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Welfare reform on the Web (February 2007): Care of the elderly – UK

Are different forms of care-management for older people in England associated with variations in case-mix, service use and care managers’ use of time?

D. Challis and others

Ageing & Society, vol.27, 2007, p. 25-48

A sample representative of different approaches to care management was selected from a national survey of local authorities to explore the association between types of care management and case-mix, the services received by clients, and the use of staff time. This paper addresses the categorisation of the types of care management and the differences associated with these. The care management teams were distinguished by whether they used a “targeted approach”, had “specialist older people’s teams”, or used other arrangements. It was found that those with a targeted approach undertook more multi-disciplinary assessments, provided more assistance to older people with mental health problems, and that their staff spent less time in direct contact with users and carers. Conversely, those with specialist older people’s teams had more users in receipt of occupational therapy.

Battle on the home care front: perceptions of home care workers on factors influencing staff retention in Northern Ireland

G. Fleming and B.J. Taylor

Health and Social Care in the Community, vol.15, 2007, p.67-76

The provision of home care services is key to avoiding inappropriate admission of older people to institutional care and preventing delayed discharges from hospital. However, there is a growing problem of retention of home care workers, making it difficult to deliver services. Results of a survey of a sample of 45 home care workers in Northern Ireland showed that the main reasons for job dissatisfaction were irregular and antisocial hours, lack of management support, and workload pressures. Home care workers are being required to provide care for people with ever more complex health and social needs in an increasingly tightly regulated environment. This makes the job more demanding, which is not recognised in the training and working conditions offered to home care workers.

Care-home providers as professionals: understanding the motivations of care home providers in England

T. Matosevic and others

Ageing & Society, vol.27, 2007, p. 103-126

This article examines the underlying motivation of people providing residential care for older people. It focuses on the motivation of a sample of managers and owners of care homes drawn from eight English local authorities, highlighting professional achievement, recognition and job satisfaction. The majority of respondents’ primary motivation was to meet the needs of older people and to achieve professional aspirations. They also reported high levels of job satisfaction, were happy with their career choice, and felt that, through their work, they were contributing to society.

Competition and choice in the care home sector for older people: a case study of the market in Surrey

W. Knibb

Quality in Ageing, vol.7, Dec. 2006, p.3-10

Competition in the care home sector is encouraged by government as a means of increasing efficiency, driving down prices and raising quality. Consumer choice in the sector is also being promoted as a means of improving service provision. This study considered the evidence of care home provider competition and enhanced user choice through analysis of the market in Surrey. The longitudinal change in market structure was reviewed and opportunities for user choice identified through the investigation of fees paid and vacancy levels in homes. Results suggest that user choice is only available for those able and willing to pay higher fees.

Ensuring fair access to the internet for all

S. Richards

Working with Older People, vol.10, Dec. 2006, p.19-23

Research conducted by the Welsh Consumer Council shows that a significant proportion of those without internet access are older people. There is concern that those who do not use the net may be missing a valuable source of information and channel of communication with family and friends. Barriers to internet use among older people could be removed by provision of training, improved web site design and action to reduce costs.

Families told elderly care crisis looming

D.Brindle

The Guardian, Jan 10th 2007, p.1

This report focuses on the growing crisis in homecare for the elderly in the UK. At the moment, the elderly cannot expect help from the state unless their needs are considered ‘critical’. A Commission for Social Care Inspection report claims that councils “respond to spiralling demand by concentrating resources on fewer people with greater needs. Dame Denise Platt, who chairs the commission, has called for a “proper infrastructure in place to enable people to find alternative sources of care and to offer greater support for family carers.” At the moment those who do not qualify for public homecare have to source alternatives with no assistance. Higher life expectancy is the reason given for the current ‘crisis’ in care for the elderly. Local councils are finding it hard to deal with the pressure of providing homecare: Two in three English councils now limit homecare to those who are deemed in ‘critical’ need. This situation is also expected to be tightened by the end of 2007. Even though the inspectorate understands the ‘rationing’ of homecare, it insists that councils are doing little to aid the elderly and their families in sourcing affordable alternatives to government help.

Having a voice, being heard

L. Bright

Working with Older People, vol.10, Dec. 2006, p.24-26

Exeter Senior Voice, a user involvement project with nearly 300 active members, ran an election in 2006 for the 12 places on its panel of representatives. Those representatives attend a wide range of meetings with staff of statutory and voluntary bodies discussing service development and mapping strategies designed to respond to older people’s needs.

How older people are improving the health and well-being of Northampton residents

D. Klee

Working with Older People, vol.10, Dec. 2006, p.27-30

Age Concern in Northampton has successfully recruited and trained a group of older volunteers who have run a range of projects aimed at improving the health of the community. These include a falls prevention event, training in cooking skills, and a fun day promoting healthy eating in schools. The greatest achievement of the initiative has been to provide meaningful activities which enable older people to contribute to their communities.

Partnership in inspection: lessons from the review of the NSF for older people

D. Klee and J. Manthorpe

Journal of Integrated Care, vol.14, Dec. 2006, p.45-51

During 2005 the Healthcare Commission, the Commission for Social Care Inspection, and the Audit Commission jointly reviewed progress in implementation of the National Service Framework for older people through joint inspections in 10 local communities. This paper reflects on the lessons learnt from partnership working across a number of systems.

Positive outcomes

J. Maddison

Community Care, Jan. 11th-17th 2007, p. 32-33

This article summarises research on the outcomes valued by older people and lessons learned from local authorities developing outcomes-focused services in England and Wales.

Professionalising the care of older people: transforming the workforce

I. Eyers and K. Bryan

Quality in Ageing, vol.7, Dec. 2006, p.37-45

The quality of life of frail older people living in care homes is closely linked to the skills and knowledge of staff employed to assist them. This article considers the policy framework surrounding the provision of care home services in England and reviews research on whether the workforce currently meets the needs of residents. It concludes that if the present situation is to improve, the workforce needs to be upskilled and professionalized.

Transitions to a care home: the importance of choice and control: seminar report

J. Reed and D. Stanley

Quality in Ageing, vol.7, Dec. 2006, p.12-17

Report of a seminar organised to explore aspects of moving into a care home, the preparation work involved, and the implications for practitioners and service providers. Papers presented suggest that there are ways in which older people can exercise control, but they are more likely to be passive if the move is rushed or service-provider led. Much also depends on the quality of the support older people receive after their move.

Who can afford computers?

C. McCreadie and R. Stuchbury

Working with Older People, vol.10, Dec. 2006, p.15-18

This article highlights low income as a barrier to computer ownership, preventing the digital inclusion of millions of older people. The government has attempted to make access possible for low-income groups through provision of internet terminals in public libraries and adult education centres, but this does not help older people with mobility problems and no access to a car.

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