Results for 'home care'
Results 11 - 20 of 22
Examines older people’s expectations from their housing and housing providers and the choices the UK housing market currently offers older and vulnerable people, and explores innovative housing and care solutions that could meet the demands of an ageing population and more widely support people with other social needs. The study drew on both quantitative surveys and qualitative interviews undertaken in previous research to establish what older groups need and expect from the housing market, and then used statistical methods to create a clear picture of the housing that older people inhabit now and the choices that the English housing market offers to them. Having established that the market presents only a limited range of options to older people, the research explored the international literature to identify different models of housing and support, focusing on countries that face similar demographic challenges. The report considers ideas that could potentially be adopted in England and adapted to an English housing and health context. A number of options were tested with two focus groups, involving over-55s and over-65s. Finally, based on the information drawn from the research, and through consultation with external experts, this report outlines a range of possible policy measures designed to ensure that the current and future stock of housing for older people is more effectively focused on supporting their health requirements.
OXFORD BROOKES UNIVERSITY. Institute of Public Care
The case study describes the process that Wiltshire Council has used to develop its new ‘Help to Live at Home Service’ for older people and others who require help to remain at home. The approach focused on the outcomes that the older people wish to gain from social care. It involved a complete overhaul of the social care system from the role of the social worker working alongside the customer to determine the required outcomes to the role of the providers of the service who must deliver these outcomes and receive payment based on that delivery. The report aims to promote discussion about how outcomes-based, personalised support can best work in social care in England in the future.
DIXON Josie, et al
This independent economic evaluation of the British Red Cross Support at Home service focuses on four services which were found to improve outcomes in an earlier British Red Cross evaluation. The services all aim to help people to build their confidence and regain their independence during times of particular difficulty.Those evaluated were 'Next Steps', where volunteers provide home visits and monitor how people are coping following hospital discharge; 'Care in the Home' services delivered by staff and volunteers providing social visits, support and help with household tasks; and a Neighbourhood/Community service in Scotland which focused on linking people to existing services and volunteer-led services such as befriending. The final sample for this analysis consisted of a total of 52 people, the majority of who were over 65. Two outcomes were used in the economic analysis: an increased ability to manage daily activities and improved wellbeing. The evaluation identified cost savings that were related to a reduced need for formal/ informal care and general help around the home; a reduced risk of falls and malnutrition, particularly amongst those with unmet care needs; and, to a lesser degree, a reduced need for treatment of depressive symptoms. The total savings identified amounted to more than five times the cost of the service. The average cost of the intervention was £169 per person (based on the services and sample data in the Red Cross evaluation) and the identified savings came to £880 per person.
CLIFFORD Paul, et al
This summary report describes the findings of a project evaluating the potential cost savings arising from the use of telecare. Another aim was to develop a methodology that will support routine evaluation and comparison of the cost-effectiveness of local telecare implementations. Evaluation was made of the suitability of telecare for 50 clients for whom Overview Assessments had been completed by FACE Recording & Measuring Systems Ltd. Where telecare appeared suitable, the social care costs of meeting the client’s needs before and after provision of telecare were estimated. Estimates were also made of the total savings achievable by the deployment of telecare. Out of the 50 cases, 33 were identified as potentially benefitting from telecare. The average weekly cost of telecare was £6.25, compared to £167 for the average weekly care package for the sample pre-telecare. The results confirmed previous studies showing that very substantial savings are achievable through the widespread targeted use of telecare. Potential savings lie in the range of £3m to £7.8m for a typical council, or 7.4-19.4% of total older people’s social care budget.
UNIVERSITY OF YORK. Social Policy Research Unit
This report provides final findings of a study conducted with ten participating councils to investigate the benefits of homecare re-ablement. The study aimed to identify features of an effective and cost efficient services; maximise outcome and duration of benefits; and to understand and reduce the demands on other formal care, including other social services. The study comprised of three groups of councils: intervention sites which were enablement staff led; intervention sites with mixed staff teams; and comparison sites where service users had not undergone a phase of home care re-ablement. The previous interim study reflected on initial findings from the intervention sites. This report also adds findings from the comparison sites and long term impact from the follow up review stage. Main findings are discussed in the areas of assessment arrangements; discharge and onward referral arrangements; key features of re-ablement services; team skill mix; staff commitment, attitude, knowledge and skill; service users and carer views; and a strong vision of the service.
