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1 – 10 of 19Nick Smith, Ann-Marie Towers, Grace Collins, Sinead Palmer, Stephen Allan and Jennifer Beecham
Research in care homes requires the co-operation of care home managers. Noting the challenges faced by the care home sector, the purpose of this paper is to consider ways in which…
Abstract
Purpose
Research in care homes requires the co-operation of care home managers. Noting the challenges faced by the care home sector, the purpose of this paper is to consider ways in which research studies can encourage care home managers and their homes to participate in research.
Design/methodology/approach
The discussion is informed by two research projects which are used to explore methods of encouraging managers of care homes to participate in research. One of the studies included interviews with care home managers to understand their reasons for taking part in research.
Findings
This paper outlines and assesses three strategies for encouraging care home managers to participate in research: working in partnership, providing payment and providing personalised feedback on findings. Whereas all the strategies have the potential to encourage care home managers’ participation in research, partnership working in particular was found to be fraught with difficulties.
Research limitations/implications
This paper suggests that the research projects could employ any of these strategies to encourage managers of care homes to participate in research. It also suggests that proactive measures could help ameliorate the pitfalls of partnership working.
Originality/value
This paper shows the advantages and disadvantages of using a combination of strategies for encouraging the participation of care home managers in research.
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This article identifies the broad reasons why costs in children's care services might vary, illustrating them with examples from research literature relating to England. An…
Abstract
This article identifies the broad reasons why costs in children's care services might vary, illustrating them with examples from research literature relating to England. An intentionally broad use of ‘costs’ is employed. The literature has been neither systematically nor comprehensively reviewed but does include most of the recent work in the social care field. Articles have been selected to illustrate particular cost associations. This article finds that there is as yet insufficient research into the costs, cost variations or cost‐effectiveness of children's services. However, the findings provide guidance for decision‐makers as they try to understand how resources are currently deployed and why this might be.
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Paul Cambridge, John Carpenter, Jennifer Beecham, Angela Hallam, Martin Knapp, Rachel Forrester‐Jones and Alison Tate
This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study…
Abstract
This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study sites across England, who left various long‐stay hospital 12 years ago as part of a centrally monitored and evaluated government policy initiative on deinstitutionalisation. It represents the last follow‐up of a raft of linked longitudinal evaluations, conducted at four time points over a twelve‐year period. The paper identifies the findings from the last follow‐up and interprets and presents them as summary observations and trends in relation to the findings in learning disability, briefly reviewing them in relation to wider evidence on deinstitutionalisation and community care in England.
Claire Curran, Martin Knapp and Jennifer Beecham
This paper brings together findings from current research into mental health and employment from an economic perspective. The economic impact of reduced employment and…
Abstract
This paper brings together findings from current research into mental health and employment from an economic perspective. The economic impact of reduced employment and productivity for people with mental health problems is described from both individual and societal viewpoints. Interventions reported to have an impact on employment are considered, looking at both clinical interventions that have reported employment outcomes and interventions that have as their primary target the improvement of employment outcomes. The paper also describes the impact of common mental health problems on employment and productivity and reports the findings of some studies in this area. However, the quantity and quality of economic information in this area are limited.
Susan Clarke, Patricia Sloper, Nicola Moran, Linda Cusworth, Anita Franklin and Jennifer Beecham
Drawing on a wider study about the effectiveness and costs of different models of multi‐agency transition services, this paper aims to present new evidence on the ways in which…
Abstract
Purpose
Drawing on a wider study about the effectiveness and costs of different models of multi‐agency transition services, this paper aims to present new evidence on the ways in which such services meet the priorities and concerns of young people identified in previous research.
Design/methodology/approach
The evidence is based on qualitative interviews with 130 managers and staff in five transition services across England, and a quantitative survey of parents and young people receiving these services (pre‐transition), or having received the services in the last‐two years (post‐transition). In total, 110 pre‐transition and 33 post‐transition parents, and 73 pre‐transition and 24 post‐transition young people, completed questionnaires. Statistical analysis included calculating frequencies and mean values for the responses that measured met and unmet need, and qualitative results were analysed thematically. The consequence of, and reasons for, the low response rate to the family survey are also discussed.
Findings
The research found examples of good practice and innovative services to meet young people's needs. However, provision of such services was patchy, and unmet need for transition support remained high in all the priority areas studied both during and after transition: ranging from 52 to 84 per cent in parent reports and 59 to 82 per cent in young people's reports.
Originality/value
With the onset of public service cutbacks, the paper concludes that improved multi‐agency commissioning of services, based on the priorities and concerns of disabled young people, and greater engagement of transition services with a broader range of agencies, will help to address these deficiencies.
