Category Archives: Older people

Promoting the importance of human relationships: hospital social work

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Jo Moriarty, Senior Research Fellow at the NIHR Health & Social Care Workforce Research Unit, King’s College London introduces the new hospital social work report, which she wrote with Dr Nicole Steils and Prof Jill Manthorpe. World Social Work Day is on 19 March 2019 #WSWD2019 is the official hashtag. (602 words)

Mapping Hospital Social WorkThe theme for next week’s World Social Work Day is ‘promoting the importance of human relationships.’  In preparation for this we are launching our report into hospital social work, which was funded by the National Institute for Health Research Policy Research Programme at the request of the Chief Social Worker for Adults, Lyn Romeo.  Lyn has also kindly written the report’s foreword.

The origins of hospital social work lie in the decision made by the Royal Free Hospital in 1895 to appoint Mary Stewart as the first ‘lady almoner’. Her role was to interview people to decide who would be eligible for the free medical treatment that the hospital provided.  Other hospitals soon followed this example and by 1948, the Institute of Almoners had over 1000 active members.[1]  Written in the style of the time, Flora Beck’s textbook for almoners noted that their two key tasks were:

… to determine whether social problems are likely to have a bearing on the patient’s illness. The second is to make the patient feel that here is a person with whom he could, if necessary, discuss his personal difficulties; someone to whom he need not mind admitting any trivial misunderstanding which had been bothering him, and to whom he could reveal serious and confidential problems without embarrassment.[2, cited in 3] Continue reading →

Getting the message about assistive technology and telecare: new guidance

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John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. (592 words)

Last week I was invited to speak at the launch of ‘Help at Home – use of assistive technology got older people’ a review of current research evidence published by the National Institute for Health Research Dissemination Centre. My presentation discussed some of the findings from research I’d done last year as part of the NIHR School for Social Care Research funded UTOPIA project, which gets a mention in the review.

This review is timely and welcome. There has been considerable investment by local authorities in assistive technology and telecare at a time of unrelenting austerity. The research evidence to support this investment offers mixed messages, and local authority commissioners don’t have access to research findings, or even if they did, the time to read them. Worse, at least some of the information about telecare’s impact that is accessible is misleading. Local authorities are also under pressure: increasing demand for care and support, particularly from growing numbers of older people, and cuts to adult social care budgets that are unprecedented in their scale.

Is assistive technology and telecare the solution? Local authorities are keen to use it to promote independence, keep people living safely in their own homes and to reduce burdens facing family carers, which will, of course, also save money. These are all worthy objectives, but as the review suggests, more likely to be achieved by local authorities that pay good attention to the infrastructure within which assistive technology is used, rather than just the devices themselves.

The review makes the important point that much research in this field to-date appears to have focused on ‘high end digital technology’ rather than evaluating the impact of more basic technologies to help with everyday life; and more focus on the development of prototype technologies than real world testing. There are also some real challenges laid out for local authorities or other organisations that provide telecare services. For example, it reflects concerns by older people, highlighted in one international study that technology will be used as a substitute for hands on care. This is precisely what is happening in many local authorities in England at the present time. Another challenge from research is the suggestion that assessment and installation are seen as sequential one-off events (‘plug and play’) when getting the best out of it means seeing these as on-going processes, and that even simple technologies should be seen as a ‘complex intervention’. How does this compare with practices in hard pressed local authority adult social care departments at the present time?

Anyone working in this field or who is using, or thinking of using, technology, should find this report contains valuable insights, even if some of them are challenging. Research reviews can be dry-as-dust, of interest only to the scholarly or the assiduous and with little of value to care professionals. This review is readable and relevant. It offers clear summaries of current research evidence and there are also clear messages about what needs to happen for telecare to make an effective, optimal contribution towards the care and support of older people. It deserves to be widely read and for key messages to be addressed in practice.

John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. John’s presentation from the day.

The author’s own work, cited here, is independent research funded by the National Institute for Health Research School for Social Care Research. The views expressed in this blog post are those of the author and not necessarily those of the NIHR/SSCR, NHS, the National Institute for Health Research or the Department of Health and Social Care.

 

Resilience II: Older People and Social Care

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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 →

Cameos of Care Homes: stories from social care Vanguards

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Jess Harris is Research Fellow at the Social Care Workforce Research Unit, King’s College London. She led the Cameos of Care Homes project. (616 words)

Six ‘Vanguard’ areas across England have been developing approaches to enable care homes to better support the increasingly complex health needs of their residents. These six, focusing on ‘Enhanced Health in Care Homes’, were among 50 Vanguard pilot areas (2015 to 2018) tasked with developing models of care that can be sustained and replicated across England, helping the health and social care system tackle financial pressures and rising demands.

