An article examined barriers and facilitators to food provision for older people receiving home care. It said that significant time pressures limited what home-care workers could do, choice tended to be prioritized over nutritional value (but was delimited by the availability of food), and nutritional care overall had been compromised by cuts to social care budgets. The article said that, in spite of the rhetoric regarding the importance to health and well-being of social engagement and nutrition, the potential role for home-care workers was undervalued and undermined by the lack of recognition, training, and time dedicated to food-related care, and that good quality food and enjoyable mealtimes were denied to many older people.
Source: Anna Watkinson-Powell, Sarah Barnes, Melanie Lovatt, Anna Wasielewska, and Barbara Drummond, 'Food provision for older people receiving home care from the perspectives of home-care workers', Health and Social Care in the Community, Volume 22 Issue 5
Links: Abstract
Date: 2014-Sep
A paper examined the United Kingdom market in care services for older people, ways in which to address market failures in commissioning, and how to reconcile the need of public sector commissioners to contain costs with the need of providers to earn an adequate return. The paper argued for a new style of contracts with social care maintenance organizations (explained as either a not-for-profit or for-profit organization, or a statutory body or arms-length company owned by a statutory body, or a consortium made up by any of these) acting as 'lead provider' for a comprehensive range of social care services for older people with assessed care needs.
Source: William Laing, Strategic Commissioning of Long Term Care for Older People: Can we get more for less?, LaingBuisson
Links: Paper | LaingBuisson press release
Date: 2014-Sep
An article examined whistle-blowing by healthcare and social care employees in cases of mistreatment of older people in the United Kingdom. It examined employees' perceptions of, and strategies for, whistle-blowing, and called for better understanding of the importance of workplace relationships and informal channels for raising concerns.
Source: Aled Jones and Daniel Kelly, 'Whistle-blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce', Sociology of Health & Illness, Volume 36 Issue 7
Links: Abstract
Date: 2014-Sep
A report by a committee of the Northern Ireland Assembly examined the structure and availability of supported living options for older people, and their capacity to meet the policy objective of the Transforming Your Care programme in terms of reducing the need for residential home places.
Source: Review of Supported Living for Older People in the Context of Transforming Your Care, Northern Ireland Assembly Committee for Health, Social Services and Public Safety
Links: Report
Date: 2014-Sep
A report said that there was now a significant cohort of people in the United Kingdom who were living with HIV and were aged over 50, and that this presented new challenges to the way in which HIV care and treatment were designed, managed, and delivered. Recommendations included: for a national patient experience survey of people living with HIV, to be funded by NHS England; for mandatory basic training in HIV for all those working in health and social care; for ongoing support for peer networks; for the development of personal health budgets among HIV patients; and for groups and charities working with the elderly to be brought together with those supporting people living with HIV to help meet the needs of the ageing cohort.
Source: Gail Beer, Matt James, and Sean Summers, Growing Older Positively: The challenge of ageing with HIV, 2020health
Links: Report | 2020 press release
Date: 2014-Sep
An article examined users' experiences of care in a range of settings, by combining data from four studies where participants were older people living in care homes or extra care housing, or receiving care at home, to compare people's sense of control over daily life. It said that, after controlling for a range of differences, setting had a significant effect on older people's sense of control. Residents in care homes and extra care housing reported similar levels of control over daily life but consistently reported feeling more in control than older people receiving care at home. The article discussed implications for policy and practice.
Source: Lisa Callaghan and Ann-Marie Towers, 'Feeling in control: comparing older people's experiences in different care settings', Ageing and Society, Volume 34 Issue 8
Links: Abstract
Date: 2014-Aug
An article examined the support networks of older people in populations with high levels of multigenerational households, and considered the most vulnerable 'network types' in terms of loneliness and isolation. Drawing on cross-sectional data drawn from 590 elders (Gujaratis, Punjabis, and Sylhetis) living in the United Kingdom and South Asia, it said that using network typologies developed with individualistically oriented cultures could underestimate the support needs of older people from familistic cultures. The article proposed a new typology that identified different network types within multigenerational households and a greater proportion of older people with vulnerable networks.
