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1 – 10 of 40Sarah Mahon, Laura O'Neill and Rachel Boland
In 2014, the Health Service Executive (HSE) in Ireland published its Safeguarding National Policy and Procedures (HSE, 2014). Under this policy, all agencies providing services…
Abstract
Purpose
In 2014, the Health Service Executive (HSE) in Ireland published its Safeguarding National Policy and Procedures (HSE, 2014). Under this policy, all agencies providing services through the social care directorate must ensure a robust culture of safeguarding is in place. Concurrent to this has been a move in social policy, practice and research to include the voice of the service user, both in terms of planning and reviewing services. (e.g. HIQA, 2012; Flanagan, 2020) This article examines whether service users with intellectual disabilities want to be involved in safeguarding plans and, if so, how that can be supported. Using focus groups service users demonstrated their knowledge of safeguarding as a concept, how they felt about the issues raised, and, crucially what they felt they would like to see happen next in addressing a safeguarding incident or concern. The focus groups took place in a large organisation providing residential services, day services, independent living supports and clinical supports. Engaging service users in planning and responding to safeguarding concerns is a fundamental principle of human rights legislation, both nationally and internationally. This study aims to highlight that it is both possible and desirable to engage fully with service users using a range of simple communication tools. For this to be implemented as routine practice in services providing support for people with intellectual disabilities, authentic leadership is required. Services will need to devote time, human resources and will need champions to get on board with the necessary culture shift.
Design/methodology/approach
Qualitative research examined peoples’ “lived experiences” and knowledge of safeguarding. Focus groups were used with thematic analysis highlighting common themes throughout, as guided by Braun and Clarke (2006). There were two objectives: Objective 1: measuring participant’s understanding of the safeguarding process. Objective 2: compare the potential differences between safeguarding plans devised by the participants in the focus groups, versus plans devised by trained designated officers responsible for safeguarding within the service.
Findings
Four principal themes emerged – 1. participants understanding of safeguarding; 2. restorative justice; 3. consent; and 4. high levels of emotional intelligence and compassion. Participants demonstrated that they could and did want to be involved in safeguarding planning and showed little variation in the plans compared to those completed by trained staff.
Research limitations/implications
The study was completed with a small sample size in a single service in one area. It may not represent the lived experiences and knowledge of safeguarding in other services and indeed other countries. The video may have led to some priming; for instance, the Gardai in the footage being called may have resulted in the participants stating that contacting Gardai should be part of the plan. After the video was shown, there was a heightened awareness of safeguarding. This may indicate that participants are aware of safeguarding but unsure of the terminology or how to discuss it out of context.
Practical implications
For this to be implemented as routine practice in services providing support for people with intellectual disabilities, authentic leadership is required. Services will need to devote time and human resources and will need champions in the safeguarding arena to get on board with the shift in culture required.
Social implications
While there did not appear to be many barriers to listening to participants, to progress this as a standard practice a very real shift in culture will be needed. It is important for practitioners to ask: Is the vulnerable person aware that this concern has been raised? What is known of the vulnerable person’s wishes in relation to the concern? To truly engage with service users in safeguarding plans these questions need to be more than a “tick box” exercise. This process needs to be fully embedded into a culture that promotes a person-centred, rights-based, inclusive approach as a standard rather than a one-off project. Some structural changes will be needed regarding the time given to designated officers, and what resources they can access (such as speech and language therapy). However, the real difference will be made by services operating authentic leadership that champions engagement on this scale, to fully answer the question posed by the researchers at the beginning of this report, “Whose safeguarding is it anyway?”
Originality/value
There appears to be little evidence of service user engagement in terms of planning and processing safeguarding responses, either in research or anecdotally.
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Constant Van Graan, Vera Roos and Matthews Katjene
A significant increase in financial crime globally emphasises the importance of forensic interviewing to obtain useful and reliable information as part of a commercial forensic…
Abstract
Purpose
A significant increase in financial crime globally emphasises the importance of forensic interviewing to obtain useful and reliable information as part of a commercial forensic investigation. Previous research has identified two interviewing strategies that are aligned with the legal framework in South Africa: the PEACE model (P = preparation and planning; E = engage and explain; A = account, clarify and challenge; C = closure; E = evaluation) and the person-centred approach (PCA). The purpose of this paper is to explore the theoretical underpinnings and application of the PEACE model and the PCA as commercial investigative strategies aligned with the legal context in South Africa.