A recent National Audit Office (NAO) report has examined the Vanguards’ impact so far, in terms of value for money, and concluded: ‘there are early signs of a positive impact on emergency admissions’. However, at this early stage it cautions that ‘the longterm impact and sustainability of Vanguards is still not proven’. (page 47)

Staff members taking part in ‘Cameos of Care Homes’

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Personalisation and older people – better outcomes?

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John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. (455 words)

On Friday 14 September I met with a small international delegation of Occupational Therapists who work in two hospitals in Hong Kong: Pamela Youde Nethersole Eastern Hospital, an Acute District General Hospital, and Kowloon Hospital, a slightly smaller institution which offers general care to people who have chronic health conditions. They were accompanied by Denise Forte, who works as a senior lecturer in gerontology at Kingston University and who had organised the itinerary of the group. I had been invited to talk to them about two topics about which they were keen to know more: personalisation for older people in England, and the role of social workers and social services in supporting older people. Though the group was small, which enabled the seminar to be very informal, I did prepare some slides which I used where necessary.

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Intergenerational event at Portcullis House

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Charlotte Bice (17 years) and Jessica Bice (16 years), with their grandmother, Joan Rapaport, PhD took part in an intergenerational workshop at Portcullis House, 24 August 2018. The afternoon involved discussing different approaches that the young and older generation may adopt to achieve a successful outcome in resolving community challenges. The event was presented by The Way Ahead Engagement Project in association with the City of London, City Bridge Trust and Age UK London. (400 words)

Reflections on the day

‘This has been an enjoyable event’. ‘Great day’. ‘Ninety-nine per cent of the population should have this’.

We were excited to be right by the Houses of Parliament, to be sitting in the room where Select Committees hear evidence and to be working in a group to consider how we might help to improve our local amenities. The presentation How Parliament holds Government to account gave us a clear understanding about the respective roles of Parliament and Government, the duties of our MP and the work undertaken by a range of parliamentary groups. We were also told that if our MP failed to respond to a particular concern we could attend the Houses of Parliament and register our query on a green card. Our MP would then be obliged to stop what they were doing to come to see us in person! Continue reading →

Newly published in Ageing & Society: ‘Day centres for older people – a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived’

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Katharine OrellanaKatharine Orellana is a Research Associate in the Social Care Workforce Research Unit in The Policy Institute at King’s. (479 words)

Day centres for older people have been an integral part of social care in England since the 1960s. Recently, attention has focused on providing individualised support for older people with care needs. The relevance and desirability of group services, such as day centres, are questioned. Many are closing.

Our newly published review of the literature about day centres covers what people say about them and reports the evidence on centres’ benefits and purposes. Focusing on centres that do not specialise in the care of older people with dementia and covering the period 2005-17, it highlights both what is known and the gaps in evidence about these services. Continue reading →

Home care workers supporting people with dementia at end of life

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John WoolhamJohn Woolham is Senior Research Fellow at the Social Care Workforce Research Unit. (560 words)

The latest seminar in the current Perspectives series focused on research with older people took place on Monday 9 July. Kritika Samsi from SCWRU and Tushna Vandrevala from Kingston University presented findings from their research into how home care workers support people with dementia towards the end of their life. Their study investigated the experiences of home care workers working with people with dementia who were living in their own homes, the challenges they face, how these are managed and their views of the contribution of their work. Their presentation was based on semi-structured interviews with 30 care workers and 13 managers from 10 home care agencies in London and the south east of England. It was funded by Dunhill Medical Trust. Continue reading →

An alternative approach to ageing

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Today, we are posting the press release from the national charity, University of the Third Age, as it publishes a report that takes a fresh look at ageing. (409 words)

The U3A (University of the Third Age) has released research today which details a sustainable and positive approach to ageing built on group learning, skill sharing and volunteering.

The report Living Life, Extending Horizons, Challenging Conventions is based on the findings of a literature review, together with the results of a member survey and a series of focus groups around the country.

Sam Mauger, Chief Executive of the Third Age Trust (which supports U3As in the UK) said, “We think it is time to move away from the current public debate on ageing which is largely predicated on a deficit and dependency approach. Continue reading →

CQC emphasises the importance of human rights for high quality care home services

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Caroline Green is a PhD student at King’s College London. (362 words)

The Care Quality Commission (CQC), England’s care service regulator and quality inspector, is emphasising the centrality of human rights and equality when providing high quality care in care homes and other care services. Human rights are the rights we all have because we are human beings. They are legally enshrined in the Human Rights Act 1998 and the Equality Act 2010.

Andrea Sutcliffe, CQC’s Inspector-in-Chief, recently explained at CQC’s Human Rights and Equality Conference in February 2018 what role human rights play for CQC’s regulation and inspection of care homes. She said, ‘Human rights thread through all our key-lines of enquiry. It informs the judgement that we make when inspecting care services and is one way that the CQC can emphasise the importance of human rights, raise the profile and make sure that the people are being treated the way that they should.’ Continue reading →