GERALD PILKINGTON ASSOCIATES
The report ‘Homecare Re-ablement Prospective Longitudinal Study Final Report’ (Dec 2010) commissioned by the Department of Health’s Care Services Efficiency Delivery programme (CSED) has provided further insight and understanding about the nature and beneficial impacts of homecare re-ablement. However, some of the report content has resulted in a lack of clarity. The aim of this paper is to set out some of the background to the report and provide clarity on the learnings that can be gained with regard to the cost effectiveness of homecare re-ablement services. Contrary to impressions set out in various articles, the report does not indicate that homecare re-ablement as an approach has little financial benefits for a council. What it does illustrate is that councils should undertake a baseline exercise to establish an understanding of the local position and then to operationally performance manage their service to ensure that it is and remains cost effective whilst maximising the benefits of independence for as large a number of people as possible.
MAYO-WILSON Evan, et al
Background: Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalisation and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services.
Methods and Findings: Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomised controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures used were mortality, institutionalisation, hospitalisation, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness.
Results: Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programmes may have small relative effects. There was moderate quality evidence of no overall effect on the number of people institutionalised. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect, but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life and physical functioning respectively, but these may not be clinically important.
Conclusions: Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programmes that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, the authors cannot exclude the possibility that some programmes may be effective.
DOUGHTY Kevin, ORTON Mike
Purpose: The purpose of this paper is to identify opportunities where technology interventions could help manage the risks associated with fire and explosions in homes of people who are older or who are vulnerable through other causes such as mental health problems or a history of substance abuse.
Design/methodology/approach: The approach focused on reviewing the latest available statistics in order to identify the major causes and rooms in which fire accidents occurred.
Findings: The authors found that the number of incidents and fatalities continues to decrease as a result of preventive measures such as a greater use of smoke detectors, but that there remained issues with cooking safety. New products for limiting damage and managing risks are available which could have a positive impact.
Research limitations/implications: The paper concludes that the challenges are making both professionals and the public aware of the available technologies and of introducing them following appropriate assessment of needs and risks.
Practical implications: Greater resources need to be offered for training of the public and of health and safety professionals. Further funding may be needed to implement the introduction of new technology.
Originality/value: This is the most up-to-date review of fire control measures employing assistive technology and telecare for domestic properties and will be of value to community health teams, adults care organisations, housing associations and other public bodies.
SAMPSON Christopher, et al
Introduction: Occupational therapy interventions, such as home visits, have been identified as being resource-intensive, but cost-effectiveness analyses are rarely, if ever, carried out. The authors sought to estimate the cost-effectiveness of occupational therapy home visits after stroke, as part of a feasibility study, and to demonstrate the value and methods of economic evaluation.
Method: The authors completed a cost-effectiveness analysis of pre-discharge occupational therapy home visits after stroke compared with a hospital-based interview, carried out alongside a feasibility randomised controlled trial. Their primary outcome was quality-adjusted life years. Full cost and outcome data were available for 65 trial participants.
Findings: The mean total cost of a home visit was found to be £183, compared with £75 for a hospital interview. Home visits are shown to be slightly more effective, resulting in a cost per quality-adjusted life year of just over £20,000.
Conclusion: The author's analysis is the only economic evaluation of this intervention to date. Home visits are shown to be more expensive and more effective than a hospital-based interview, but the results are subject to a high level of uncertainty and should be treated as such. Further economic evaluations in this field are encouraged.
HIRANI Shashivadan Parbati, et al
Background: Home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care.
Design: A study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC).
Methods: Participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873).
Results: Analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time).
Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC.
Results 11 - 20 of 22