Source: Vanessa Burholt and Christine Dobbs, 'A support network typology for application in older populations with a preponderance of multigenerational households', Ageing and Society, Volume 34 Issue 7
Links: Abstract
Date: 2014-Aug
A report examined progress against the aims of the 2008 Independent Living Strategy. It said that there was no evidence of significant progress in improving choice and control and, although there had been an increase in the use of personal budgets for social care, there were also limitations to the effective delivery of services, and the restrictions in how personal budgets or direct payments could be used inhibited choice and control. The report also raised concerns including: services for older people; mental health services; employment prospects and support; access to appropriate accommodation; and declining levels of income.
Source: Jenny Morris, Independent Living Strategy: A review of progress, In Control/Disability Rights UK
Links: Report
Date: 2014-Jul
An article examined the characteristics of the independent organizations involved in care co-ordination for older people, the tasks undertaken, and management of the interface between the commissioning authorities and these organizations. It said that the study highlighted the potential for voluntary organizations to undertake care co-ordination activities in England, but that this would require partnership working between service commissioners and these organizations, funding and support for the development of appropriate infrastructures, and governance arrangements to facilitate information sharing. The article discussed the implications for the expansion of the voluntary sector, and for the employment prospects of sector staff.
Source: Chengqiu Xie, Jane Hughes, Helen Chester, Caroline Sutcliffe, and David Challis, 'Exploring the role of independent organisations in care coordination for older people in England', Journal of Social Work, Volume 14 Number 4
Links: Abstract
Date: 2014-Jul
A report by a committee of MPs said that achieving the government's agenda to change and improve adult social care would require unprecedented levels of co-ordinated working between government departments, between central and local government, and across local authorities and health bodies. The committee questioned whether expectations were too high, and the report outlined concerns and made recommendations in three areas: for collaboration across all bodies involved in the care system; for better understanding of the capacity of the system and whether money was reaching frontline services; and for the government's oversight arrangements to reflect the overriding importance of quality of care. The committee raised concerns about the nature of employment contracts in the care sector and, in particular, the use of zero-hours contracts and the numbers of staff earning the minimum wage.
Source: Adult Social Care in England, Sixth Report (Session 2014–15), HC 518, House of Commons Public Accounts Select Committee, TSO
Links: Report
Date: 2014-Jul
A report by a committee of MSPs said that the ageing population combined with a decreasing overall annual Scottish Government budget would make progress in shifting care for older people from hospitals to the home more difficult. The report said that spending on health and social care for older people would need to rise from approximately £4.5 billion in 2011-12 to nearly £8 billion by 2031 to meet increasing demand. The report acknowledged progress made to date in some areas, but made a range of recommendations, including for better use of existing data and for proposals to address limitations in the available data on longer term trends and spending on older people.
Source: Report on Reshaping Care for Older People, 6th Report 2014, SP Paper 562, Scottish Parliament Public Audit Committee
Links: Report | Scottish Parliament press release
Date: 2014-Jun
An article examined the experiences, influences, and consequences of transitions between health and social care settings for older adults at the end of life who were diagnosed with heart failure, lung cancer, or stroke. It said that transitions between care settings in the previous year of life were a common component of end-of-life care, and many moves were made shortly before death. While the family doctor was found to be a valued, central figure in end-of-life care across settings, out-of-hours services and care homes were identified by many as contributing to unnecessary transitions. The article said that patients and carers found the system disorganized, with organizational processes prioritized over individual needs and, in many cases, family carers excluded from participation in institutional care. The article concluded that the development of a shared understanding of carers' and professionals' roles in end-of-life transitions was important for patients' experiences. It noted concern about the persistence of issues for carers in spite of policy change, and made recommendations for future research to inform improvements in a range of areas.
Source: Barbara Hanratty, Elizabeth Lowson, Gunn Grande, Sheila Payne, Julia Addington-Hall, Nicole Valtorta, and Jane Seymour, 'Transitions at the end of life for older adults – patient, carer and professional perspectives: a mixed-methods study', Health Services and Delivery Research, Volume 2 Issue 17
Date: 2014-Jun
A think-tank report examined British society after the economic downturn and proposed changes to the systems of support for families, young people, older people, and those facing social exclusion, and reforms to social security, employment support, and housing policy.
Source: Kayte Lawton, Graeme Cooke, and Nick Pearce, The Condition of Britain: Strategies for social renewal, Institute for Public Policy Research
Links: Report | Summary | IPPR press release | CPAG press release | PACEY press release | Guardian report | Inside Housing report
Date: 2014-Jun
An article said that the incorporation of active ageing into the policy agendas of the welfare systems for older people should be understood by reference to the perceived effects of demographic trends on demand for services. It said that the active ageing agenda had became inextricably linked with the broader policy agenda to reduce older people's call on public resources in order to manage the increasing proportions of older people in the population, and the implications of these developments for social work were significant.