Design/methodology/approach
A scoping review was undertaken to identify literature relevant to the theoretical assumptions and application of the PEACE model and the PCA.
Findings
Literature for the most part reports on the PEACE model but offers very little information about the PCA. A critical analysis revealed that the PEACE model incorporates a clear guiding structure for eliciting information but lacks content needed to create an optimal interpersonal context. To promote this, the PCA proposes that interviewers demonstrate three relational variables: empathy, congruence and unconditional positive regard. The PCA suggests a basic structure for interviewing (beginning, middle and end), while providing very little guidance on how to structure the forensic interview and what information is to be elicited in each phase.
Originality/value
Combining the PEACE model and PCA presents an integrated interviewing technique best suited for obtaining useful and reliable information admissible in a South African court of law. The PEACE model has a clear structure, and the PCA assists in creating an optimal interpersonal context to obtain information in an interview.
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Anya Ahmed, Lorna Chesterton and Matthew J. Ford
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion…
Abstract
Purpose
The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive.
Design/methodology/approach
This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities.
Findings
A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia.
Practical implications
The authors’ premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination.
Originality/value
This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities.
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Teresa Atkinson and Rebecca Oatley
The purpose of this paper is to present the views of people living with dementia in extra care housing (ECH). This is a model of housing with care and support aiming to support…
Abstract
Purpose
The purpose of this paper is to present the views of people living with dementia in extra care housing (ECH). This is a model of housing with care and support aiming to support older people, including those with dementia, to live independently. Previous research identifies benefits but is predominantly derived from third-party accounts, with the voices of those living with dementia in ECH significantly absent.
Design/methodology/approach
This study adopted a qualitative approach conducting 100 interviews across 8 ECH schemes in England. Over half of the interviews were conducted with people living with dementia and their families with the remainder involving staff and commissioners.
Findings
Findings suggest there are a range of benefits including owning your own home, having a safe, age friendly location with flexible support, social interaction and continuing to live as a couple. Challenges included availability of staff, flexible resourcing, loneliness and the advancing symptoms of dementia.
Research limitations/implications
Despite efforts to create an inclusive, diverse sample, the participants were all White British. Participants involved were identified by gatekeepers, which may present some bias in the selection.
Practical implications
Whilst ECH offers benefits to people living with dementia, addressing the challenges is essential for effective dementia care. Improving staff training, promoting person-centred care and fostering an inclusive community are critical for enhancing residents’ well-being and quality of life.
Originality/value
This paper explored the lived experiences of residents and family members, providing new insight into the advantages and disadvantages of ECH for people living with dementia.
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Jennifer Hillman, Dave Lochtie and Olivia Purcell
In this case study, we offer an analysis of feedback from a student experience survey completed by Black undergraduate students who received proactive, targeted coaching and…
Abstract
Purpose
In this case study, we offer an analysis of feedback from a student experience survey completed by Black undergraduate students who received proactive, targeted coaching and mentoring support during 2021–2022. All the students were studying at a large higher education institution in the United Kingdom which offers a broad range of degree courses by distance learning.
Design/methodology/approach
This paper reports on the intervention delivered and analyses the student experience of being offered, and receiving, proactive coaching and mentoring. It is based on the responses of 102 students who engaged with the experience survey after having self-selected to receive the intervention. What follows is an analysis of their experiences using a qualitative in vivo approach based on word frequency in students’ free-text comments.
Findings
The findings presented are that, in this intervention, students who self-select to receive coaching and mentoring support experience tangible (self-reported) behaviour changes with potentially longer term benefits for their studies. These include improved self-confidence and self-efficacy, increased proactive help-seeking behaviour, greater recognition of strengths and achievement and personal growth and self-awareness.
