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Social Services (social + services)
Terms modified by Social Services Selected AbstractsMAKING THE CORE CONTINGENT: PROFESSIONAL AGENCY WORK AND ITS CONSEQUENCES IN UK SOCIAL SERVICESPUBLIC ADMINISTRATION, Issue 2 2008KIM HOQUE In recent times, the UK has witnessed a steady growth in the use of agency workers to fill core professional roles in public sector organizations. Similar trends have been noted elsewhere, particularly in Australia and the US. In this paper our objective is to explore some of the consequences of this growth, drawing on case study research on social services. We point to a number of problems associated with the management of agency workers and to the potentially negative consequences for the quality of services. These problems, in turn, may impact on key aspects of a (largely functional) public service employment model founded on strong internal labour markets, employment stability and collegial ethos. We also note that while there are ways in which public organizations can manage this situation, certain constraints may prevent them from doing so. [source] TOWARDS A PARADIGM OF DEMOCRATIC PARTICIPATION: CITIZEN PARTICIPATION AND CO-PRODUCTION OF PERSONAL SOCIAL SERVICES IN SWEDENANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 2 2009Victor Pestoff ABSTRACT:,Many countries in Europe are now searching for new ways to engage citizens and involve the third sector in the provision and governance of social services in order to meet major demographical, political and economic challenges facing the welfare state in the 21st Century. Co-production provides a model for the mix of both public service agents and citizens who contribute to the provision of a public service. Citizen participation involves several different dimensions: economic, social, political and service specific. The extent of citizen participation varies between different providers of welfare services, as too does user and staff influence. Empirical materials from a recent study of childcare in Sweden will be used to illustrate these points. However, the role of citizens and the third sector also varies between countries and social sectors. Third sector providers facilitate citizen participation, while a glass ceiling for participation exists in municipal and for-profit providers. Moreover, co-production takes place in a political context, and can be crowded-in or crowded-out by public policy. These findings can contribute to the development of a new paradigm of participative democracy. [source] RELATIONAL GOODS, MONITORING AND NON-PECUNIARY COMPENSATIONS IN THE NONPROFIT SECTOR: THE CASE OF THE ITALIAN SOCIAL SERVICESANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 1 2007Michele Mosca ABSTRACT,:,This paper investigates the nonprofit wage gap suggesting a theoretical framework where, like inAkerlof (1984), effort correlates not only with wages, but also with non-monetary compensations. These take the form of relational goods by-produced in the delivery of particular services. By paying higher non-pecuniary compensations, the nonprofit sector attracts intrinsically similarly skilled, but more motivated workers, able to provide in fact a similar (or potentially higher) level of effort than their counterparts in the forprofit sector. On an empirical ground, the paper provides a number of econometric tests that confirm the main predictions of the model in Italy's case. It adds to the available empirical literature by introducing in the analysis direct measures of non-pecuniary compensations and job satisfaction. [source] THE SECOND ANNUAL MEYER ELKIN ADDRESSFAMILY COURT REVIEW, Issue 1 2000The Changing Family in the New Millennium A year ago, our journal had the opportunity to publish the inaugural Meyer Elkin Address by Jonah, Peter, and Marian Wright Edelman. This past summer, the Association of Family and Conciliation Courts was honored to have George Thomson speak at its conference in Vancouver, British Columbia. Thomson was presented with this honor for his hard work and dedication to family law in Canada and throughout the world. The Family and Conciliation Courts Review is honored to publish this speech by Thomson. Described by his colleagues as a "miracle worker" and "superman", Thomson has led a fascinating career that has followed several different paths. As an undergraduate student, Thomson attained a B.A. in philosophy and English from Queen's University in Kingston, Ontario. He remained at Queen's University and received an LL.B., then completed his formal education with an LL.M. from the University of California. Thomson has had a diverse background in the legal field, serving as an educator, a judge, and a government official. From 1968 until 1971, he worked as both an associate professor and assistant dean at the University of Western Ontario in London, Ontario. After his brief stint with the university, he was appointed judge of the Provincial Court for the Province of Ontario. Thomson held this position for five years before becoming an associate deputy minister of Community and Social Services, where he served as the head of the Children's Services Division. In the 1980s, Thomson returned to the bench in the provincial court. Additionally, he was the director of education for the Law Society of Upper Canada. Most notably, however, Thomson chaired a provincial committee on social welfare reform. By 1989, Thomson had moved from the bench into governmental work. He