Source: Liz Lloyd, Denise Tanner, Alisoun Milne, Mo Ray, Sally Richards, Mary Pat Sullivan, Christian Beech, and Judith Phillips, 'Look after yourself: active ageing, individual responsibility and the decline of social work with older people in the UK', European Journal of Social Work, Volume 17 Issue 3
Links: Abstract
Date: 2014-Jun
An article examined commissioning and contracting arrangements for domiciliary care and care home provision for older people in England, and their influence on the recruitment and retention of staff in these services.
Source: Helen Chester, Jane Hughes, and David Challis, 'Commissioning social care for older people: influencing the quality of direct care', Ageing and Society, Volume 34 Issue 6
Links: Abstract
Date: 2014-Jun
An article examined the role of voluntary organizations in care co-ordination for older people in England. It highlighted the need for partnership working between service commissioners and voluntary organizations, and for funding and support to enable voluntary organizations to develop appropriate infrastructures.
Source: Chengqiu Xie, Jane Hughes, Helen Chester, Caroline Sutcliffe, and David Challis, 'Exploring the role of independent organisations in care coordination for older people in England', Journal of Social Work, Volume 14 Number 4
Links: Abstract
Date: 2014-Jun
A study examined end of life care systems in the United Kingdom where no costs (stemming from social care) were borne by the individual or their family. The research had looked at a range of service models: Hospice at Home; voluntary and community sector initiatives; commissioning group-funded service models; and national service frameworks and policies. The report said that there was considerable variation in: definitions of 'end of life'; drivers for the development and provision of free end of life care; who could access or refer into services; time periods over which services were available; the capacity and capability of providers; and the quality of care available. The report concluded that there were still many barriers and challenges in the existing system to making free social care at end of life a reality and said the absence of national guidance on implementation, together with a lack of understanding of the system, led to restricted choice for people at the end of life. It made a range of recommendations.
Source: Leigh Johnston, Lucy Smith, Max Kowalewski, and Chih Hoong Sin, How Could Free Social Care at End of Life Work in Practice?, OPM
Links: Report | NCPC summary
Date: 2014-Jun
A new book examined long-term care provision and regulation, drawing on a series of case studies from Europe, North America, and Asia to compare different approaches that countries had adopted, and to consider the wider issues regarding the need to regulate the quality of long-term care.
Source: Vincent Mor, Tiziana Leone, and Anna Maresso, Regulating Long-Term Care Quality: An international comparison, Cambridge University Press
Links: Summary
Date: 2014-Jun
A report evaluated the Community Visitor (CV) pilot scheme in three care homes for older people in Essex, south east England. CVs visited care homes every week, aiming to befriend older people and to enhance communication between care home managers, staff, residents, and their families. The report said that: residents valued the company and conversation of CVs, were less isolated, and took part in a greater range of activities; CVs often made a big difference in addressing the 'little things' that mattered to older people; while CVs were able to make observations and helped care homes in developing their approach, they had limited influence on the culture of care homes; and the pilot had highlighted the role of committed, supported volunteers in augmenting the work of the care home. The report made recommendations.
Source: Chris Tanner and Bethany Morgan Brett, "We'll Meet Again – Don't Know Where, Don't Know When": Supporting community visiting in Essex care homes, University of Essex
Date: 2014-Jun
An article said that social care for older people in England faced an 'unprecedented assault' on the resources needed to maintain older people within the community, with particular implications for the development of social work practice with older people.
Source: Mark Lymbery, 'Austerity, personalisation and older people: the prospects for creative social work practice in England', European Journal of Social Work, Volume 17 Issue 3
Links: Abstract
Date: 2014-Jun
An article examined trends in place and causes of death for centenarians in England, drawing on death registration data linked with area-level indices of multiple deprivations for people aged 100 years or over who died between 2001 and 2010 in England, compared with those dying at ages 80-99. It said that centenarians were more likely to die as a result of acute conditions such as pneumonia and conditions related to frailty, and less likely to have causes of death of cancer or ischemic heart disease, compared with younger elderly patients. Most were found to have died in a care home (nursing or residential), but 27 per cent died in hospital. It noted implications for policy on residential and anticipatory care for the oldest old.