Originality/value
In presenting this case study, we aim to contribute to the growing corpus of practitioner case studies and research papers that show the benefits of coaching and mentoring in higher education and – more specifically – why coaching and mentoring can be a worthwhile targeted intervention for students from underrepresented backgrounds. This lends support to the growing consensus that students with positive, proactive help-seeking behaviours perform better than students not able to access support (Byrne et al., 2014). We conclude the case study with some practical implications for providers looking to provide targeted support to students.
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Danielle Adams, Richard P. Hastings, Ian Maidment, Chetan Shah and Peter E. Langdon
Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to…
Abstract
Purpose
Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.
Design/methodology/approach
In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.
Findings
Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.
Originality/value
There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.
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Benjamin Thomas Gray and Matthew Sisto
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a…
Abstract
Purpose
The purpose of this study is to describe peer support work in a men’s mental health unit from a lived experience and service user’s perspective. The intertwining of process (a lived experience perspective) and subject (the therapeutic value of peer support) leads to greater knowledge and insight into peer support for people with mental health problems.
Design/methodology/approach
This service user narrative draws on the extracts from a reflective journal of interactions and conversations with people with mental health problems as well as feedback from service users and staff about the value of peer support. These methods allow a first-person, service user’s, reflective and narrative account of peer support work.
Findings
Peer support work, particularly hearing voices sessions, are found to be highly therapeutic and worthwhile. They promote insight and create feelings of safety and hope in what can sometimes be a frightening and hostile ward environment. Peer support provides emotional and practical support. Sharing stories and experiences of mental illness with people leads to trust, feelings of being valued, heard and accepted as well as better experiences of care and being seen as a person first. Due to their shared experiences, peer support workers are able to befriend people with mental health problems on the ward. Peer support work bridges the gap and vacuum of care between people with mental health problems and staff. It compensates for understaffing to provide more holistic and person-centred care and support.
Originality/value
Lived experience/ service user perspectives and narratives on peer support are rare, particularly in a hospital setting. This article provides a rich, perhaps overlooked and hidden narrative on the nature of peer support work. People with mental health problems, like Ben, are often excluded from society, health and social care, education, employment and research. This narrative opens up a pathway to understanding peer support from a service user perspective.
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In Germany, various approaches have been taken to tackle the current teacher shortage in technical and vocational education and training (TVET). One attempt to remedy the shortage…
Abstract
Purpose
In Germany, various approaches have been taken to tackle the current teacher shortage in technical and vocational education and training (TVET). One attempt to remedy the shortage in Bavaria has been the introduction of an engineering education study programme at universities of applied sciences. Ideal candidates for this programme should have an interest in both engineering and social interaction. For effective recruitment, therefore, it is necessary to know applicants’ characteristics such as their vocational interests. In this study, the vocational interest profiles of students in TVET teacher training programmes were identified and their interest profiles and further characteristics were compared with those of other VET students at universities and universities of applied sciences.
Design/methodology/approach
An online questionnaire based on Holland’s interest theory and adapted from the Allgemeiner-Interessen-Struktur-Test-3 (interest structure test) was administered to 85 students in TVET teacher training programmes at universities and universities of applied sciences in Bavaria. Items regarding reasons for choosing a particular study programme, university location and other personal details were added.
Findings
The vocational interest profiles of students at universities and universities of applied sciences can be described as similar but weakly differentiated. Insights are provided by the characteristics of students such as the majority being first-time academics in the family. The reasons for choosing the degree programme and university location highlight the fact that a large proportion of students in engineering education would not have chosen a teaching-related degree programme if it had not been offered at the respective university of applied sciences.
Research limitations/implications
Although the sample in this study was small and, therefore, limiting, it represented a high proportion of TVET teacher training students in Bavaria and a substantial proportion of first-year students in TVET teacher training programmes at universities and universities of applied sciences in Bavaria (section 2.2 and 3.1). Thus, the findings provide valuable insights into commonalities in interest profiles between engineering education students at universities of applied sciences and other TVET students at universities. With respect to the domain of the chosen vocational specialisation, differentiated profiles emerged that, for example, showed a stronger artistic orientation among students in construction technology/wood. For further analysis, the previous variable-centred orientation of the analysis can be supplemented by person-centred analyses (e.g. cluster analysis and latent variable mixture modelling, LVMM) (cf. Leon et al., 2021).
