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Article
Publication date: 16 July 2019

Fiona Aspinal, Martin Stevens, Jill Manthorpe, John Woolham, Kritika Samsi, Kate Baxter, Shereen Hussein and Mohamed Ismail

The purpose of this paper is to present findings from one element of a study exploring the relationship between personalisation, in the form of personal budgets (PBs) for…

Abstract

Purpose

The purpose of this paper is to present findings from one element of a study exploring the relationship between personalisation, in the form of personal budgets (PBs) for publicly funded social care and safeguarding.

Design/methodology/approach

Semi-structured interviews were conducted with 12 people receiving PBs who had recently been the focus of a safeguarding investigation. Participants were recruited from two English local authority areas and data were subject to thematic analysis.

Findings

The analysis identified three main themes: levels of information and awareness; safeguarding concerns and processes; and choice and control. Many of the participants in this small study described having experienced multiple forms of abuse or neglect concurrently or repeatedly over time.

Research limitations/implications

This was a small scale, qualitative study, taking place in two local authorities. The small number of participants may have had strong opinions which may or may not have been typical. However, the study provides some rich data on people’s experiences.

Practical implications

The findings suggest that adults receiving PBs may need information on an ongoing and repeated basis together with advice on how to identify and address poor quality care that they are arranging for themselves. Practitioners need to be aware of the influence of the level of information received and the interaction of organisational or legal requirements when responding to safeguarding concerns when care being supplied tries to reflect the benefits of choice and control.

Originality/value

This paper reports original research asking adults with care and support needs about the interaction between two key policies of safeguarding and personalisation.

Details

The Journal of Adult Protection, vol. 21 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 18 April 2017

Jason Scott, Yvonne Birks, Fiona Aspinal and Justin Waring

Keeping individuals safe from harm and exploitation is a clearly articulated goal within both the health and social care sectors. Two key concepts associated with…

Abstract

Purpose

Keeping individuals safe from harm and exploitation is a clearly articulated goal within both the health and social care sectors. Two key concepts associated with achieving this common aim are safety and safeguarding. The purpose of this paper is to critically appraise the differences in safety terminology used in health and social care, including opportunities and challenges for greater integration of safety systems across health and social care in England.

Design/methodology/approach

This paper presents the authors’ viewpoint based on personal, professional and research experience.

Findings

In healthcare, safety is usually conceptualised as the management of error, with risk considered on a universal level. In social care, the safeguarding process balances choice and control with individualised approaches to keeping adults safe, but lacks the established reporting pathways to capture safety incidents. Efforts to safely integrate health and social care services are currently constrained by a lack of shared understanding of the concepts of safety and safeguarding without further consideration of how these approaches to keeping people safe can be better aligned. As such, there is a need for a single, unified discourse of patient safety that cuts across the patient safety and safeguarding concepts and their associated frameworks in health and social care settings.

Originality/value

A single unified concept of safety in health and social care could coincide with an integrated approach to the delivery of health and social care, improving the care of patients transitioning between services.

Details

Journal of Integrated Care, vol. 25 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 January 2004

Rhidian A. Hughes, Anu Sinha, Fiona Aspinal, Maria Dunckley, Julia Addington‐Hall and Irene J. Higginson

Clinical outcome measures are used in clinical audit to monitor the quality of care provided to patients. As information technology (IT) is increasingly being integrated…

508

Abstract

Clinical outcome measures are used in clinical audit to monitor the quality of care provided to patients. As information technology (IT) is increasingly being integrated into the delivery of health care, computerising the use of clinical outcome measures has been proposed. However, little is known about the attitudes of health professionals towards this. Aims to understand professionals’ views on adapting one clinical outcome measure – the palliative care outcome scale (POS) – for use on hand‐held computers. Concludes that these results reinforce existing research on clinical outcome measures and IT in health care; identify special palliative care issues when considering the use of computerised clinical outcome measures with patients; and highlight the need for further research.

Details

International Journal of Health Care Quality Assurance, vol. 17 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 9 February 2015

Jill Manthorpe, Martin Stevens, Kritika Samsi, Fiona Aspinal, John Woolham, Shereen Hussein, Mohamed Ismail and Kate Baxter

The purpose of this paper is to report on a part of a study examining the interrelationships between personalisation and safeguarding practice. Specifically the authors…

Abstract

Purpose

The purpose of this paper is to report on a part of a study examining the interrelationships between personalisation and safeguarding practice. Specifically the authors aimed to examine how safeguarding practice is affected by the roll out of personalisation in adult social care, particularly when the adult at risk has a personal budget or is considering this.

Design/methodology/approach

A sample of annual reports from Adult Safeguarding Boards in England was accessed for content analysis covering the period 2009-2011. One part of this sample of local authorities was selected at random; the other authorities selected had been early adopters of personalisation. The reports were analysed using a pro forma to collect salient information on personalisation that was cross-referenced to identify common themes and differences.

Findings

The authors found variable mentions of personalisation as part of the macro policy context reported in the annual reviews, some examples of system or process changes at mezzo level where opportunities to discuss the interface were emerging, and some small reports of training and case accounts relevant to personalisation. Overall these two policy priorities seemed to be more closely related than had been found in earlier research on the interface between adult safeguarding and personalisation.

Research limitations/implications

There was wide variation in the annual reports in terms of detail, size and content, and reports for only one year were collected. Developments may have taken place but might not have been recorded in the annual reports so these should not be relied upon as complete accounts of organisational or practice developments.