Source: Catherine Evans, Yuen Ho, Barbara Daveson, Sue Hall, Irene Higginson, and Wei Gao, 'Place and cause of death in centenarians: a population-based observational study in England, 2001 to 2010', PLoS Medicine, Volume 11 Number 6
Links: Article | Abstract | BBC report
Date: 2014-Jun
A report said that older people in Northern Ireland were being denied access to assessments for NHS Continuing Healthcare, a package of National Health Service-funded ongoing care for individuals found to have a 'primary health need'. The report said that there was no clear guidance on the issue in Northern Ireland and, as a result, many older people were paying for care that should be paid for by the NHS. The report called for a range of measures, including: for the publication of guidance on NHS Continuing Healthcare in Northern Ireland; for trusts to meet their obligations to make a determination of NHS Continuing Healthcare prior to any placement in a care setting; and for the Health, Social Services and Public Safety Committee and the Commissioner for Older People to make formal investigations.
Source: Judith Cross and Brenda Kearns, The Denial of NHS Continuing Healthcare in Northern Ireland, Age NI
Links: Report | Age NI press release
Date: 2014-May
A report examined how pensions might be used to help fund long term care needs, and the financial impact of the proposed cost cap for individuals in England. The report said that people needed to be encouraged to save more for retirement and potential care needs, and that the pensions system provided an existing framework for meeting the costs of care. It said that costs of care varied across the country, but most people requiring care would not reach the proposed cost cap, and all would have daily living costs (and possible top-up care costs) that were not covered by the cap. The report made recommendations, including for better communication regarding the implications of the cap, and for high quality information and advice.
Source: How Pensions Can Help Meet Consumer Needs under the New Social Care Regime: An overview, Institute and Faculty of Actuaries
Links: Report | IFOA press release | BBC report | Guardian report
Date: 2014-May
A new book examined the case for the development of ethically-driven, research-informed policy and practice to safeguard older people from abuse, drawing on original research findings.
Source: Angie Ash, Safeguarding Older People from Abuse: Critical contexts to policy and practice, Policy Press
Links: Summary
Date: 2014-Apr
A report examined the delivery of care in residential services for children and young people, residential services and supported housing for people with learning disabilities, and hospice care, and considered how learning from those settings might be applied in care homes for older people.
Source: Liz Burtney, Davina Figgett, Deirdre Fullerton, Paul Buchanan, Karen Stevens, and Madeline Cooper-Ueki, Learning for Care Homes from Alternative Residential Care Settings, Joseph Rowntree Foundation
Date: 2014-Apr
An article examined the role of older people as carers. It said that the work of older caregivers was more intensive – caring for longer hours, and providing more co-residential and personal care – and there was likely to be a greater need for assistance.
Source: Fiona Carmichael and Marco Ercolani, 'Overlooked and undervalued: the caring contribution of older people', International Journal of Social Economics, Volume 41 Issue 5
Links: Abstract
Date: 2014-Apr
A think-tank report discussed the projected demand for care for older people in the United Kingdom and made recommendations for meeting a predicted shortfall (by 2017) in the provision of unpaid care, pointing to innovative practice in Germany, Japan, Australia, and Leeds (England).
Source: Clare McNeil and Jack Hunter, The Generation Strain: Collective solutions to care in an ageing society, Institute for Public Policy Research
Links: Report | IPPR press release | Age UK press release | Independent Age press release | BBC report
Date: 2014-Apr
A report examined the messages from Better Life – a programme of work developed by the Joseph Rowntree Foundation that explored how to achieve a good quality of life for older people with high support needs. It said that seven key challenges had been identified (including: challenging ageist assumptions; meeting needs of diverse individuals; and giving service users a voice), and the report considered ways in which to respond, within the contemporary policy context in Scotland.
Source: Delivering A Better Life for Older People with High Support Needs in Scotland, Institute for Research and Innovation in Social Services
Links: Report | Better Life project
Date: 2014-Apr
A report examined health and care services for older people in England, in the context of an ageing population. It said that a fundamental shift was required, moving towards co-ordinating care around individual needs rather than single diseases, alongside the prioritization of prevention and support for maintaining independence. The report outlined areas of good practice, identified aspects of care that required improvement, and highlighted the need for integrated working across teams to ensure that sufficient and appropriate services would be available in the right locations.