briefly served as the deputy minister of citizenship for Ontario. He was then appointed the deputy minister of labor until 1992. From 1992 until 1994, Thomson served as Ontario's deputy attorney general. He then became the deputy minister of justice and deputy attorney general of Canada. Most recently, Thomson has been a special advisor to the minister of justice and attorney general of Canada. The following Meyer Elkin address was presented at the annual Convention of the Association of Family and Conciliation Courts in Vancouver, Canada, in June 1999. [source] Health care managers' perspectives on new nursing and midwifery roles: perceived impact on patient care and cost effectivenessJOURNAL OF NURSING MANAGEMENT, Issue 5 2009Adv Dip Ed RNT, BSc(Hons), DPhil, DipN(Lond), FRCSI, HUGH McKENNA CBE Aims, The aim of this study was to explore new nursing and midwifery roles and associated levels of practice from the health care providers' perspective. This paper will present findings relating to the perceived cost effectiveness of these roles and their impact on patient care. Background, Profound changes in the way the health care systems are organized, managed and financed have resulted in the proliferation of new nursing and midwifery roles. However, the evidence base for these workforce developments is limited, especially with regard to health care providers' perspectives on cost effectiveness and patient outcomes. Method, Qualitative interviews were carried out with all Directors of Nursing in the 18 Health and Social Services (HSS) Trusts and the Chief Nurses and Directors of Primary Care in the four HSS Boards in Northern Ireland. Results, Key findings were as follows: there was widespread support for the development of these roles, they are perceived to have a positive impact on patient care; however, the need for support was recognized to ensure the continuation of such roles. Securing funding was problematic and this was influential on the kind of new roles that were developed. Implications for Nursing Management, Issues relating to effective implementation and the need for further research into the efficacy and effectives of such initiatives is required. [source] Nurse leadership within primary care: the perceptions of community nurses, GPs, policy makers and members of the publicJOURNAL OF NURSING MANAGEMENT, Issue 1 2004AdvDipEd, DipN (Lond), FRCS, Hugh McKenna BSc(Hons) Aim, The aim of this section of a wider study was to seek the views of community nurses, general practitioners, members of the public and policy makers on nursing leadership in primary care. The wider study aimed to review the role and function of primary care services and community nursing with reference to developments in practice, education, research and policy. Background, Key messages, challenges and opportunities for leaders within nursing have been highlighted in the literature and in turn emphasis placed on the positive effect this would have on improved quality of services [Department of Health and Social Services (1998) Valuing Diversity.. A Way Forward. Department of Health and Social Service, Belfast]. In order to grasp these opportunities, nursing has to invest in the development of leaders. Methods, A two round Delphi technique was employed using a focus group approach in round one and a postal questionnaire in round two. Semi-structured interviews were carried out with senior policy makers. Results, Findings show that there was agreement that strong leadership was needed for the development of community nursing but that at present there is confusion and disagreement over whether it exists currently. Other findings focus on problems inherent in identifying future nurse leaders. Conclusion, The traditional subservient culture of community nursing is blamed for the perceived inability to nurture strong leaders. Recommendations are made for the development of nurse leaders. [source] Prevalence of Pervasive Developmental Disorders in Two Canadian ProvincesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2006Hélène Ouellette-Kuntz Abstract, Although it is generally accepted that the proportion of children diagnosed with pervasive developmental disorders (PDDs) has increased in the past two decades, there is no consensus on the prevalence of these conditions. The accompanying large rise in demand for services, together with uncertainty regarding the extent to which the observed increases are due to a true change in risk, has made PDDs a major public health concern. As few data exist on the prevalence of PDDs in Canada, the aim of this study was to estimate the prevalence of diagnosed PDDs in two Canadian provinces (Manitoba and Prince Edward Island (PEI)) and compare characteristics of diagnosed cases between the two regions. To obtain the estimates, children under the age of 15 years with a PDD diagnosis who lived in either province in 2002 were identified by workers at Children's Special Services, a provincial government program that supports children with special needs in Manitoba, and by the PEI provincial early intervention coordinator (Department of Social Services and Seniors) and special education autism coordinator (Department of Education). The findings show that the prevalence among children 1,14 years of age was 28.4 per 10,000 (95% confidence interval: 26.1,30.8) in Manitoba and 35.2 per 10,000 (95% confidence interval: 28.2,43.4) in PEI. In Manitoba, children of aboriginal identity with PDDs (8.3%) were significantly underrepresented