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An independent review of Shared Lives for older people and people living with dementia


Shared Lives is based around a Shared Lives carer sharing their home with an adult in need of care, to encourage meaningful relationships, independent living skills and community integration. This review explores how Shared Lives’ respite service for older people and people with dementia compare to ‘traditional’ forms of care for across three areas: outcomes for service users, carer and care commissioners; direct care costs to commissioners; and impact on the broader health system, such as a reduced usage. The review found that Shared Lives model provides positive outcomes for both service users and carers. It found that Shared Lives arrangements were able to reduce social isolation experience by carers and help increase their general wellbeing. Shared Lives also resulted in increased independence, wellbeing and choice for service users. In addition, the study found that the costs Shared Lives approach are similar to ‘traditional’ respite provision and provide an important option for commissioners. Appendices include details of calculations of the cost of providing Shared Lives respite care and day services; the results of a rapid evidence assessment on outcomes of 'traditional' respite care; and details of Healthcare service usage modelling.

Care and Health Improvement programme: efficiency project


This report provides practice examples from ten councils who took part in the Care and Health Improvement Programme during 2016/17. It describes the innovative approaches they took to achieve greater efficiencies from their adult social care budgets and draws conclusions as to what other councils might learn from them. The examples cover three main areas: managing demand for social care by offering residents a different type of service; more effectively using the capacity in communities to help find new care solutions; and working closer with partners in the NHS to reduce pressures in the care and health system. They highlight the importance of councils dealing with people effectively at their first point of contact; the benefits of using strength-based approaches; that developing social enterprises can be a cost effective way of meeting demand and reducing shortage of supply; and the potential of collaboration between councils to reduce costs and demand for services. The 10 councils are: Bristol City Council, Poole Borough Council, Swindon and Wiltshire Councils; Norfolk County Council; Waltham Forest Council; Somerset Council; Newcastle City Council; Nottingham City Council; and Nottinghamshire County Council.

Tackling loneliness and social isolation: the role of commissioners


This briefing explores the opportunities and barriers faced by commissioners seeking to address loneliness and social isolation in older people. It identifies evidence that points the way to a better understanding of effective interventions to tackle loneliness and social isolation, provides examples of emerging practice across the country, and examines what needs to happen next to improve the commissioning environment, and the changes that need to happen in other parts of society. It draws on discussions from a seminar organised by SCIE and Renaisi attended by commissioners, local authorities and third sector representatives, as well as the findings from previous research and evaluation.

Improving outcomes for carers via GP surgeries: implications for commissioners


Reports on a pilot project, funded by the Chiltern Clinical Commissioning Group, which sought to help GPs identify previously unknown carers and improve carer experience and wellbeing outcomes. The pilot offered carers a free health and wellbeing check with a carer support worker and a social prescription to access services provided by Carers Bucks where appropriate. The health and wellbeing check used the 'Carers Star' covering seven outcome areas: health, the caring role, managing at home, time for yourself, how you feel, finances, and work. A total of 203 carers attended the carers clinics. Approximately a quarter of carers were caring for someone with dementia and a quarter were caring for someone with a physical disability. Analysis of comments received by carers attending the clinic identified three key themes: carers appreciated the clinics because they felt it was rare for anyone to ‘care’ for them; carers felt listened to; and received useful information about support they didn’t know existed. The paper maps learning from the project against the Institute of Public Care commissioning cycle and makes recommendations for commissioners.

Evaluation of the Rotherham mental health social prescribing service 2015/16/-2016/17


Updated findings of an independent evaluation of the Rotherham Social Prescribing Mental Health Service, a service to help users of secondary mental health services build their own packages of support by accessing voluntary activity in the community. Voluntary activities covered four broad themes: befriending and peer support, education and training, community activity groups and therapeutic services. The service was delivered in partnership by Rotherham, Doncaster and South Humber NHS Foundation Trust (RDASH) and a group of local voluntary sector organisations led by Voluntary Action Rotherham. The evaluation looks at the impact of the service on the well-being of service users, the wider outcomes and social benefits, the impact of the service on discharge from secondary mental health services and explores the potential economic benefits of the service. It reports that over the two years of the evaluation, the service had engaged with more than 240 users of secondary mental health services in Rotherham. The service made a significant and positive impact on the well-being of mental health service users, with more than 90 per cent of service users making progress against at least one wellbeing outcome measure. Service users also experienced a range of wider benefits, including taking part in training, volunteering, taking up physical activity and sustained involvement in voluntary sector activity. Initial evidence about discharge from mental health services was also positive. The evaluation estimates that the well-being benefits experienced by service users equate to social value of up to £724,000: a social return on investment of £1.84 for every £1 invested in the service.