Source: David Oliver, Catherine Foot, and Richard Humphries, Making Our Health and Care Systems Fit for an Ageing Population, King's Fund
Links: Report | Kings Fund press release | CSP press release
Date: 2014-Mar
A study examined the impact of paperwork requirements on the care of older people in residential settings in England. The report said that regulatory and other requirements meant that care homes completed many separate items of paperwork, some duplicated, and that this was often fuelled by fear of blame or litigation. The report called for care homes, commissioners, and regulators to generate more collective approaches to accountability and to improve shared learning and calculated risk-taking across the care home sector.
Source: Joy Warmington, Asif Afridi, and William Foreman, Is Excessive Paperwork in Care Homes Undermining Care for Older People?, Joseph Rowntree Foundation
Date: 2014-Mar
A report examined the challenges in caring for increasing numbers of frail older people in the United Kingdom. It made recommendations for change, including: improvements to information sharing; wider use of technology, such as telemedicine; annual frailty checks for people over the age of 75, along with priority access and rapid assessment schemes; personal or per capita budgeting to fund home repairs, adaptations, and homecare support; and changes in responsibilities, alongside new commissioning/funding models, for health and social care providers.
Source: Better Care for Frail Older People: Working differently to improve care, Deloitte Centre for Health Solutions, Deloitte LLP
Links: Report | Deloitte press release
Date: 2014-Mar
An article examined how the timing of parental divorce within a child's lifecourse influenced the obligations they felt to care for their parents later in life. It said that midlife experiences of parental divorce, as well as deteriorating relationships between non-separated parents, weakened adult children's relationships with their parents. The article considered how this might impact on future willingness to provide care.
Source: Joanna Sage, Maria Evandrou, and Jane Falkingham, 'The timing of parental divorce and filial obligations to care for ageing parents', Families, Relationships and Societies, Volume 3 Number 1
Links: Abstract
Date: 2014-Mar
An article examined housing with associated care for older adults, based on a review of United Kingdom and international literature. The article discussed how care and support was provided, the role of the built environment, and the benefits for resident well-being. It said that there were substantial gaps in the research evidence, but the review had found evidence to suggest that housing with care could deliver 'most if not all' of the United Kingdom government's aspirations.
Source: Teresa June Atkinson, Simon Evans, Robin Darton, Ailsa Cameron, Jeremy Porteus, and Randall Smith, 'Creating the asset base a review of literature and policy on housing with care', Housing Care and Support, Volume 17 Number 1
Links: Abstract
Date: 2014-Mar
A report examined the scale and nature of reductions in publicly funded social care for older adults in England that had occurred in part as a result of government reductions in public sector spending. It said that local authority funding had been reduced by 26 per cent in real terms between 2011-12 and 2014-15, resulting in real terms reductions in net existing spending on social care for older adults of 15 per cent. The report noted areas in which the cuts had occurred, and said that this had happened at a time when demand had increased while the population aged. It said that the combination of cuts and demand had resulted in growing numbers of older people either using their own resources, or going without care, but poor linkage between health and social care data at the national level meant that the impact, and the consequent level of unmet need, was difficult to quantify.
Source: Sharif Ismail, Ruth Thorlby, and Holly Holder, Focus On: Social Care for Older People – Reductions in adult social services for older people in England, Nuffield Trust/Health Foundation
Links: Report | Quality Watch press release | Age UK press release | Guardian report
Date: 2014-Mar
An article examined the relationship between personalization reforms of social care services in England and the redevelopment of day centres for older people and people with a disability. It discussed the nature of the narrative of personalization and its relationship with the closure of day care centres and creation of alternative community spaces.
Source: Catherine Needham, 'Personalization: from day centres to community hubs?', Critical Social Policy, Volume 34 Issue 1
Links: Abstract
Date: 2014-Feb
A report examined evidence from seven case study countries on the provision of integrated care for older people with complex needs.
Source: Nick Goodwin, Anna Dixon, Geoff Anderson, and Walter Wodchis, Providing Integrated Care for Older People with Complex Needs: Lessons from seven international case studies, King s Fund
Links: Report
Date: 2014-Jan
An article examined the importance of the care relationship in providing care, before outlining the development of social care services for older people in England from 1990. The paper considered whether competition and choice could result in 'good care' for older people.
Source: Jane Lewis and Anne West, 'Re-Shaping Social Care Services for Older people in England: policy development and the problem of achieving good care ', Journal of Social Policy, Volume 43 Number 1
Links: Abstract
Date: 2014-Jan