Practical implications

Authors of Safeguarding Adults Board reports may benefit from learning that their reports may be read both immediately and potentially in the future. They may wish to ensure their comments on current matters will be intelligible to possible future readers and researchers.

Originality/value

There does not appear to have been any other previous study of Safeguarding Adult Boards’ annual reports. Documentary analysis at local level is under-developed in safeguarding studies.

Details

The Journal of Adult Protection, vol. 17 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

Content available
Article
Publication date: 15 August 2011

Andy Mantell and Patti Simonson

318

Abstract

Details

Social Care and Neurodisability, vol. 2 no. 3
Type: Research Article
ISSN: 2042-0919

Article
Publication date: 15 June 2012

Sylvia Bernard, Fiona Aspinal, Kate Gridley and Gillian Parker

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for…

220

Abstract

Purpose

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with long‐term neurological conditions (LTNCs). It seeks to provide benchmarks for integrated service provision and to discuss possible reasons for the variability in progress.

Design/methodology/approach

Earlier phases of the research identified three models of care that promoted continuity of care for people with LTNCs: community interdisciplinary neurological rehabilitation teams, nurse specialists and pro‐active day opportunities. Based on this evidence, a benchmarking questionnaire was developed and a telephone survey of PCTs in England undertaken in 2009.

Findings

The survey found that the prevalence of models of good practice varied widely across and within PCT areas. Strategic support and commissioning arrangements were also variable. A little over half of responding PCTs had completed a joint strategic needs assessment (JSNA) that included a reference to LTNCs and a quarter of PCTs had no joint commissioning arrangements in place for LTNCs. The complex interplay between strategy, organisational structures and models of delivery, in a context of competing priorities, may account for this variation and patchy progress.

Originality/value

Service provision for people with LTNCs is an under‐researched area, despite having major implications for long‐term care and support. The paper will be valuable to policy makers and commissioners in benchmarking organisational activity and models of good practice for integrated services.

Details

Journal of Integrated Care, vol. 20 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 15 August 2011

Kate Gridley, Fiona Aspinal, Sylvia Bernard and Gillian Parker

This paper seeks to report key findings of a study, whose purpose was to: understand what helps or hinders the commissioning and provision of integrated services for…

Abstract

Purpose

This paper seeks to report key findings of a study, whose purpose was to: understand what helps or hinders the commissioning and provision of integrated services for people with long‐term neurological conditions (LTNCs); identify models of best practice from the perspectives of people with LTNCs and the professionals who work with them; and develop a benchmarking system to assess the extent to which these models are available in England.

Design/methodology/approach

The research had three main components: a rapid systematic literature review of evidence; in‐depth case studies of six neurology “service systems”; and a survey of all English PCTs to audit progress towards implementation of the National Service Framework (NSF) for LTNCs.

Findings

A number of elements that contribute to the experience of continuity and three service models that incorporate these elements were identified: community interdisciplinary neurological rehabilitation teams; nurse specialists and proactive, holistic day opportunities services. The survey results reinforced many of the case study findings, particularly around the varying levels of service available depending on diagnosis and location, and problems of access even where high‐quality services existed. The paper concludes that the systematic approach to delivering treatment and care for people with LTNCs envisaged in the NSF has not yet been achieved.

Originality/value

This study uses a mix of methods to assess progress towards national service improvement, based on evidence from people with LTNCs and those who work with them. As such, it provides a comprehensive benchmark at a critical point in the implementation of the NSF for LTNCs.

Details

Social Care and Neurodisability, vol. 2 no. 3
Type: Research Article
ISSN: 2042-0919

Keywords

Abstract

Details

Ethnicity and Inequalities in Health and Social Care, vol. 1 no. 2
Type: Research Article
ISSN: 1757-0980

Article
Publication date: 20 November 2009

Kaveri Harriss and Sarah Salway

Abstract

Details

Ethnicity and Inequalities in Health and Social Care, vol. 2 no. 3
Type: Research Article
ISSN: 1757-0980

Article
Publication date: 10 June 2019

Fiona Henderson, Kelly Hall, Audrey Mutongi and Geoff Whittam

This study aims to explore the opportunities and challenges Self-directed Support policy has presented to Scottish social enterprises, thereby increasing understanding of…

Abstract

Purpose

This study aims to explore the opportunities and challenges Self-directed Support policy has presented to Scottish social enterprises, thereby increasing understanding of emerging social care markets arising from international policy-shifts towards empowering social care users to self-direct their care.

Design/methodology/approach

This study used guided conversations with a purposive sample of 19 stakeholders sampled from frontline social care social enterprises; social work; third sector; health; and government.

Findings

An inconsistent social care market has emerged across Scotland as a result of policy change, providing both opportunities and challenges for social enterprises. Social innovation emerged from a supportive partnership between the local authority and social enterprise in one area, but elsewhere local authorities remained change-resistant, evidencing path dependence. Challenges included the private sector “creaming” clients and geographic areas and social enterprises being scapegoated where the local market was failing.

Research limitations/implications

This study involved a small purposively sampled group of stakeholders specifically interested in social enterprise, and hence the findings are suggestive rather than conclusive.

Originality/value

This paper contributes to currently limited academic understanding of the contribution of social enterprise to emerging social care markets arising from the international policy-shifts. Through an historical institutionalism lens, this study also offers new insight into interactions between public institutions and social enterprise care providers. The insights from this paper will support policymakers and researchers to develop a more equitable, sustainable future for social care provision.

Details

Social Enterprise Journal, vol. 15 no. 4
Type: Research Article
ISSN: 1750-8614

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