HSCWRU researchers have a ball at the British Society of Gerontology 2019 Annual Conference in Liverpool

Caroline Norrie, Katharine Orellana and Laura Cole report from BSG 2019. (725 words)

HSCWRU researchers enjoyed two and a half days of stimulating presentations, symposia and keynote speeches at the British Society of Gerontology’s (BSG) 2019 Annual Conference held this year in Liverpool. The 48th BSG annual conference was entitled Resilience and Living Well in Local Communities and took place from 10 to 12th July at the University of Liverpool.

Keynote speakers presented on each day. Professor Gill Windle from Bangor University kicked off the conference with a discussion about resilience in later life – and the uses and abuses of this myth/metaphor/or measure. Professor Frank Oswald from Goethe University in Germany discussed environmental gerontological perspectives and the types of research studies that arise from these approaches. Professor Chris Todd, joint lead of the NIHR Policy Research Unit – Older People and Frailty, discussed his aim of using an ‘equality lens’ in the setting up and undertaking of work in this recently formed team together with Newcastle University and the London School of Economics. Continue reading

Resilience II: Older People and Social Care

Joan RapaportDr Joan Rapaport was inspired at a conference organized by the Social Care Workforce Research Unit at King’s College with London Age UK London and Making Research Count, that was also supported by the British Society of Gerontology. She provides her views of the event. Presentations are available on the conference website. (1,282 words)

In his welcome, Paul Goulden, Director of Age UK London explained that the conference was the second half of the Annual Joint Conference which had been held in March but was curtailed because of snow storms. This was indeed an event that had tested everyone’s resilience and explained why this conference was being held again thanks to the speakers and to the overall organizer, Jess Harris.

Paul Goulden, Daniel Webster, Lynne Phair and Dave Martin at the conference in Bloomsbury

Paul Goulden, Daniel Webster, Lynne Phair and Dave Martin at the conference held at Age UK London’s offices in Bloomsbury on 29 October

Using the Sit&See Tool to capture and celebrate Care and Compassion for Older People: Lynne Phair, Independent Consultant Nurse and Expert Witness

When investigating an allegation of hospital neglect, a manager had asked Lynne: ‘How do I know if staff are caring and compassionate?’ This started her on the road that ultimately led to the development of the Sit&See Tool, designed to capture care and compassion. Continue reading

Integrated care from an international perspective

Jo Moriarty is Senior Research Fellow and Deputy Director at the Social Care Workforce Research Unit. (578 words)

The 18th International Conference on Integrated Care was hosted by the International Foundation of Integrated Care (IFIC) in partnership with the National Institute of Public Health and the Environment (RIVM and Vilans (the National Centre of Expertise for Long-term Care in the Netherlands) in Utrecht from 23-25 May 2018.  Michelle Cornes and I were both fortunate to be among the 800 or so delegates attending the conference.

The increase in the number of people with complex long-term conditions whose support needs span traditional boundaries across health, social care and housing has led to many developments aimed at improving collaboration across different organisations and enhancing quality of care for individuals.  However, there is no single definition of what is meant by ‘integrated care’. Continue reading

At the 12th UK Dementia Congress

Jo Moriarty Nov 2014bJo Moriarty is Senior Research Fellow and Deputy Director at the Social Care Workforce Research Unit. (736 words)

The 12th UK Dementia Congress ran from the 7-9 November at Doncaster Racecourse. I was one of over 700 delegates who included people living with dementia, family carers, health and social care professionals, and researchers. Organised by the Journal of Dementia Care, in partnership with the University of Bradford and with support from the Alzheimer’s Society, there were over 150 different presentations and workshops. I spoke about the Unit’s completed study about handovers in care homes funded by the Abbeyfield Foundation and explained that we have just started a new phase which will focus on the views of residents and relatives. Continue reading

At the 9th Deafblind International European Conference

simcock, peterPeter Simcock is Senior Lecturer in Social Work (Adults) at Staffordshire University, and PhD Student, Social Care Workforce Research Unit, King’s College London. He reports from Touch of Closeness: The 9th Deafblind International European Conference, Aalborg. (621 words)

Having been inspired at the 16th Deafblind International (DbI) World Conference in Bucharest in 2015, I was delighted to present at the 9th Deafblind International European Conference, in the lovely city of Aalborg, at the beginning of September 2017. Linda Erikson, pedagogue at the National Resource Centre for Deafblindness in Sweden and herself deafblind, observes that the sense of touch is crucial for all deafblind people. It was therefore fitting that the Conference adopted ‘Touch of Closeness: Maintaining Social Connectedness’ as its theme. Continue reading

Families and children’s services: international perspectives

Dr Mary BaginskyMary Baginsky is Senior Research Fellow at the Social Care Workforce Research Unit at King’s College London. (565 words)

