Results for 'prevention'
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NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.
DOUGHTY Kevin, MULVIHILL Patrick
Purpose: The purpose of this paper is to consider the importance of digital healthcare through telecare and portable assistive devices in supporting the reengineering of healthcare to deal with the needs of an older and more vulnerable population wishing to remain in their own homes.
Design/methodology/approach: It supports the importance of the assessment process to identify hazards associated with independent living, and the possible consequences of accidents. By measuring and prioritising the risks, appropriate management strategies may be introduced to provide a safer home environment.
Findings: A process for assessing and managing these risks has been developed. This can be applied to a wide range of different cases and yields solutions that can support independence.
Research limitations/implications: The developed digital reablement process can be used to provide vulnerable people with a robust form of risk management.
Practical implications: If telecare services follow the process described in this paper then they will improve the outcomes for their users.
Originality/value: The process described in this paper is the first attempt to produce a robust assessment process for introducing telecare services in a reablement context.
WARD Cally, COOPER Vivien
Purpose: The purpose of this article is to provide a perspective from family carers on the promotion of independence and the prevention of avoidable dependency.
Design/methodology/approach: Narrative review and discussion.
Findings: Family carers frequently experience their own or their relatives’ needs being met only when they have reached crisis point. A shift to a more preventive approach, delivered in a personalised and family-centred manner, could transform the experiences of people with learning disabilities and their families.
Originality/value: Attention is drawn to the importance of strengthening the case for a preventive approach and the role of co-ordinated and strategic leadership in its delivery.
SMITH Naomi, BARNES Marian
The ‘Partnerships for Older People Projects’ programme provided government funding for local and health authorities to pilot prevention and intervention services in partnership with the voluntary sector and older people between 2006 and 2009. This evaluation of a pilot in southern England used a Theory of Change approach to gather and reflect on data with different groups involved in the delivery of this model of prevention. This whole-system model, although complex and challenging to implement, was considered overall to have been a success and provided significant learning for partners and stakeholders on the challenges and benefits of working across professional and sectoral boundaries. New posts were created as part of the model – two of these, recruited to and managed by voluntary sector partners, were identified as ‘new jobs’, but echoed ‘old roles’ within community and voluntary sector based health and social care. The authors reflect on the parallels of these roles with previously existing roles and ways of working and reflect on how the whole-system approach of this particular pilot enabled these new jobs to develop in appropriate and successful ways.
Older people represent the main in-patient group, at any one time occupying more than two-thirds of acute hospital in-patient beds. Providers and commissioners need to put in place cost-effective, community based services, which can both prevent the need for hospital admission and safely reduce length of stay for older people. A hospital admission can occur when an older person has reached breaking point because of a combination of problems that have been building up before admission: social circumstances (such as living alone or having caring responsibilities) or general frailty. The aim of this publication is to disseminate examples of positive practice in avoiding hospital admission, supporting safe discharge and preventing readmission for older people. This publication highlights 5 examples of local Age UK services, charting the ‘pathway’ of prevention from identifying older people in the local community who may be at risk, to supporting people who are in A&E, and ensuring that discharge from in-patient care is safe and well co-ordinated.
BUCKINGHAMSHIRE COUNTY COUNCIL
Sets out a prevention-focused model of adult health and social care services which place emphasis on maintaining people’s independence and resilience; preventing deterioration into substantial or critical categories of need. The document outlines the current system challenges, the existing lack of joint working between sectors and services, a reactive approach to creating support services and networks and a lack of confidence or capacity to innovate and invest in prevention without an evidence base or business case. It then presents a framework for building the evidence for investment in prevention, proposing a measurement methodology and a definition of the target user group and of outcomes and impact. The document puts forward a new prevention-orientated service model, identifying the high‐level functions, which are shared by different agents and delivery mechanisms, on which the model rests. These are: intelligence and knowledge about the effectiveness of prevention‐related activities, bridging and building networks between formal and informal service delivery, connecting people, maximising existing resources and motivating and enabling. The document examines the core components of the model, which include an intelligence hub, a volunteer hub, community links officers, and community prevention officers. Funding and implementation considerations are also included.
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.
AIDEN Hardeep, BUSH Marc
A third of all people using care services are disabled adults of working age. This pamphlet builds on the analysis in 'The other care crisis', which provided evidence that exposed the £1.2 billion gap in social care spending for disabled adults. Based on new research undertaken by Deloitte, this pamphlet quantifies the long-term savings to individuals and the Government of closing this gap in social care expenditure. It recommends that the Government's Spending Review should commit to establishing a national minimum threshold for eligibility that encourages councils to provide social care to people with ‘moderate’ or equivalent level needs The Government should encourage councils and the NHS to jointly invest in preventative care and support through Health and Wellbeing Boards. The Care Bill should contain a duty on Health and Wellbeing Boards to identify, plan for and commission preventative services that maximise the independence of disabled people. This should be a statutory part of their Joint Strategic Needs Assessments and Health and Wellbeing strategies. The pamphlet has been jointly produced by the National Autistic Society, Mencap, the Lenard Cheshire Disability, Sense, and Scope.
MILLER Robin, et al
Purpose: The purpose of this paper is to explore the delivery of preventative services for older people from third sector organisations (TSOs) and the extent to which current commissioning arrangements enables the aspirations of policy to be achieved.
Design/methodology/approach: Semi-structured interviews with key-contacts within a sample of TSOs which had been identified by directors of Adult Social Services as delivering one of the top three preventative interventions in their local authority area.
Findings: There was evidence of considerable trust between local authorities and TSOs and as a consequence TSOs were given autonomy to develop holistic and integrated models of delivery that supported rather than diverted the TSOs’ core missions. Both sectors found it difficult to set target outcomes and connected performance frameworks for preventative services. As a consequence a major element of the commissioning cycle is not being completed and TSOs cannot be confident that they are using their resources as effectively as possible.
Research limitations/implications: This study was based in one English region, and would benefit from being extended to other English regions and home nations.
Practical implications: Universities, policy makers, commissioners and the third sector need to work together to develop common outcome frameworks for preventative services and to gather consistent data sets that can be more easily synthesised to give a “realistic” understanding of the impact of different interventions and delivery models.
Originality value: The paper contributes to the limited evidence bases of commissioning of TSOs and preventative services.
ABENDSTERN Michele, et al
Prevention, comprising services that seek to delay deterioration of existing conditions and circumstances or prevent their occurrence by early access to support, is recognised as having an important role in adult social care. The gateway to social care services has traditionally been via needs-led assessments undertaken with professionals. In England, self-assessment, promoted as a means of accessing services more independently, has come to the fore in recent years. This article explores the relationship between prevention and self-assessment in practice. Data are derived from interviews with social services managers of five self-assessment projects situated within the adult social care sector that were described as providing a preventative approach, as well as project development documentation. A number of issues are highlighted including for whom self-assessment might be most optimal, the potential of self-assessment to widen access and the role it can play in promoting self-determination. It is argued that a natural relationship exists between self-assessment and prevention and that both concepts are at the core of the personalisation agenda. However, in order to achieve its potential in practice, self-assessment must be offered in conjunction with support and as an additional rather than alternative means of accessing preventative services.
Results 71 - 80 of 82