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Results for 'complex needs'

Results 1 - 10 of 14

Shared Lives intermediate care: evaluation report

NATIONAL DEVELOPMENT TEAM FOR INCLUSION
2019

An evaluation of Shared Lives intermediate care, a pilot programme to develop Shared Lives as a ‘home from hospital’ service for older people. The evaluation looks at the impact of the programme for people who are ready to leave hospital, but unable to return home. It draws on qualitative data from people in Shared Lives arrangements, Shared Lives carers, health and social care professionals, as well as data gathered from the seven pilot sites. The findings show that by the end of the Shared Lives Intermediate Care Pilot programme, which ran from October 2016-April 2019, there had been 31 home from hospital referrals into a Shared Lives arrangement. This included people with learning disability, mental health problems and physical disability. Although referrals were low, overall the evaluation demonstrate the potential benefits of Shared Lives Intermediate Care for the health outcomes of people with multiple or complex needs, in particular, people with mental health issues. Key challenges experienced by the pilots included getting health professionals to trust the Shared Lives model and make referrals. There were also capacity and resource issues, with two sites withdrawing from the pilots. The report makes recommendations for Shared Lives Schemes and services.

Service-users’ perspectives of link worker social prescribing: a qualitative follow-up study

WILDMAN Josephine M., et al
2019

Background: Social prescribing enables health-care professionals to address non-medical causes of ill-health by harnessing the resources of the voluntary and community sectors in patient care. Although increasingly popular in the UK, evidence for the effectiveness of social prescribing is inconclusive and longer-term studies are needed. This study aimed to explore experiences of social prescribing among people with long-term conditions one to two years after their initial engagement with a social prescribing service. Methods: Qualitative methods comprising semi-structured follow-up interviews were conducted with 24 users of a link worker social prescribing service who had participated in an earlier study. Participants were aged between 40 and 74 years and were living in a socioeconomically-deprived area of North East England. Results: Participants reported reduced social isolation and improvements in their condition management and health-related behaviours. However, many participants had experienced setbacks, requiring continued support to overcome problems due to multi-morbidity, family circumstances and social, economic or cultural factors. Findings indicated that, in this sample of people facing complex health and socioeconomic issues, longer-term intervention and support was required. Features of the link worker social prescribing intervention that were positively appraised by participants, included a highly personalised service to reflect individual goal setting priorities and a focus on gradual and holistic change dealing with issues beyond health. The important role of a strong and supportive relationship with an easily-accessible link worker in promoting sustained behaviour change highlights the importance of link worker continuity. A lack of suitable and accessible voluntary and community services for onward referral acted as a barrier to involvement for some participants. Conclusions: This study highlights issues of interest to commissioners and providers of social prescribing. Engagement with social prescribing for up to two years was examined and continued involvement was identified for those with complex issues, suggesting that a long-term intervention is required. The availability of onward referral services is an important consideration for social prescribing in a time of constrained public spending. From a research perspective, the range of improvements and their episodic nature suggest that the evaluation of social prescribing interventions requires both quantitative and qualitative data collected longitudinally.

Health at home: a new health and wellbeing model for social housing tenants

PEABODY
2018

Explores how housing support services and community-based health services can deliver effective services at lower cost; encourage self-care for the most vulnerable customers and reduce dependency on direct support; work with other agencies to ensure a coordinated response to the residents’ complex and multiple health needs. The report sets out the findings of a study which aimed to test a person-centred support model using a randomised control trial of 261 general needs residents aged over 50. The service model employed health navigators and volunteers to coach and connect residents with the relevant health, housing and community services they need. The study used to measurement tools to assess impact: the Patient Activation Measure (PAM) and Coaching for Activation (CFA). The study found that three months of intervention with those who started in PAM Level 2 was sufficient to move them up, on average, an entire PAM level. This increase in activation was sustained for at least nine months after the intervention ended, suggesting that participants gained the skills and confidence to effectively manage their health without further support after the initial intensive intervention. This is significant as one of the largest studies into cost reductions from PAM level changes in the United States found that patients who moved from Level 2 to Level 3 reduced their annual healthcare costs by 12%. Existing evidence also indicates that when people become more active in self-care, they benefit from better health outcomes, and fewer unplanned health admissions. The report concludes that there is a clear and compelling case for continuing to support integrated care and strengthen links between the health and housing agendas.

Arts on prescription for community‐dwelling older people with a range of health and wellness needs

POULOS Roslyn G., et al
2019

Published evidence for the role of participatory art in supporting health and well‐being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community‐dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8–10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre‐ and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. This study found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick–Edinburgh Mental Well‐being Scale (WEMWBS) as well as a statistically significant increase in the level of self‐reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs.