Early in September I had the privilege of attending the International Conference on New Perspectives for Outcome-Based Evaluation and Research on Families and Children’s Services’. It was held at the Chinese University of Hong Kong and emerged from a collaboration between the University, the International Association for Outcome-based Evaluation and Research on Family and Children’s services (iaOBERfcs) and the Zancan Foundation, based in Padua, Italy. It brought together over 150 participants from 14 countries. The conference opened with children and young people performing traditional Chinese drumming and dragon dances and was followed by opening addresses and presentations. As interesting as the latter were, I was still contemplating how the girls at the back of the dragons had danced for 15 minutes while bent at an angle of 90 degrees. Continue reading

Data and Debate – reflections on the SSRG Annual Workshop

Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s, was at the Social Services Research Group Annual Workshop this week. (801 words)

This year’s Social Services Research Group (SSRG) Annual Workshop, held at the London School of Economics (LSE) on 15 April was a particularly thought-provoking event. Entitled ‘Evidencing Service Improvement for Vulnerable Children and Adults’, the workshop featured an expertly chosen group of speakers whose presentations stimulated animated discussion from the floor. With the Care Act coming on stream and the increased drive for integration, participants, who were predominantly social care managers with responsibilities for data and organisational performance, enjoyed a great opportunity to discuss service re-figuration and its measurement. Continue reading

On compassionate care

Dr Joan RapaportDr Joan Rapaport reports on the seventh Annual Joint Conference of the Social Care Workforce Research Unit, Making Research Count, and Age UK London (with support from the British Society of Gerontology), which took place at King’s last week. (2,508 words)

In her welcoming introduction, Professor Jill Manthorpe (Social Care Workforce Research Unit, King’s College London) said the topic ‘Compassionate Care’ had been chosen to explore what we mean by compassion, where it might be needed in older people’s care, its place within the hierarchy of priorities and whether it concerns individuals or wider social relationships. She said the purpose of the conference was to find out:

  • Where is the passion in compassion?
  • Should we all be compassionate all the time?
  • Do all older people want compassion?

Continue reading

Push and pull: doctors deciding to leave the UK for New Zealand

Stephen MartineauStephen Martineau is a researcher at the Social Care Workforce Research Unit in the Policy Institute at King’s. (670 words)

The Social Care Workforce Research Unit (SCWRU) last week hosted a lecture by Robin Gauld of the University of Otago, New Zealand. Professor Gauld, who is 2014 NZ-UK Link Foundation Visiting Professor, presented new research (done with Dr Simon Horsburgh) on the migration of medical professionals from the UK to New Zealand. Audience members, who included the High Commissioner of New Zealand and the Executive Dean of the Faculty of Social Science and Public Policy at King’s, also heard formal responses from Stephen Bach (Dept of Management at King’s) and Jill Manthorpe, Director of SCWRU. Continue reading

My House or My Home? The challenges of ageing and housing

Joan Rapaport

by Joan Rapaport

Last week (6 February) the Social Care Workforce Research Unit hosted its sixth joint annual conference on the theme of older people. It is organised jointly with Age UK London and Making Research Count and, this year, supported by The British Society for Gerontology. The topic: housing and older people. Speakers included Jill Manthorpe, Vic Rayner, Jeremy Porteus, Simon Evans, Maureen Crane, Louise Joly and Maria Brenton. Joan Rapaport reports.

 

Why the interest in older people’s housing?

Professor Jill Manthorpe (Director, Social Care Workforce Research Unit) highlighted increasing interest in the role of housing and environment on health and wellbeing in later life. She pointed to the sudden (re)discovery of the triangle of health, housing and care contributing to quality later life. Poor housing and environments undermine the potential benefits of social care and technological advances. Depressing environments may foster depression and inaccessible or hazardous environments compound isolation. We have long known that dampness, mould and cold are bad for health; recent research also suggests that loneliness can be as bad as smoking on health. Whilst some commentators accuse older people of stealing the pensions of their younger counterparts and draining health resources, and denying them access to the housing ladder, the idea of a ‘jilted generation’ has scant evidence. If anyone had been jilted it was the generations who were promised ‘homes fit for heroes’ many of whom who spent their old age in cold, disabling and poor housing.

Jeremy Porteus

Jeremy Porteus

Drawing on a recent personal experience, Jeremy Porteus (Director, Housing, Learning and Improvement Network (LIN)) highlighted the problems people face when planning for old age. There is no central ‘Ideal Home Exhibition’ point from which to make the perfect choices, there are psychological barriers to facing the future and a decision may have to be made in a crisis. Although the government is greatly concerned about the ageing population, the Select Committee on Public Service and Demographic Change (Lord Filkin, 2013) found that the housing market is delivering much less specialist housing for older people than is required and that national and local government and housing associations urgently need to make plans. Jeremy commented that if we are to build better homes then we also need to shape communities: making this more just a question of supply and demand.