compared with the general population of aboriginal children living off native reserves (15.6%). Sex ratio, sibling risk, and age at initial diagnosis were similar in the two provinces. These findings can serve as a baseline from which to monitor the prevalence of these conditions over time, providing valuable data for researchers, planners, and service providers. [source] Implementation of a Coordinated School Health Program in a Rural, Low-Income CommunityJOURNAL OF SCHOOL HEALTH, Issue 9 2007BSHRM, Lisa Cornwell RN ABSTRACT Background:, Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and a low-income, high-need population. Methods:, In 2001, Stafford County's Unified School District 349 began a multiyear CSHP development process, which required adaptations for implementation in a rural area. First, a CSHP team was formed of community and administrative stakeholders as well as school system representatives. Next, the CSHP team assessed school district demographics so the program framework could be targeted to health needs. During a yearlong planning phase, the CSHP team determined 4 priority areas for program development, as limited staff and funds precluded developing programs in all 8 traditional CSHP areas. Program activities were tailored to the population demographics and available resources. Results:, Program outcomes were supported by School Health Index (SHI) data. Of the 8 CSHP focus areas, the SHI found high scores in 3 of the Stafford CSHP's priority areas: Health Services; Psychological, Counseling, and Social Services; and Physical Education. The fourth Stafford CSHP priority area, Nutrition Services, scored similarly to the less prioritized areas. Conclusions:, The process by which the Stafford school district modified and implemented CSHP methods can serve as a model for CSHPs in other rural, high-need areas. [source] System Change through Collaboration,Eight Steps for Getting from There to HereJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2002JUDGE SHARON S. TOWNSEND ABSTRACT Family courts and child welfare agencies across the country are charged with protecting the safety of our children. That mission has become more challenging with increasing federal legislation and decreasing funding. In Buffalo, N.Y., the Family Court and the Department of Social Services have teamed up to respond to this challenge. With minimal additional staffing and resources, they have led a collaboration of agencies and service providers to change the way business is done in child welfare. By engaging each other in an interagency system change effort, the amount of time children spend in foster care has been reduced. The collaboration has been able to accomplish in a relatively short time what no agency had previously been able to accomplish on its own. The beneficiaries have been the children and families of Erie County. [source] Should We Have Faith in Faith-Based Social Services?NONPROFIT MANAGEMENT & LEADERSHIP, Issue 1 2002Rhetoric Versus Realistic Expectations Early in his administration, President George W. Bush set forth his Faith-Based Initiative, which would authorize and encourage religious groups to compete for and provide publicly funded social services. This article analyzes the arguments made by supporters of faith-based social services in regard to their underlying values and premises. This analysis forms the basis for examining the managerial track record of faith-based organizations in the delivery of social services. To identify issues and trends within this category of service providers, the authors analyzed press reports of instances of wrong doing in faith-based groups from 1995 to 2001. Findings reveal that faith-based groups appear to be as susceptible to managerial and accountability inadequacies, if not outright wrongdoing, as are nonsectarian service providers. The authors identify implications regarding the credibility of faith-based groups and public trust as they pertain to an enhanced role in the less regulated service system that the president envisions. [source] Effective Contracting of Social ServicesNONPROFIT MANAGEMENT & LEADERSHIP, Issue 1 2001Barbara Peat The continued growth in the use of privatization for the delivery of social services increases the need for a systematic method to analyze the contracting process. Using a modified form of the basic systems model, the authors examine the impact of antecedents and situational factors and explore the use of traditional management steps in the contracting process. The authors focus on one state's experience with contracting to explore the implications of such a model. [source] Social services and Primary Care Groups: a window of collaborative opportunity?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2000Bob Hudson This paper reports on the findings of two investigations into the relationship between social services and Primary Care Groups (PCGs): a national postal questionnaire and a series of regional seminars. The key findings of both explorations are summarised and placed in the context of other available evidence on the development of PCGs. Issues covered include: the background and status of social services representatives; preparation and support for the board role; feedback and accountability, and early contributions. It is concluded that progress is being made in bringing together the agendas and activities of PCGs and social services, and to a lesser extent the wider local authority, but that important obstacles remain in place. The enduring significance of the resource dependency model needs to be a key factor in emerging partnerships. [source] Mental health care reform in Sweden, 1995ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001C.