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Michael Little and Nick Axford
This article reviews the first volume of the Journal of Children's Services. In doing so, it discusses broader directions and challenges in research, policy and practice. The…
Abstract
This article reviews the first volume of the Journal of Children's Services. In doing so, it discusses broader directions and challenges in research, policy and practice. The article focuses on discussion about outcomes, the ‘idea’ of children's services and the impact of interventions on children's health and development. It welcomes reflections on different approaches to outcome measurement, analyses of the practicalities of implementing policy reforms and rigorous evaluations of the impact of Early Years, parenting and other programmes. At the same time, it suggests specific areas in which more work would be valuable, including: socio‐political commentary on policy developments; methods of and results from need analyses; empirical research on inter‐agency initiatives; how to improve the processes and structures that underpin good outcomes; transitions; and understanding ‘what works’ in research dissemination and utilisation. The value of international perspectives (including intra‐UK comparisons) is stressed. Forthcoming special editions on randomised controlled trials (RCTs) (2007) and anti‐social behaviour by young people (2008) will help to address other points raised.
Lorna Rixon, Shashivadan P. Hirani, Martin Cartwright, Michelle Beynon, Abi Selva, Caroline Sanders and Stanton P. Newman
The widespread deployment of telehealth (TH) has been conducted in the absence of any clear understanding of how acceptable these devices are to patients. One potential limitation…
Abstract
Purpose
The widespread deployment of telehealth (TH) has been conducted in the absence of any clear understanding of how acceptable these devices are to patients. One potential limitation of the widespread deployment of TH is that patients may refuse. Moreover an understanding of the reasons for refusing to use TH devices will provide an understanding of the barriers.
Design/methodology/approach
This investigation from the Whole Systems Demonstrator (WSD) programme, a pragmatic cluster randomised controlled trial into the effectiveness of TH, examined reasons for patients in the intervention cohort of the trial refusing TH, and the potential barriers to its deployment.
Findings
Active rejection of the TH intervention was the most frequent reason for withdrawal. After examination of trial-related, health, socio-demographic, cognitive, emotional and behavioural factors, patients diagnosed with diabetes, as opposed to heart failure or chronic obstructive pulmonary disease, and patients’ beliefs about the acceptability of the intervention predicted whether or not they withdrew from the trial because of the intervention.
Originality/value
Beliefs that the TH intervention resulted in increased accessibility to care, satisfaction with equipment and fewer concerns about the privacy, safety and discomfort associated with using TH equipment predicted continued participation in the WSD trial. Findings suggest that potentially modifiable beliefs about TH predict those more likely to reject the intervention. These findings have important implications for understanding individual differences in the acceptance of TH and subsequent success in mainstreaming TH in healthcare services.
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Valentina Iemmi, David Crepaz-Keay, Eva Cyhlarova and Martin Knapp
– The purpose of this paper is to evaluate the effectiveness and cost-effectiveness of a peer-led self-management intervention for people with severe mental disorders.
Abstract
Purpose
The purpose of this paper is to evaluate the effectiveness and cost-effectiveness of a peer-led self-management intervention for people with severe mental disorders.
Design/methodology/approach
This is a one-arm longitudinal study without control group. In all, 262 adults with (self-reported) severe mental disorders, who have used secondary mental health services and were living in the community were evaluated at three time points (baseline, six and 12 months). Socio-demographic data were collected at baseline. Wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), functional living skills (Health Promoting Lifestyle Profile II) and service use (Client Service Receipt Inventory) data were assessed over time.
Findings
Self-management for people with severe mental disorders improved wellbeing and health-promoting lifestyles. After an increase in the short term, costs appeared to decrease in the longer term, although this change was not statistically significant. Due to the lack of a control group, the authors are unable to attribute those changes to the intervention only. Nevertheless, the self-management intervention appears to warrant further attention on both wellbeing and economic grounds.
Originality/value
Self-management may facilitate recovery, helping to support people with severe mental disorders at no additional cost. Given recent emphasis on recovery, peer workers and self-management, this peer-led self-management approach for people with severe mental disorders appears to have potential.
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Valentina Iemmi, Martin Knapp, Caroline Reid, Catherine Sholl, Monique Ferdinand, Ariane Buescher and Marija Trachtenberg
Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that…
Abstract
Purpose
Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that challenges. While recent evidence suggests it has a positive impact on behaviour and carer ability to cope, there is little evidence of its economic costs or benefits. The paper aims to discuss this issue.
Design/methodology/approach
An exploratory cross-sectional study was conducted to evaluate the cost of providing positive behavioural support to ten children and adolescents with learning disabilities and behaviour that challenges living in the community in Ealing, West London. Comparison was also made with the cost estimate of possible alternative support packages for children and adolescents with learning disabilities and behaviour that challenges in the UK, as obtained through a Delphi exercise.
Findings
Total cost of services per child was £1,454 per week for young people supported short-term, and £1,402 supported long-term. Children and adolescents were making use of a range of social care, education and health services. Over the full sample, half of the total cost was accounted for by education services. The Delphi exercise estimated the weekly cost of residential-based care as more expensive than the cost of community-based care for children and adolescents with learning disabilities and behaviour that challenges. At the end of the ITSBS, all ten children and adolescents initially at risk of imminent residential placement were living in the community with less service-intensive and less expensive support. This suggests that avoiding residential-based care could reduce costs in the long term.
Originality/value
Positive behavioural support has potential to support people with learning disabilities and behaviour that challenges in the community, leading to potential cost advantages. However, this is a small study and more robust research is needed.
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