidence that local circumstances (population configuration and deprivation levels) were associated with this approach to commissioning. Conclusions The significant role of health partners in the delivery of social care services to support older people living with dementia in their own homes is evident. As the population with dementia ages and physical health needs increase, how dementia specific services differ from and complement those services available to all older people warrants further investigation. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: journal abstract)
  • Trauma: A unifying concept for social work

    Joseph, Stephen; Murphy, David (2014)
    The aim is to show how traumatic stress provides a unifying concept for social work. In the last ten years, there have been significant changes in the nature of organisations that provide social care for people in the UK, with social work practice no longer confined to traditional local authority services. Increasingly, social workers are taking up posts in a variety of settings and sectors demanding new knowledge and skills. The field of traumatic stress is not currently viewed as a social work discipline. However, trauma cuts across a range of contexts and client groups and, as such, needs to be a core component of education and training in social work. The concept of trauma and recent developments in post-traumatic growth offer a new way of thinking that necessitates the development of genuinely psycho-social and relationship-based help and support for individuals, families, groups, communities and organisations affected by adversity.
  • Relationship-based social work and its compatibility with the person-centred approach: Principled versus instrumental perspectives

    Murphy, David; Joseph, Stephen (2013)
    In recent years, there has been a resurgence of interest in social work towards relationship-based practice. In this article, we discuss the conceptualisation of relationship-based practice from a person-centred point of view and its applicability to contemporary social work. It will be shown that the person-centred point of view has a meta-theoretical basis that makes it incompatible with modern statutory social work practice. First, we outline the theoretical and philosophical underpinnings of the person-centred approach and argue that a potential conflict lies at the heart of the contemporary social workers' capacity to truly accommodate person-centred theory. Next, the resurgence of interest in relationship-based practice, paying particular attention to the person-centred approach, is considered within the context and influence of risk management, managerialism and consumerism on social work. We then challenge the assumption that relationship-based social work founded on the person-centred approach legitimately supports service users' ability and capacity towards self-determination. Our challenge is based on the premise that the person-centred approach is defined by principled non-directive practice. On this basis, we conclude that a person-centred relationship-based approach to contemporary social work is untenable.
  • Conditional discharge: The role of the social supervisor - a preliminary study

    Lewis, Keith T.; Humphreys, M. (2006)
    The process of statutory community aftercare for restricted hospital order service users is acknowledged as successful. Previous research examining the attitudes of forensic psychiatrists to the use of restriction orders has indicated that they view them as a useful clinical tool in some circumstances, particularly where there is evidence of previous breakdown of followup. This study, as part of a larger project examining the effectiveness of statutory community aftercare, focused on the attitudes of social supervisors to the process of conditional discharge and their role within it. The findings showed that social supervisors agree that there are positive and negative aspects to the process. They overwhelmingly agreed that the legal framework ensured that service users continued engagement with psychiatric services, leading to enhanced compliance with treatment and follow-up, but recognised that, at times, the role, because of its control aspect, created tension in the social worker-service user relationship. Social supervisors suggested that investment should be made into providing appropriate accommodation for this group of people and, where appropriate, access to drug and alcohol misuse services. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
  • A critical review of the psychometric evidence base of the child abuse potential inventory

    Walker, Clare A. (2010)
    Screening for potential child abuse is an essential component of work in many child and family services. The Child Abuse Potential inventory (CAP; Milner 1986) is one measure developed to help in this task. The primary aim of this review is to critically evaluate studies reporting psychometric information of the CAP. A previous paper by Milner (Clinical Psychology Review 14(6): 547-583 1994) reviewed studies evaluating the psychometric properties of the measure up to 1994. Since then over 100 articles have been published that consider the measurement properties of this tool. This review considers 27 papers published since Milner's (Clinical Psychology Review 14(6): 547-583 1994) review that clarify previous findings in relation to specific psychometric properties of the CAP. In particular, this review focuses on studies that provide information on the cross-cultural validity of the CAP, on the internal consistency of the CAP measure as a whole and its subscales, or on sensitivity and specificity classification rates. Studies providing information on the differential validity of the CAP (using at least two differentiated sample groups) or the efficacy of the CAP to identify change are also considered. Published evidence suggests that the CAP can help assess for a range of difficulties associated with increased risk for physical child abuse. The CAP scales have shown good internal consistency estimates across sample groups and cultures, with similar underlying themes for CAP factors reported for the different cultures studied. The differential validity of the CAP has also been shown, although sensitivity and specificity classification rates have varied. The CAP appears able to indicate some degree of pre-to post-intervention change, although further investigation is required to clarify what changes in CAP scores actually reflect. Further investigation of this measure in other countries is also required.
  • Computer aided interviewing in psychiatric social work

    Ferriter, Michael (1993)
    This paper describes a research project on the process of collecting information for psychiatric social history. Subjects were patients’ parents. Ten subjects were interviewed by computer and fourteen by persons. Unstructured interviews were obtained from old social histories. Structured interviewing collected significantly more information than unstructured interviewing. A comparison of structured human and computer interviews showed greater extremes of response with fewer discrepancies of fact in the computer condition, indicating greater candidness of subjects in that group and therefore greater validity of data collected by computer. © 1993 Taylor & Francis Group, LLC.