-G. Stefansson Objective:,To describe the content of the Community Mental Health Care reform in Sweden, in effect from 1995 and directed to severely mentally ill people (SMI). Method:,Evaluating changes, at local and national level, in living conditions among SMI and resources of services directed to them, by using registers, questionnaires, interviews and case studies. Results:,A survey, covering 93% of the population, identified 43 000 SMI (prevalence of 0.63%); 4000 long-stay patients and 400 rehabilitation programmes were transferred from psychiatric services to social services (15% of the budget of psychiatric services). Employment and rehabilitation projects, family support and user programmes and educational projects for social services staff, were launched (funded by state subsidies). Conclusion:,SMI still have difficulties in obtaining adequate support on the basis of disability laws and there continue to be barriers between social services and psychiatric services. [source] Multidisciplinary antenatal care for opiate-using women: Child-care issuesDRUG AND ALCOHOL REVIEW, Issue 2 2010ADERONKE A. ADENIJI Abstract Introduction and Aims. The fact that particular parents suffer afflictions limiting their ability to care does not mean that they should automatically be deemed unsuitable parents. Prompted by neonatal team concerns about child-care issues, a local multidisciplinary group was set up to care for substance-abusing pregnant women in our region. Design and Methods. This project was conducted in order to review the records of all the women who had been discussed at our management planning meetings over the past 5 years. Our assessment tool records were reviewed and analysed using spss. Results. A total of 233 women were assessed. The majority of patients booked before 20 weeks (62%) and 96 women (41%) attended over 80% of their antenatal appointments. There was little change in substance use during the course of pregnancy. Overall, at delivery, 196 of the 233 women (84%) used methadone and 89(38%) used heroin. There was no correlation between usage and foster care of the baby (methadone: ,2 = 0.5, P = 0.8 NS) (heroin: ,2 = 3.1, P = 0.08 NS). There was an absolute correlation between social services involvement and foster care (,2 = 2.33, P < 0.0001). Adherence with planned antenatal appointments significantly increased the likelihood of a child being discharged with his mother (,2 = 6.7, P = 0.009). Discussion and Conclusions. The majority of newborns were discharged home with their mothers directly with the most significant factor in placing a child in foster care being prior involvement of social services. However, many of these families will continue to need support during the children's early years.[Adeniji AA, Purcell A, Pearson L, Antcliffe JM, Tutty S, Sinha C, Pairaudeau PW, Lindow SW. Multidisciplinary antenatal care for opiate-using women: Child-care issues. Drug Alcohol Rev 2009] [source] At-risk mental state (ARMS) detection in a community service center for early attention to psychosis in BarcelonaEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2010Yanet Quijada Abstract Aim: To describe the strategy and some results in at-risk mental state (ARMS) patient detection as well as some of the ARMS clinical and socio-demographical characteristics. The subjects were selected among the patients visited by an Early Care Equipment for patients at high risk of psychoses, in Barcelona (Spain) during its first year in operation. Methods: Descriptive study of the community,team relations, selection criteria and intervention procedure. Description of patient's socio-demographic and symptomatic characteristics according to the different instruments used in detection and diagnoses, taking account of four principal origins of referrals: mental health services, primary care services, education services and social services. Results: Twenty of 55 referred people fulfilled the at-risk mental state criteria, showing an incidence of 2.4 cases per 10 000 inhabitants. They were mainly adolescent males referred from health, education and social services. Overall, negative symptoms were predominant symptoms and the more frequent specific symptoms were decrease of motivation and poor work and school performance, decreased ability to maintain or initiate social relationships, depressed mood and withdrawal. Conclusions: It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community , including the social services , contributes to the process. The utilization of a screening instrument and a two-phase strategy , the second carried out by the specialized team , seems to be an appropriate approach for early psychosis and ARMS detection. [source] Drug Policy and the Public Good: a summary of the bookADDICTION, Issue 7 2010Drugs, Public Policy Group ABSTRACT Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence. [source] Doing harm reduction better: syringe exchange in the United StatesADDICTION, Issue 9 2009Don C. Des Jarlais ABSTRACT Objective To trace the growth of syringe exchange programs (SEPs) in the United States since 1994,95 and assess the current state of SEPs. Methods Annual surveys of US SEPs known to North American Syringe Exchange Network (NASEN). Surveys mailed to executive directors with