Search results

The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use.

Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing.

Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care.

This paper is a first attempt to compare national social care statistics concerning day services and home care for adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

Purpose: The aim is to explore how family relations are affected by societal changes in relation to informal and formal caregiving and self-determination of older adults.

Design/methodology/approach: Care managers (CMs)/social workers (SWs) (N = 124) participated in a comparative vignette study including Japan, South Korea, and Sweden. Systems theory was used.

Findings: Japanese CMs/SWs clearly describe their efforts to create networks in a relational way between formal and informal actors in the community. South Korean CMs/SWs balance between suggesting interventions to support daily life at home or a move to a nursing home, often acknowledging the family as the main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting the older adult and the interventions offered, and families primarily give social support. Regarding self-determination, the Japanese priority is for CMs/SWs to harmonize within the family and the community. South Korean CMs/SWs express ambivalent attitudes to older adults’ capability for self-determination in the intersection between formal and family care. Swedish CMs/SWs adhere to the older adult’s self-determination, while acknowledging the role of the family in persuading the older adult to accept interventions. The results suggest emerging defamilialization in South Korea, while tendencies to refamilialization are noticed in Japan and Sweden, albeit in different ways.

Research limitations/implications: In translation, nuances may be lost. A focus on changing families shows that country-specific details in care services have been reduced. For future research, perspectives of “care” need to be studied on different levels.

Originality/value: Using one vignette in three countries with different welfare regimes, discussing changing views on families’, communities’ and societal caregiving is unique. This captures changes in policy, influencing re- and defamilialization.

This study aims to compare the level of needs for home-care robots amongst older adults, family caregivers and home-care staff and clarify the factors constituting these needs.

A cross-sectional, anonymous questionnaire survey was administered. It included 52 items related to needs for home-care robots rated on a four-point Likert scale. Means and standard deviations were calculated, and the Kruskal-Wallis test was performed for each item. Factor analysis was conducted on the needs of home-care staff.

Responses from 79 older adults, 54 family caregivers and 427 home-care staff were analysed. For all three groups, the level of agreement was high for the following needs: to inform family and support personnel immediately when older adults fall, about their location in case of natural disasters and about mismanagement of fire by older adults with dementia. For family caregivers and home-care staff, the level of need concerning monitoring was higher than for older adults. Extracted using factor analysis, the six factors representing the essential needs for home-care robots were risk minimisation, daily monitoring of the physical condition, supporting activities of daily living (ADL) and instrumental ADL, pre-empting problems, communication and miscellaneous support.

The results showed that the education of caregivers and the co-design process of robot development should involve home-care staff, older adults and family caregivers, which are important for making decisions about the use of home-care robots for older adults.

This paper aims to explore the content of Safeguarding Adult Reviews (SARs) from older adult care homes to understand how safety is understood and might be measured in practice.

SARs relevant to older adult care homes from 2015 onwards were identified via the Social Care Institute of Excellence SARs library. Using thematic analysis, initial inductive coding was mapped to a health-derived safety framework, the Safety Measurement and Monitoring Framework (SMMF).

The content of the SARs reflected the dimensions of the SMMF but gaining a deeper understanding of safety in older adult care homes requires additional understanding of how this unique context interacts with these dimensions to create and prevent risks and harms. This review identified the importance of external factors in care home safety.

This study provides an insight into the scope of safety issues within care homes using the SARs content, and in doing so improves understanding of how it might be measured. The measurement of safety in care homes needs to acknowledge that there are factors external to care homes that a home may have little knowledge of and no ability to control.

Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes.

Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support.

The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes.

To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development.

Serious Case Reviews (SCRs, now Safeguarding Adults Reviews (SARs)) may be held at local level in England when a vulnerable adult dies or is harmed, and abuse or neglect is suspected, and there is cause for concern about multi-agency safeguarding practice. There has been no analysis of SCRs focussing on pressure ulcers. The purpose of this paper is to present findings from a documentary analysis of SCRs/SARs to investigate what recommendations are made about pressure ulcer prevention and treatment in a care home setting in the context of safeguarding. This analysis is presented in cognisance of the prevalence and risks of pressure ulcers among care home residents; and debates about the interface of care quality and safeguarding systems.

Identification of SCRs and SARs from England where the person who died or who was harmed had a pressure ulcer or its synonym. Narrative and textual analysis of documents summarising the reports was used to explore the Reviews’ observations and recommendations. The main themes were identified.

The authors located 18 relevant SCRs and 1 SAR covering pressure ulcer care in a care home setting. Most of these inquiries into practice, service communications and the events leading up to the death or harm of care home residents with pressure ulcers observed that there were failings in the care home, but also in the wider health and care systems. Overall, the reports reveal specific failings in multi-agency communication and in quality of care. Pressure ulcers featured in several SCRs, but it is problems and inadequacies with care and treatment that moved them to the safeguarding arena. The value of examining pressure ulcers as a key line of inquiry is that they are “visible” in the system, with consensus about what they are, how to measure them and what constitutes optimal care and treatment. In the new Care Act 2014 context they may continue to feature in safeguarding enquiries and investigations as they may be possible symptoms of system failures.

Reviews vary in content, structure and accessibility making it hard to compare their approach, findings and recommendations. There are risks in drawing too many conclusions from the corpus of Reviews since these are not published in full and contexts have subsequently changed. However, this is the first analysis of these documents to take pressure ulcers as the focus and it offers valuable insights into care home practices amid other systems and professional activity.