Jeremy described the benefits deriving from purpose built projects and the emerging evidence base for positive outcomes. As just one example, people who were lonely with high needs had moved into Extra Care accommodation that had been funded by the Department of Health (DH). Within six months to a year many had experienced improvements in their wellbeing, ability to self-care and autonomy, creating savings in health and social care budgets. Extra Care projects are provided in a wide variety of ways including community led housing, cooperatives and cohousing as well as sheltered housing, retirement villages, almshouses and homesharing. Jeremy exhorted conference participants to join Housing LIN to keep abreast of strategic developments and opportunities and service innovations. Housing LIN is the leading ‘learning lab’ for a growing integrated network of housing, health and social care professionals in England involved in planning. As such, it is at the forefront of policy, research and practice developments and is a member of the Prime Minister’s The Dementia Challenge health and care champion group.

Vic Rayner (Chief Executive, SITRA) questioned the source of the ‘drain’ perceptions of older people in society. The evidence shows that contrary to these ‘doom and gloom’ predictions, people living longer lives are an asset to their communities and families, many working as volunteers, providing neighbourly support and helping with childcare responsibilities.

Vic Rayner

Vic Rayner

And the pictures of older people being drains on taxpayers are exaggerated, she observed. Close analysis of available data illustrates that the average annual unit cost of sheltered accommodation is just £311.10 – an amazing bargain! An investment of £198.20 in sheltered accommodation yields a saving of £646.90; of £32.40 in sheltered accommodation for older people with higher needs, savings of £123.40 and older people receiving floating support £97.3 and £628 respectively. Service user objectives of having access to assistive technology, security of tenure, personal security, greater autonomy and contact with family and friends are largely met. Yet supported provision for older people when compared to other population groups, is meager and may now be additionally under threat from local authority budgetary constraints.

‘On the Pulse’ case studies show how good practices in housing and health delivery can achieve good outcomes in:

  • Transferable care packages from housing to hospital and vice versa
  • Supporting re-ablement through telecare
  • Creating solution orientated partnerships across traditional health, social care and housing sectors

Vic highlighted the importance of commissioners’ valuing what matters to service users and including in their audits ‘soft’ and ‘hard’ outcomes, rather than focusing on a set of outputs defined by funders. She endorsed views that deeply ingrained attitudes towards older people needed to change.

Dr Maureen Crane and Dr Louise Joly (Honorary Senior Research Fellow and Research Fellow respectively at the Social Care Workforce Research Unit) drew on their current research on the housing and support needs of older homeless people.

Louise Joly

Louise Joly

Emerging findings from this unique study investigating what has happened to homeless people since they were rehoused five years ago demonstrate the potential problems of withdrawing support. Their research suggests that homelessness amongst people aged over 50 years is increasing, although no accurate figures are available. Homelessness in later life happens for a variety of reasons, such as breakdown in long-term marital or partnership relationships, death of a parent or spouse as well as mental health and substance misuse problems. Some people have poor budgetary skills and become evicted from the former family home. Some have literacy difficulties. While homelessness can be short term, so far nearly half of their research sample had been homeless for more than five years before being rehoused.

In this study, participants were first interviewed six months after they had been rehoused. Most, by far, not surprisingly, were glad to have been rehoused, regarded their accommodation as ‘home’, valued their privacy and control, and felt safe and comfortable. However, almost half were in debt. Significantly, those in sheltered accommodation were less likely to be worried or to mention they felt depressed.

Maureen Crane

Maureen Crane

Five years on about a third were still in their original accommodation. Of the minority who had moved, some had changed to live in more supported accommodation. Of those in their original accommodation, case examples highlighted struggles that had increased once their support workers had been withdrawn. These people were living impoverished, isolated lives. Unrealistically, some with health problems were being required to look for work. Maureen had been unable to interview one individual, in a great state of despair about her finances, until she had helped her to complete an application for welfare benefits. Some of the questions were difficult to understand. The form was 57 pages long and had to be printed: for this the internet café was the only option. The individual, who had relied on friends for money for two months, had to pay £8 from her benefits’ for her application to be printed!

This research is indicating that many older homeless people want permanent accommodation but many require supported or specialist living arrangements. The support needs of homeless people can fluctuate once rehoused and some do not seek help when faced with difficulties. There is currently a lobbying vacuum following the demise of the UK Coalition on Older Homelessness in 2010. Maureen and Louise highlighted the need for a new campaigning group to raise awareness of the particular needs of older homeless people.