follow-up interviews by telephone and/or e-mail. Response rates have varied between 70% and 88% since surveys were initiated in 1996. Results The numbers of programs known to NASEN have increased from 68 in 1994,95 to 186 in 2007. Among programs participating in the survey, numbers of syringes exchanged have increased from 8.0 million per year to 29.5 million per year, total annual budgets have increased from $6.3 to $19.6 million and public funding (from state and local governments) has increased from $3.9 to $14.4 million. In 2007, 89% of programs permitted secondary exchange and 76% encouraged it. Condoms, referrals to substance abuse treatment, human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) counseling and testing and naloxone for overdose were among the most commonly provided services in addition to basic syringe exchange. Each of these services was provided by 40% or more of SEPs in 2007. Conclusions While syringe exchange has remained controversial in the United States, there has been very substantial growth in numbers of programs, syringes exchange and program budgets. Utilizing secondary exchange to reach large numbers of injecting drug users and utilizing SEPs as a new platform for providing health and social services beyond basic syringe exchange have been the two major organizational strategies in the growth of SEPs in the United States. [source] New regionalism in five Swiss metropolitan areas: An assessment of inclusiveness, deliberation and democratic accountabilityEUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 4 2007DANIEL KÜBLER In the first, theoretical, part it draws upon the debate on old and new routes towards regionalism in order to identify four different types of metropolitan governance. It then develops two working hypotheses , an optimistic and a pessimistic one , in order to analyse the implications of various types of metropolitan governance on inclusiveness, modes of decision making and democratic accountability. In the second part, these hypotheses are tested on the basis of comparative case studies on twenty schemes of area-wide policy coordination in five Swiss metropolitan areas in the fields of water supply, public transport, social services for drug users and cultural amenities. The results suggest that ,governance' is superior to ,government' in terms of inclusiveness, that it cannot be seen as significantly linked to the fostering of deliberative decision making, and that it can present serious flaws in terms of accountability. It is noted, however, that a shift ,from government to governance' does not intrinsically imply democratic drawbacks. Contextual factors play a strong conditioning role. [source] Expenditure Incidence in Africa: Microeconomic EvidenceFISCAL STUDIES, Issue 3 2000David E. Sahn Abstract In this paper, we examine the progressivity of social sector expenditures in eight sub-Saharan African countries. We employ dominance tests, complemented by extended Gini/concentration coefficients, to determine whether health and education expenditures redistribute resources to the poor. We find that social services are poorly targeted. Among the services examined, primary education tends to be most progressive and university education is least progressive. The benefits associated with hospital care are also less progressive than other health facilities. Our results also show that, while concentration curves are a useful way to summarise information on the distributional benefits of government expenditures, statistical testing of differences in curves is important. [source] The Swedish Welfare State and the Emergence of Female Welfare State OccupationsGENDER, WORK & ORGANISATION, Issue 4 2000Lars Evertsson The Swedish welfare state has, during the twentieth century, developed into the primary guarantor of health and social services as well as economic security. As the welfare state has developed, a new group of professions has emerged which can be described as welfare state professions. In this paper I will point out a few central aspects of how female-dominated welfare state professions have emerged and developed within the framework of the Swedish welfare state's expansion. These ideas will then be demonstrated on two female-dominated occupations, nurses and occupational therapists, which have developed in close association with the expansion of the welfare state. The results indicate that the emergence of a centrally planned welfare state and the occupational groups' organizational resources have been of crucial importance for the professional development of female-dominated health and care occupations in Sweden. The welfare state has opened up new professional fields and created a stable labour market, which has provided good conditions for professional organizing. The state has also been quick to establish relationships with occupational groups whose professional competence has been deemed to be suited to the welfare political context. However, the state's interests in professional matters have often been in conflict with those of the professions themselves, regarding, for example, education, sub-specialization and certification. One conclusion that can be drawn is that the Swedish welfare state has acted both as an engine and a brake regarding professional development and status. [source] Laissez-faire governance and the archetype laissez-faire city in the USA: exploring HoustonGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 1 2003Igor Vojnovic This