This analysis highlights that it is not inevitably poor quality care in a care home that gives rise to pressure ulcers among residents. Several SCRs note problems in wider communications with healthcare providers and their engagement. Nonetheless, poor care quality and negligence were reported in some cases. Various policies have commented on the potential overlap between the raising of concerns about poor quality care and about safeguarding. These were highlighted prior to the Care Act 2014 although current policy views problems with pressure ulcers more as care quality and clinical concerns.

The value of this documentary analysis is that it rests on real case examples and scrutiny at local level. Future research could consider the findings of SARs, similar documents from the rest of the UK, and international perspectives.

The value of having a set of documents about adult safeguarding is that they lend themselves to analysis and comparison. This first analysis to focus on pressure ulcers addresses wider considerations related to safeguarding policy and practice.

Institutionalized older adults in care homes and long-care facilities have been identified as being at greater risk of COVID-19 related morbidity and mortality. Thus, this paper aims to explore the impact of COVID-19 on care homes in south-east Nigeria given the recent increasing popularity of care homes in Nigeria.

The study adopted qualitative research method, and data was collected from 10 older residents and 5 caregivers using interviews from two care homes, while ensuring the safety of the researcher and participants. The collected data was analyzed using thematic analysis.

Findings revealed that the physical health impact of the COVID-19 pandemic is not a major problem in the homes. However, fear and anxiety, social disconnection and economic hardship were the major problems identified by the older residents and caregivers in the homes.

The popularity of care homes in Nigeria is growing as family structures continue to change. However, previous studies which have revealed devastating effect of COVID-19 on institutionalized older adults have been from the global north. This is the first study designed to bridge the gap in literature and contribute to knowledge on this topic from Nigeria and Sub-Saharan Africa.

This paper aims to explore the match between needs and services related to participation for frail older adults receiving home care.

A qualitative multiple case study was conducted with 11 triads each involving an elder, a caregiver and a healthcare provider working in a Health and Social Services Centers (HSSCs).

Although HSSCs in Québec are supposed to promote social integration and participation of older adults, services provided to the older adults in this study focused mainly on safety and independence in personal care, dressing, mobility and nutrition, without fully meeting older adults’ needs in these areas. Discrepancies between needs and services may be attributable to the assessment not covering all the dimensions of social participation or accurately identifying older adults’ complex needs; older adults’ and their caregivers’ difficulties identifying their needs and accepting their limitations and the assistance offered; healthcare providers’ limited knowledge and time to comprehensively assess needs and provide services; guidelines restricting the types and quantity of services to be supplied; and limited knowledge of older adults, caregivers and healthcare providers about services and resources available in the community.

To improve and maintain older adults’ participation, a more thorough assessment of their participation, especially in social activities, is required, as is greater support for older adults and their families in using available community resources. It is also important to review the services provided by HSSCs and to optimize partnerships with community organizations.

The purpose of this paper is to explore the lived experiences of adapting to care dependency among adults receiving health and social care in ordinary housing.

This was done by conducting a phenomenological study by interviewing ten adults, receiving home care services in ordinary housing.

Participants not only adapted by becoming a “good patient” but they had four strategies they used: sociability, distance, competence and compliance, contributing to a sense of dignity and personal safety.

Further research is needed regarding how to preserve quality of care with adults with various ways of adapting to care dependency.

The relationship between professionals and adults in care dependency is a dynamic process where a need for understanding different modes of adaptation is vital. Good treatment and quality care may be different things to different adults, depending on what aspects of the process of adaptation concern them the most, and depending on their individual adaptation strategy.

This paper contributes to the understanding of modes of adaptation to care dependency from the perspective of adults indicating that working person centered may include respecting strategies not traditionally being associated with “the good patient.”

This paper aims to explore 15 UK adult social care workers’ experiences during the COVID-19 pandemic.

This paper’s 15 open-ended interviews with adult social care workers are complemented by digital ethnography in COVID-19 social media forums. This data set is taken from a global mixed-methods study, involving over 2,000 participants from 59 different countries.

Workers reported a lack of planning, guidance and basic provisions including personal protective equipment. Work intensification brought stress, workload pressure and mental health problems. Family difficulties and challenges of living through the pandemic, often related to government restrictions, intensified these working conditions with precarious living arrangements. The workers also relayed a myriad of challenges for their residents in which, the circumstances appear to have exacerbated dementia and general health problems including dehydration, delirium and loneliness. Whilst COVID-19 was seen as partially responsible for resident deaths, the sudden disruptions to daily life and prohibitions on family visits were identified as additional contributing factors in rapid and sudden decline.

Whilst the paper’s sample cohort is small, given the significance of COVID-19 at this present time the findings shed important light on the care home experience as well as act as a baseline for future study.

Care homes bore the brunt of illness and death during the first and second COVID-19 waves in the UK, and many of the problems identified here have still yet to be actioned by the government. As people approach the summer months, an urgent review is required of what happened in care homes and this paper could act as some part of that evidence gathering.

This paper offers revealing insights from frontline care home workers and thus provides an empirical snapshot during this unique phase in recent history. It also builds upon the preliminary/emerging qualitative research evidence on how the COVID-19 pandemic impacted care homes, care workers and the residents.