Next to present, Dr Simon Evans (Senior Research Fellow, Institute of Health and Society, University of Worcester) asked what Extra Care housing offered older people? Drawing on emerging findings from the ASSET research project (funded by NIHR School for Social Care Research), Simon explained that Extra Care housing covers units for rent, purchase and includes some retirement villages. Extra Care is typically characterized by having facilities that enable social interaction, activities, outside support and the ability to buy in flexible care packages. The model provides many opportunities to meet the diverse needs and circumstances of older people. For example, the characteristics and needs of residents are wide ranging. Schemes may rely on multiple funding sources, multiple partners and multiple commissioning agencies. There is a range of financial and legal considerations such as for rent, or purchase, and charges for service, support and/or care packages. There are many types of building options such as ‘top of the market’ facilities, specific age friendly designed complexes, or converted council tower blocks. The literature on social care and support in housing for older people is meager.

When planning for their ‘ideal home’ consumers may be faced with differing local authority arrangements, the effects of welfare reforms and budgetary constraints, new models of commissioning and different approaches regarding levels of need. Simon explained that agreement on priorities and tendering arrangements with local authorities preoccupy commissioners. Key factors regarding the commissioning of social care in housing include the relationship between the housing and care provider, the building type, layout and location, the facilities on offer, tenure and letting policy and the mix of care needs required by the residents. However, ideas about what facilities are wanted by people with high needs are changing. As one example, meals and restaurants on site are proving popular but they may not meet everyone’s preferences.

Despite these complications, Simon ended by highlighting some of the benefits of extra housing such as:

  • Serving as community hubs for services
  • Supporting couples to stay together (in contrast to traditional models of residential care)
  • Promoting independence
  • Potential for saving money when compared with the costs of care homes.

Concluding the day, Maria Brenton (Project Consultant to Older Women’s Cohousing Company) outlined the concept of cohousing: which essentially aims to combine personal autonomy with community in old age. Maria explained that there are a small number of cohousing schemes emerging in England where people are coming together with the intention of living in a community and a commitment to mutual support. They share values and each agrees to share responsibility for the group as a whole. Each ‘cohousee’ has her or his own accommodation and own front door. The model is well established on the continent but is starting to gain some momentum here.

Maria Brenton, Jill Manthorpe and Simon Evans

Maria Brenton, Jill Manthorpe and Simon Evans

Maria highlighted the potential strengths of cohousing particularly in respect of combatting loneliness ‘which is probably a killer’. As people come together to design, build, develop and manage the project, they get to know each other well. Cohousing offers the prospect of good social contact, opportunities to share skills and the benefits of old fashioned communities with help at hand right next door.

In the UK 14 schemes are in the pipeline. The scheme she is involved in ‘OWCH’ (Older Women’s Housing Cooperative) is likely to be the first of its kind in the country. However, the model is very new to commissioners and cohousing pioneers face many challenges. A shift in perspectives is required.

For social workers and social care practitioners there were several key messages from the day

  • Loneliness is a potential killer – it is important to consider when thinking about outcomes. The contribution of housing and the built environment to contributing to loneliness should be assessed and addressed.
  • Attitudes about ageing and older people need to change and social work can play its part in this by working with older people and their organisations.
  • Extra Care is often cost effective and outcomes are often good; social workers should be familiar with what is on offer and its opportunities.
  • Not providing Extra Care may cost the public purse more so local investment in it could be supported. As well as providing construction jobs, Extra Care offers local work.
  • There is wide variety of supported housing schemes and social workers need a local ‘map’ to know what people might consider or should be confident that there are local information and advice agencies that can provide person-centred services.
  • The potential of older people to design their own schemes has not been realized; social workers can put people in touch with national bodies.
  • The importance of older people engaging in national and local consultations to improve their housing and wellbeing is one that social workers can convey in community development work.

This conference was the 6th annual joint event (CPD certified) held by Making Research Count at the Social Care Workforce Research Unit with Age UK London. This year the conference was supported by the British Society for Gerontology. It was held on 6 February 2014 at Henriette Raphael House, Guy’s Campus, King’s College London.

Dr Joan Rapaport was, until recently, Visiting Research Fellow at the Social Care Workforce Research Unit, King’s College London and is a lay member of the Mental Health Review Tribunal.

Conference photographs: Cliff Chester

For more on the conference (including presentations) go to the Event website.

For your attention:                                                                                                            Gordon Deuchars, Age UK London, stated that the Mayor of London had issued a Public Consultation on a New London Housing Strategy. This also concerns housing for older people. The consultation ends on 17.2.14. Please contribute to this consultation: www.london.gov.uk/priorities/housing-land/consultations/draft-london-housing-strategy