article explores the governance of Houston, the archetype laissez-faire city in the USA. The research examines the complexity of Houston's minimal government intervention rhetoric, which in practice involves extensive federal, state and local government involvement in economic development in combination with a disinterest in social service and income maintenance programmes. This governance strategy is outlined through an examination both of regional public policy and local public finances. The analysis illustrates that Houston's local governance has historically been based on a management approach that attempts actively to minimize costs for potential investors to locate in the City, through public intervention, while at the same time generating an unattractive urban environment for the socially marginalized , hence the disinterest in social services. Thus, despite the local laissez-faire rhetoric, government intervention in Houston's growth has been vital and has produced the extraordinary impacts usually expected from public involvement in local economic development. The foundations of this local governance strategy are both predicted and advocated by the public choice approach, a theoretical framework whose emphasis on inter-municipal competition advances management tactics based on maintaining low taxes and low expenditures on public welfare. The research also shows, however, that Houston is unique, when compared to other economically successful US cities, in following such an extreme approach of this management strategy. [source] Self-efficacy, social support and service integration at medical cannabis facilities in the San Francisco Bay area of CaliforniaHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2008Amanda E. Reiman PhD MSW Abstract In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out onsite. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups , all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a social model of cannabis care, including allowing patients to use medicine onsite and offering social services. This approach has implications for the creation and maintenance of a continuum of care among bottom-up social and health services agencies. [source] Organisation and features of hospital, intermediate care and social services in English sites with low rates of delayed dischargeHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2007Matt Baumann MSc Abstract In recent years, there has been significant concern, and policy activity, in relation to the problem of delayed discharges from hospital. Key elements of policy to tackle delays include new investment, the establishment of the Health and Social Care Change Agent Team, and the implementation of the Community Care (Delayed Discharge) Act 2003. Whilst the problem of delays has been widespread, some authorities have managed to tackle delays successfully. The aim of the qualitative study reported here was to investigate discharge practice and the organisation of services at sites with consistently low rates of delay, in order to identify factors supporting such good performance. Six ,high performing' English sites (each including a hospital trust, a local authority, and a primary care trust) were identified using a statistical model, and 42 interviews were undertaken with health and social services staff involved in discharge arrangements. Additionally, the authors set out to investigate the experiences of patients in the sites to examine whether there was a cost to patient care and outcomes of discharge arrangements in these sites, but unfortunately, it was not possible to secure sufficient patient participation. Whilst acknowledging the lack of patient experience and outcome data, a range of service elements was identified at the sites that contribute to the avoidance of delays, either through supporting efficiency within individual agencies or enabling more efficient joint working. Sites still struggling with delays should benefit from knowledge of this range. The government's reimbursement scheme appears to have been largely helpful in the study sites, prompting efficiency-driven changes to the organisation of services and discharge systems, but further focused research is required to provide clear evidence of its impact nationally, and in particular, how it impacts on staff, and patients and their families. [source] Evaluating the impact of integrated health and social care teams on older people living in the communityHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2003Louise Brown CQSW BSc(Hons) MSc Abstract Although it is perceived wisdom that joint working must be beneficial, there is, even at this stage, little evidence to support that notion. The present study is an evaluation of two integrated co-located health and social care teams which were established in a rural county to meet the needs of older people and their carers. This study does identify that patients from the ,integrated teams' may self-refer more and are assessed more quickly. This might indicate that the ,one-stop shop' approach is having an impact on the process of service delivery. The findings also suggest that, in the integrated teams, the initial stages of the process of seeking help and being assessed for a service may have improved through better communication, understanding and exchange of information amongst different professional groups. However, the degree of ,integration' seen within these co-located health and social care teams does not appear to be