Practical implications
The findings in this study reveal the potential for attracting candidates to universities of applied sciences if they prefer to study in rather rural areas close to their hometowns. With the aim to educate prospective teachers for future work not only in metropolitan regions but in rural areas too, offering bachelor degree programmes in rural areas would seem promising. A regional option can boost the recruitment of new students and attract candidates that otherwise would be unable to pursue studies or a career as a teacher in vocational education. The results of this study and those of previous studies suggest that universities of applied sciences can cooperate with universities to help solve the teacher shortage problem.
Social implications
Overall, it is apparent that the students' interests reached comparatively high values in all interest orientations and thus are only weakly differentiated. If undifferentiated profiles indicate low levels of career readiness, this significantly affects the recruitment of young people for the teaching profession. Assessing career orientation and promoting vocational interests should be prioritised during secondary school education. Vocational orientation measures are essential and should provide insight into typical activities of daily work life in different professions and thus pique and foster interests.
Originality/value
This study provides insight into how to respond to the teacher shortage in VET by identifying important characteristics of engineering education students using vocational interest profiling.
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This paper aims to explore how accounting is fostering neoliberal citizenship through the participants of Australia’s National Disability Insurance Scheme (NDIS). More…
Abstract
Purpose
This paper aims to explore how accounting is fostering neoliberal citizenship through the participants of Australia’s National Disability Insurance Scheme (NDIS). More specifically, this paper aims to understand how accounting discourse and the management accounting technique of budgeting, when intertwined with automated administrative processes of the NDIS, are giving rise to a pastoral form of power that directs people’s behaviour toward certain ends.
Design/methodology/approach
Publicly available data has been crafted into an autoethnographic case study of one fictitious person’s experiences with the NDIS – Mina. Mina is an amalgam created from material submitted to the Joint Parliamentary Standing Committee on the NDIS. Mina’s experiences are then analysed through the lens of Foucault’s concept of pastoral power to explore how accounting has contributed to marketising and digitising public disability services.
Findings
Accounting rhetoric appears to be a central part of rationalising the decision to shift to individualised disability funding. Those receiving payments are treated as self-governable, financially responsible subjects and are therefore expected to have knowledge of management accounting techniques and budgeting. However, NDIS’s strong reliance on the accounting concepts of funds, budgets, cost and price is limiting people’s autonomy and subjecting them to intervention and control.
Originality/value
This paper addresses calls to explore the interplay between accounting and current disability policies. The analysis shows that incorporating accounting into the NDIS’s algorithms serves to conceal the underlying ideology of the programs, subtly driving behaviours towards neoliberal objectives. Further, this research extends the Foucauldian accounting literature by revealing the contribution of accounting to reinforcing the authority of digital pastors in contemporary times.
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Ane Bast, Marit Engen and Maria Røhnebæk
This paper aims to explore the role of frontline employees (FLEs) as mediators in transformative service processes within services targeting vulnerable users.
Abstract
Purpose
This paper aims to explore the role of frontline employees (FLEs) as mediators in transformative service processes within services targeting vulnerable users.
Design/methodology/approach
This paper is based on a case study of the development and implementation of a dementia village, and the data consist of documents, in-depth interviews and field observations.
Findings
The analysis identifies FLEs as mediators in six different roles. These roles highlight how FLEs perform as mediators, acting in between and for vulnerable users and thus supporting their well-being. Specifically, the roles explicate the mediating role of FLEs in the design and planning of transformative changes and in daily work practices.
Practical implications
The different mediating roles of FLEs presented here should inform care providers and managers of how employees can become assets for supporting vulnerable users’ well-being during the design and planning stages of transformative change and through daily service work.
Originality/value
This paper offers novel insights into the multifaceted roles of FLEs in transformative services. The findings add to the current debate on mediation in transformative services and contribute to the literature by extending and refining the established conceptual and empirical understandings of the role of transformative service mediators in consumers’ well-being.
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