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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.

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.

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.

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.

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.

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

The purpose of the paper is to investigate the inter‐ and intra‐organisational relationships in the commissioning of secondary care by primary care trusts in England, using a principal‐agent framework.

The methodology is a qualitative study of three case studies. A total of 13 commissioning‐related meetings were observed. In total, 21 managers and six consultant surgeons were interviewed.

There are a number of different levels at which contractual and managerial control take place. Different strengths of control at one level can affect willingness to comply with agreements at other levels. Agreements at one level do not necessarily result in appropriate or expected action at another.

The system for commissioning in the National Health Service (NHS) has changed with the introduction of payment by results and practice‐based commissioning. However, the dynamics of the inter‐ and intra‐organisational relationships studied remain.

Incentives within organisations are as important as those between organisations. Within a chain of principal‐agent relations, it is important that a strong link in the chain does not result in the exploitation of weaknesses in other links. If government targets and frameworks are to be met through commissioning, it may be advantageous to concentrate efforts on developing incentives that align clinician with NHS trust objectives as well as NHS trust with primary care trust (PCT) and government objectives.

This paper is based on original empirical work. It uses a principal‐agent framework to understand the relationships between PCTs and NHS trusts and highlights the importance of internal NHS trust governance systems in the fulfilment of commissioning agreements.

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.

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.

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.

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.

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.

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.

Primary care in the UK has been the subject of numerous changes and reorganizations since 1990. Each innovation in organization, with the exception of fundholding, has been the subject of evaluation. However, the complexities of some innovations make the evaluation process problematic and this is further complicated by the trend towards central policy decision making being subject to local interpretation and implementation, by means of simultaneous devolution and centralization. This paper discusses the challenges and problems posed by attempting to evaluate these new organizations, particularly with regard to whether or not they can be considered to be “successful”. It draws specifically on the national evaluation of the total purchasing pilots and indicates how the findings can be applied to primary care groups.

The purpose of the current innovative practice paper is to introduce a technique to explore leader identity development and meaning-making that builds on the narrative pedagogical tradition. In this paper, we recommend a process for combining turning-point graphing and responsive (semi-structured) interviews to co-explore leadership identity development and meaning-making with college students.

The paper provides student feedback data on the effectiveness of the technique in improving understanding of leader identity and transforming meaning-making.

We hope practitioners can utilize this approach to build leadership identity development and meaning-making capacity in college students.

As a network analyst, I am fascinated by social interactions. The ways in which people connect with one another and exercise power and authority by deploying different forms of capital. This piece returns to the underlying and changing kinship network structure of the village of Ambridge over time, explores the role of ‘kin-keeping’ as deployed by the matriarchs Peggy and Jill. I am most interested in the ways in which gender as performed by the women of the village intersects with abundance or lack of other forms of capital, and how far inequalities persist and why. It is clear that there is an intergenerational power dynamic at play in the spreading or hoarding of the various dimensions of power layered together and how forms of capital intersect for protection or precarity. Social and cultural capital at birth in the village is defining in terms of both ‘serious’ life outcomes as well as how more minor infractions and foibles are viewed. Further, I return to discuss how my various network-based predictions have fared over time. The Headlam Hypothesis and the fate of Ed Grundy – King of Ambridge are revisited and their durability explored.

This paper aims to survey and interview parents of young children with disabilities to document their perspectives on what professionals working with their children need to know. Rather than comparing opinions over time or as part of an outcome study, this paper met with participants at a single point in time for a conversation addressing two questions with implications for training, program development and continuing research, namely, to what extent do families believe the Advancing Community College Efforts in Paraprofessional Training (ACCEPT) standards and topics are important to include in educational programs preparing professionals to work with young children with disabilities in inclusive settings (survey)? How satisfied or dissatisfied are families with the practices of early childhood educators working with their children with disabilities in inclusive and other settings (focus group)? What knowledge and skills do families recommend are important for the preparation of early childhood educators working with children with disabilities in inclusive and other settings (focus group)?

An exploratory design was used to gather information for use in future research and program development and research efforts. Descriptive statistics were compiled for the survey data and focus group interviews were content-analyzed for themes consistent with the project’s eight standards and topics.

Analyzes of survey and focus group interview data indicated that parents/caregivers held consistent views about information and skills needed to prepare teachers and others to work with children with disabilities in inclusive settings. Parents/caregivers were asked to complete a brief survey prioritizing the importance of the eight ACCEPT standards and topics when preparing early childhood educators for working with children with disabilities in inclusive settings. They all (n = 21) rated each standard and topic as “very important” (4) and provided 184 comments during follow-up interviews that represented positive examples, negative examples and recommendations distributed across the eight focusing standards.