sufficiently well developed to have had an impact upon the clinical outcomes for the patients/service users. It appears unlikely from the available evidence that measures such as co-location go far enough to produce changes in outcomes for older people. If the Department of Health wishes to see benefits in process progress to benefits to service users, then more major structural changes will be required. The process of changing organisational structures can be enhanced where there is evidence that such changes will produce better outcomes. At present, this evidence does not exist, although the present study does suggest that benefits might be forthcoming if greater integration can be achieved. Nevertheless, until the social services and National Health Service trusts develop more efficient and compatible information systems, it will be impossible to evaluate what impact any further steps towards integration might have on older people without significant external resources. [source] Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older peopleHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2003G. Samuelsson PhD Abstract The present study was designed to describe the pattern of long-term formal support received by people with mental disorders, and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support. This study is based on a cohort (n = 192) of people born in 1902 and 1903 in a community in Southern Sweden. The research participants were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 years, and then on eight further occasions until they were 92. The participation rate ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% of people with other psychiatric diagnoses and 12% of people with good mental health. The last group had all physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% of people with good mental health did not receive any formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other two groups. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with a mental disorder, including dementia, were significantly more likely to use formal support compared to people with good mental health. Social factors were the main factors predicting formal support. [source] Community mental healthcare in England: associations between service organisation and quality of lifeHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2002Justine Schneider Abstract The present authors set out to explore the relationship between different forms of service organisation and quality of life (QoL) for service users. Four mental health trusts and their corresponding social services departments were recruited to exemplify: (1) high and low levels of integration between health and social services; and (2) high and low levels of targeting at users with severe mental health problems. The authors used the Lancashire Quality of Life Profile, and chose their sample size to be able to detect a difference of 0.5 in subjective satisfaction scales. Analysis of covariance was used to investigate the simultaneous impact of variables representing user characteristics, objective and subjective QoL, and service organisation. Two hundred and sixty users selected at random from the active caseloads of mental health services in the four districts were interviewed at time 1 and 232 people were interviewed 6 months later (time 2). No bias was detected in the non-respondents at time 2. The authors found few differences between districts. As in other similar studies, QoL seemed to be stable for the whole sample over time. In 6 months, general satisfaction with leisure increased and the number of people who had been in hospital fell. Negative affect score was the only variable found to be associated with subjective QoL, and no predictors of objective QoL were identified. There was some evidence of better objective outcomes for people in receipt of integrated mental health services. They socialised more, and seemed to have less difficulty accessing police and legal services. The results also suggest that interventions targeted at negative affect could have benefits for subjective QoL. [source] Research and development at the health and social care interface in primary care: a scoping exercise in one National Health Service regionHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2002Jo Cooke MA Abstract The present project aimed to identify research activity at the health and social care interface in primary care within one National Health Service region, and to determine levels of research capacity and support within social services. The study was commissioned by a primary care research network (PCRN) in order to assess opportunities to increase research capacity within social services. Data were collected in two phases from 61 managers, team leaders and senior practitioners in social care, and six public health representatives in health authorities, using telephone interviews and focus groups. The findings highlighted a lack of infrastructure and support for research and development in social care. However, many social care respondents wanted opportunities to develop research skills with healthcare colleagues. Despite poor support, many small-scale projects were described, and many respondents showed an enthusiasm for engaging with research. Methods in use included surveys, action research, needs analysis and evaluation of service developments. Many examples of user involvement were given. Interface projects were usually instigated by interagency