Mixing matters: how shared sites can bring older and younger people together and unite Brexit Britain


Sets out why increasing connections between generations is key to the health, wellbeing and future of individuals, communities and the country. While Britain has become more age segregated in recent decades, this paper demonstrates there is a growing movement to tackle ‘age apartheid’. The paper focuses on how older and younger people can come together through ‘shared sites’ with many inspiring and practical examples that could be replicated across the UK. Four specific themes are explored: shared care and play; shared housing and living; shared learning and work; and shared community spaces and activities. The paper sets out an ambition to develop 500 shared sites by 2022, arguing that with some 75,000 care homes, nurseries and schools in the UK, there is massive scope for the shared sites challenge to achieve much more.

Building dementia-friendly faith communities: how faith groups are supporting people living with dementia, their families and their carers


This booklet is a collection of case studies that illustrate how faith communities from different traditions help support people living with dementia and their carers; and how they can also help to prevent dementia from developing in the first place. Faith communities can offer spiritual and emotional support for individuals affected by dementia; practical support, including activities and services, opportunities for social interactions and support with day-to-day living, such as transport and help with taking medication correctly; and a dementia-friendly faith-community within the wider community and a supportive network of motivated people and resources. In addition, faith groups can play an important role in prevention, and in helping people with the things that will reduce their risk of developing dementia. They can do this by helping people to keep mentally active – through opportunities for social engagement, such as meeting others and volunteering; through stimulating their brains through activities such as reading; and through helping people to keep learning new things. Faith groups can also help people adopt and follow a healthier lifestyle, through stopping smoking, reducing alcohol consumption, and encouraging physical activity and healthy eating. The report makes a number of suggestions on what the health and care system should know about engaging with faith communities. This includes: finding out whom to engage within the community; making links with institutions that train faith leaders; and considering the need for different approaches in different communities.

Joining the dots: integrating practical support in mental healthcare settings in England


This report provides an analysis of the advice needs of Citizens Advice clients in England who report having a mental health problem. It shows how recognising the links between people’s mental health and their wider practical problems is crucial both for preventing mental health problems from escalating and improving recovery rates. The report draws on the results of an analysis of client data, a survey of Citizens Advice advisors and a survey of 2,000 people across England. The analysis shows that a growing number of people who turn to Citizens Advice for advice report having mental health problems. In addition, clients with mental health problems tend to have more complex, urgent and multiple advice needs. The report uses Citizen Advice data to explore the advice needs of people with mental health problems across the areas of: finance, essential services, housing, employment, and benefits. It also provides evidence to show that the provision of practical advice and support alongside mental health services can improve patient wellbeing and outcomes and reduce demand on public services. Despite this, the research found that less than a third of people (32 per cent) nationally who access NHS services are referred to advice services, while twice as many (64 per cent) said this would be helpful. The report recommends that service providers should take action to ensure they are responding effectively to the needs of people with mental health problems and calls for government to fund a pilot for integrated practical support in primary mental healthcare settings.

Effectiveness of befriending interventions: a systematic review and meta-analysis


Objective: Befriending is an emotional supportive relationship in which one-to-one companionship is provided on a regular basis by a volunteer. It is commonly and increasingly offered by the voluntary sector for individuals with distressing physical and mental conditions. However, the effectiveness of this intervention on health outcomes is largely unknown. This systematic review examines the benefits of befriending. Design: Systematic review Methods: A systematic search of electronic databases was conducted to identify randomised controlled trials and quasi-experimental trials of befriending for a range of physical and mental health indications including depression, anxiety, mental illness, cancer, physical illness and dementia. Main outcomes included patient-relevant and disease-specific outcomes, such as depression, loneliness, quality of life, self-esteem, social support and well-being. Results: A total of 14 trials (2411 participants) were included; 7 were judged at low risk of bias. Most trials showed improvement in symptoms associated with befriending but these associations did not reach statistical significance in all trials. Befriending was significantly associated with better patient-reported outcomes across primary measures. However, there was no significant benefit on single outcomes, including depression, quality of life, loneliness ratings, self-esteem measures, social support structures and well-being. Conclusions: There was moderate quality evidence to support the use of befriending for the treatment of individuals with different physical and mental health conditions. This evidence refers to an overall improvement benefit in patient-reported primary outcomes, although with a rather small effect size. The current evidence base does not allow for firm conclusions on more specific outcomes. Future trials should hypothesise a model for the precise effects of befriending and use specified inclusion and outcome criteria.

Connect for a kinder tomorrow: new approaches to loneliness


This report, from the Jo Cox Commission on Loneliness, argues that loneliness is everybody’s business and calls for every individual to make better connections in order to tackle the problem. It provides suggestions for individuals, voluntary and community groups, employers, local and central government on what they can do to tackle loneliness on a day to day basis. It also makes reference to examples of good practice throughout. In order to build a less lonely nation, it recommends people to adopt a ‘five a day’ rule and have a minimum of five conversations each day and take a ‘Connect 4’ approach, where individuals have four meaningful relationships they can count on.

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