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Results for 'complex needs'

Results 1 - 10 of 10

“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.

Mental health and housing

SAVAGE Jonny
2016

This study examines how different types of supported accommodation meet the needs of people with mental health problems. Supported accommodation covers a wide range of different types of housing, including intensive 24 hour support, hostel accommodation, and accommodation with only occasional social support or assistance provided. The document focuses on five approaches to providing supported accommodation, including: Care Support Plus; integrated support; housing support for people who have experienced homeless; complex needs; low-level step down accommodation; and later life. The report draws on the expertise of people living and working in these services across England, and presents their views of both building and service related issues. It sets out a number of recommendations, focusing on: quality; co-production; staff recruitment and training; policy informed practice; and resourced, appropriate accommodation.

Growing old together: sharing new ways to support older people

COMMISSION ON IMPROVING URGENT CARE FOR OLDER PEOPLE
2016

Final report from the Commission on Improving Urgent Care for Older People which provides guidance for those involved in designing care for older people and outlines eight key principles the health and care sector can adopt to improve urgent care for older people. The Commission was established out of a concern that the care system was not meeting the needs of older people, resulting in lower quality of care, a lack of out-of-hospital services as an alternative to A&E, not enough focus on prevention and early intervention, and delayed transfers of care. It brought together a range of experts, received over 60 evidence submissions; carried out visits to sites using innovative ways to deliver care; consulted with NHS Confederation members and patient and carer groups; and commissioned an evidence review. The report draws on the evidence to look at the case for change. It then outlines eight key principles that can be used when redesigning health and social care system: start with care driven by the person’s needs and personal goals; a greater focus on proactive care; acknowledge current strains on the system and allow time to think; the importance of care co-ordination and navigation; greater use of multi-disciplinary and multi-agency teams; ensure workforce, training and core skills reflect modern day requirements; leadership should encourage us to do things differently; and metrics must truly reflect the care experience for older people. Short case studies of innovative practice are included in the report, covering acute and primary care, voluntary sector and local government partners and commissioners.

Building the right support: a national plan to develop community services and close inpatient facilities for people with learning disability...including those with a mental health condition

NHS ENGLAND, LOCAL GOVERNMENT ASSOCIATION, ASSOCIATION OF DIRECTORS OF ADULT SOCIAL SERVICES
2015

Sets out a national plan to enable people with learning disabilities who display behaviour that challenges to be supported to live more independently in their local community and reduce reliance on institutional care and long stay hospitals. The plan looks at the learning from the six 'fast track' areas; describes the new services that will be needed to better support people with learning disabilities to live in the community; and outlines how transforming care partnerships (commissioning collaborations of local authorities, CCGs and NHS England partners) in health and care will need to work together to deliver these changes. Areas discussed include: the need for appropriate local housing, such as schemes where people have their own home but ready access to on-site support staff; an expansion of the use of personal budgets, enabling people and their families to plan their own care, beyond those who already have a legal right to them; for people to have access to a local care and support navigator or key worker; and investment in advocacy and advice services run by local charities and voluntary organisations. To achieve the shift from inpatient to community-based services the plan identifies three key changes: that local councils and NHS bodies will join together to deliver better and more coordinated services; pooled budgets between the NHS and local councils to ensure the right care is provided in the right place; and adoption of a new service model.

Complex needs survey: informing the development of a community recovery and rehabilitation team

BEKAS Stavros
2013

This study aimed to inform the development of a new, recovery-oriented rehabilitation service, identify local needs and create a pathway for appropriate referrals, accelerating the build up of case-load. 1353 secondary service users subject to Care Programme Approach under four local community teams, an assertive outreach team and an early interventions service were surveyed using a purpose-made needs assessment and case identification questionnaire. Significant unmet need for rehabilitation and recovery-oriented interventions was found. The results were used to invite referrals, create a case-load of 150 and allocate the appropriate resources for the new team. The results highlight the untapped recovery potential among users of mainstream secondary mental health services and support investment in rehabilitation at a time of resource restriction. This work also supports a similar, evidence-based approach to targeting appropriate referrals during the development and the early stages of rehabilitation services.

Results 1 - 10 of 10

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News

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

My Guide: new case example

My Guide: new case example My Guide is a sighted guiding service, started by The Guide Dogs for the Blind Association (Guide Dogs), in which trained volunteers assist blind and partially sighted adults to get out and about, thus helping to prevent social isolation.
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