forums and funded from multiple sources. Most project work was motivated by service improvement or development, rather than aiming to produce generalisable knowledge. Barriers to conducting research included lack of confidence, research skills and time, as well as workload demands, lack of cover to release staff for research and lack of supervision. Research was not seen as legitimate work in some social care environments or as part of a career path. Existing joint working initiatives (such as the National Service Frameworks) were highlighted as flashpoints for potential research and evaluation activity. The findings suggest clear opportunities for PCRNs to develop research capacity at the interface with social care; for example, by signposting available resources, providing training grants and secondments for social care staff, and supporting interagency networks with a focus on evaluation. In turn, experience in promoting user involvement in social services could add value to research expertise at the primary care,social care interface. [source] The responsibility to care for single homeless peopleHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001Maureen Crane RGN RMN MSc PhD Abstract This paper examines the reasons why in contemporary Britain many single homeless people with severe physical and mental health problems and welfare needs do not receive the treatment, care and financial support that they manifestly need, and in particular considers the interaction between their personal characteristics and the organisation and the obligations of services. Homelessness is a complex concept associated with problems of housing, health, social care and income. The greatest weaknesses of the service system are that no single agency has a statutory responsibility to ensure that vulnerable homeless people are served, and none of the generalist welfare agencies have a duty to seek out those who do not present. As a result, single homeless people fall between the housing, health and social services and amass exceptional unmet needs. The paper appraises the approaches to single homeless people's problems that have recently been introduced by the Rough Sleepers' Unit (RSU), and discusses the ways in which current reforms of the welfare services may impact on the situation of homeless people. With the possibility that the RSU's prime responsibility for commissioning single homeless people's services will transfer to local authorities in 2002, the paper concludes by specifying the implications for voluntary and statutory providers and makes recommendations about the attribution of the responsibility to care for this vulnerable group. [source] Social services and Primary Care Groups: a window of collaborative opportunity?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2000Bob Hudson This paper reports on the findings of two investigations into the relationship between social services and Primary Care Groups (PCGs): a national postal questionnaire and a series of regional seminars. The key findings of both explorations are summarised and placed in the context of other available evidence on the development of PCGs. Issues covered include: the background and status of social services representatives; preparation and support for the board role; feedback and accountability, and early contributions. It is concluded that progress is being made in bringing together the agendas and activities of PCGs and social services, and to a lesser extent the wider local authority, but that important obstacles remain in place. The enduring significance of the resource dependency model needs to be a key factor in emerging partnerships. [source] Using focus groups to seek the views of patients dying from cancer about the care they receiveHEALTH EXPECTATIONS, Issue 3 2000Norma V. Raynes Purpose The prime purpose of the study was to investigate whether focus groups were a practical way of seeking the views of dying people and whether the information collected added to that collected by more established methods. Design A sample frame of Macmillan nurse patients was collated from which three cluster samples were randomly selected to participate in focus groups. The focus groups were structured with an experienced facilitator and recorder to answer three key questions. Setting and participants Patients of Macmillan nurses in three NHS Trusts in West Yorkshire who were living at home with incurable cancer. They were aware of their condition and were willing to participate. Main variables studied The three key questions were; what kind of help are you currently receiving? What sort of help do you want? Of the kind of help you are receiving what kind is most important to you? Results 17 patients participated in three focus groups. Participants were generally fairly able and living with spouses or relatives. They were of varying age with different types and duration of cancer. They were receiving a range of health and social services of varying importance to them. More help was particularly wanted with support for daily living, support from specialist cancer nurses, help getting out and with housework. Macmillan nurses and general practice services were highly rated in some but not all three trust areas. Conclusions We propose that focus groups are a practical way of collecting information about dying patients that can complement other sources of information in planning and auditing the provision of care. [source] | |||||||||||||||||||||||||||||||||||||||||||