“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England

CHEETHAM M., et al
2018

Background: A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods: The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results: Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions: An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

People powered recovery: social action and complex needs. Findings from a call for evidence

TURNING POINT
2018

The UK All-Party Parliamentary Group (APPG) on complex needs and dual diagnosis was established in 2007 in recognition of the fact that people seeking help often have a number of over-lapping needs including problems around access to housing, social care, unemployment services, mental health provision or substance misuse support. This report sets out the findings from a call for evidence on how social action can improve outcomes and develop more responsive services for people with complex needs or a dual diagnosis. Social action is about people coming together to tackle an issue, support others or improve their local area, by sharing their time and expertise through volunteering, peer-led groups and community projects. The report provides examples of how social action can support recovery, self-worth and confidence, boost employment prospects and skills, reduce stigma, better shape services to meet people’s needs, contribute to better health and wellbeing and save money. It also looks at how to overcome some of the challenges and barriers to developing social action focused around complex needs. These include resources, stigma, procedural issues, leadership, commissioning structures and demonstrating benefits.

Person-centred approaches: empowering people to live their lives and communities to enable to upgrade in prevention, wellbeing, health, care and support

SKILLS FOR HEALTH, SKILLS FOR CARE
2017

This education and training framework, commissioned by Health Education England, sets out core skills to support health and social care workforce to deliver person-centred approaches. It will help to staff communicate meaningfully, ensure they tailor the care and advice they give to suit peoples’ needs. It is applicable across services, sectors and across different types of organisations. The framework begins by describing the values, communication and relationship building skills that everyone delivering services should have to ensure consistent person-centred approaches. It arranges these into three ‘steps’: conversations to engage with people; conversations to enable and support people; and conversations with people to collaboratively manage highest complexity and significant risk. Within each step, the framework outlines behaviours which aim to illustrate what people and their carers would see in practice; learning outcomes; and short practice examples. Where appropriate, the framework encourages shared decision making and ensuring that all information is personalised, accessible and useful. The framework includes tips for delivering training and enablers for embedding a person-centred approach in organisations. The framework has been developed with the participation of health and social care experts and people who are experts by experience.

Peer support in accommodation based support services: a social return on investment

NEWTON Angela, WOMER Jessica, WHATMOUGH Suzy
2017

This evaluation assessed the peer support delivered across three accommodation services in Hampshire to understand the ways in which it impacted people’s lives and what they valued most about it. The services provided support for people experiencing mental distress, many of who had multiple complex needs. A total of 12 volunteers delivered peer support both on-to-one support and group peer support. A total of 22 people completed questionnaires for the evaluation, which included 12 services users (71 per cent of all service users who had used peer support), and 10 Peer Supporters (83 per cent of all Peer Supporters). Costs of providing peer support and the number of hours of direct support provided by peer supporters were also collected. From this, the return on investment in peer support was calculated using a methodology for measuring the equivalent worth of activity in social terms. The results found that the majority of peer supporters and service users who took part in the study had improved levels of confidence, felt more able to manage their mental health; had an improved social life and support network; felt more accepted; and felt more hopeful about the future. It also calculated that every pound spent on peer support provided a social return worth £4.94. The findings demonstrate that peer support is valued by those involved and helps support people to achieve their outcomes and lead more independent and fulfilling lives. The results of the study will also help communicate the value of peer support in financial terms to with commissioners and funders.

The crises facing our independent living service users: research, evaluation and impact

BLANCHARD Catherine, BRITTAIN Andrea
2016

British Red Cross Independent Living services such as Support at Home, Home from Hospital, and Mobility Aids provide time-limited support to help people live independently in their own home. This study explores the challenges facing people using these services, whose increasingly complex needs are creating greater obstacles to their ability to live independently. Phase one of the study conducted interviews with 29 service users, eight volunteers and 22 staff members into the problems service users face to living independently. Phase two used follow up questionnaires with 170 service users to explore key issues in more depth, including carers, mobility, information and advice, social isolation and loneliness. The results of the questionnaires found high levels of mobility reported-difficulties, which could impact on people's ability to maintain existing relationships and over half of respondents found difficult to find information and advice; The research also found that high numbers of service users live alone and also have high levels of social isolation and loneliness that require long-term intervention. Of the167 service users who answered questions on social isolation, 64 per cent experienced 'some' social isolation and a quarter fell into the 'most isolated' group. Drawing on findings, the report makes recommendations for the Independent Living service in relation to service development, advocacy and communications and data collection. These include: for services to be person-centred, consider partnerships and employ good practice in signposting; for the collection of data on whether people live alone, how long they have lived alone; and being clear in communications that loneliness and social isolation are different concepts.

More than shelter: supported accommodation and mental health

BOARDMAN Jed
2016

This report looks at evidence about the provision of supported housing for people with mental health problems in England, including those with multiple needs and substance misuse, and presents key themes for its future development. It highlights the significant links between housing and mental wellbeing, indicating that factors such as overcrowding, insufficient daylight and fear of crime all contribute to poorer mental health. The review identifies a wide range of types of housing support, including help for people to remain their own tenancies to specialist supported accommodation, hostels, crisis houses and the Housing First approach. Although the review identified limited evidence about what kinds of housing support are most effective and cost-effective, small-scale studies suggest that housing support can reduce the costs of hospital stays. When looking at the type of support people want, the literature found most people prefer help in their own homes to being in sheltered or transitional accommodation. The report calls for better provision of housing support and also argues that housing support should be funded jointly by local authorities and the NHS to ensure that services are delivered in partnership between health, housing and social care providers.

Results 1 - 10 of 14

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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