This research identified the need for educators to understand the high value and importance of communication with parents of children with disabilities. This study further suggests the need for teachers to value each child’s individual needs and differences for their relationships with children and families to thrive.

Recently, Managed Alcohol Programs (MAPs have emerged as an alcohol harm reduction model for those living with severe alcohol use disorder (AUD) and experiencing homelessness. There is still a lack of clarity about the role of these programs in relation to Housing First (HF) discourse. The authors examine the role of MAPs within a policy environment that has become dominated by a focus on HF approaches to addressing homelessness. This examination includes a focus on Canadian policy contexts where MAPs originated and are still predominately located. The purpose of this paper is to trace the development of MAPs as a novel response to homelessness among people experiencing severe AUD and to describe the place of MAPs within a HF context.

This conceptual paper outlines the development of discourses related to persons experiencing severe AUD and homelessness, with a focus on HF and MAPs as responses to these challenges. The authors compare the key characteristics of MAPs with “core principles” and values as outlined in various definitions of HF.

MAPs incorporate many of the core values or principles of HF as outlined in some definitions, although not all. MAPs (and other housing/treatment models) provide critical housing and support services for populations who might not fit well with or who might not prefer HF models.

The “silver bullet” discourse surrounding HF (and harm reduction) can obscure the importance of programs (such as MAPs) that do not fully align with all HF principles and program models. This is despite the fact that MAPs (and other models) provide critical housing and support services for populations who might fall between the cracks of HF models. There is the potential for MAPs to help fill a gap in the application of harm reduction in HF programs. The authors also suggest a need to move beyond HF discourse, to embrace complexity and move toward examining what mixture of different housing and harm reduction supports are needed to provide a complete or comprehensive array of services and supports for people who use substances and are experiencing homelessness.

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.

We conducted and analyzed 51 in-depth, semi-structured interviews with adults living in rural New Mexican counties, covering a range of topics related to the pandemic, including vaccines. These interviews were conducted in the Summer of 2021 after the vaccines were widely available to all adults over the age of 18 and youth between the ages of 12–17, but not yet available for children under 12 years.

Two major perspectives were identified: (1) the idea that COVID-19 vaccinations are a tool that individuals can use to achieve freedom and protection and (2) the view which regarded vaccines as an infringement of personal rights and one's autonomy of health. For people who viewed the vaccine as a tool for freedom, several themes emerged, including (1) a preference for vaccine manufacturers, specifically a preference for Pfizer, and (2) frustrations related to vaccine access, specifically, older adults expressed frustrations with the difficulty of scheduling vaccination appointments. However, most participants felt as though they had enough vaccination resources. For people who viewed vaccines (and vaccine mandates) as limiting their freedom, additional themes emerged: (1) overarching distrust of government and the perception that vaccines were an extension of government and (2) distrust in the vaccines themselves, including a perceived lack of research on the vaccines and a perception that the vaccine was developed in too short of a period. Some of the people who hold these beliefs are also vaccinated. We draw from social psychology theories to better understand how people who hold a rural identity come to establish different beliefs and practices compared to larger metropolitan regions. While political identity is a contributor, of our participants, the group who were most likely to report not being vaccinated were the “independent” or “unaffiliated voters.” Our findings can help craft culturally responsive vaccine initiatives for rural communities.

Technology enabled care (TEC) equipment has been a part of adult social care (ASC) in most areas of the UK for decades. More recently, commissioners have been exploring mainstream technologies’ potential to support older people living in the community. The purpose of this paper is to examine the challenges and opportunities presented by the growing application of mainstream technologies in ASC against the backdrop of the planned UK-wide switchover from analogue to digital telecommunications by 2025.

This general review uses research evidence, literature, industry standards and policy documents to address the challenges presented by the UK’s digital switchover and the potential role of mainstream technologies such as “smart speakers” in ASC.

The use of digital TEC and mainstream devices in ASC brings challenges related to access to reliable internet connections in parts of the UK; the need to update TEC safety standards; the ethics, privacy and data security measures that ensure digital products and services safeguard the interests of users; and evidence and commissioning practice.

This general review explores emerging areas of policy and research related to the planned UK digital switchover and the use of mainstream technologies in ASC. It offers a conceptual approach and suggests ways forward for research, regulatory and commissioning agendas.