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Capture, consumption and use of person-centred information presents challenges for hospitals when operating within the scope of limited resources and the push for organisational routines and efficiencies. This paper explores these challenges for patients with Acute Coronary Syndrome (ACS) and the examination of information that supports successful hospital discharge. It aims to determine how the likelihood of readmission may be prevented through the capturing of rich, person-specific information during in-patient care to improve the process for discharge to home.

The authors combine four research data collection and analysis techniques: one, an analysis of the patient record; two, semi-structured longitudinal interviews; three, an analysis of the patient's journey using process mining to provide analytics about the discharge process, and four, a focus group with nurses to validate and confirm our findings.

The authors’ contribution is to show that information systems which support discharge need to consider models focused on individual patient stressors. The authors find that current discharge information capture does not provide the required person-centred information to support a successful discharge. Data indicate that rich, detailed information about the person acquired through additional nursing assessments are required to complement data provided about the patient's journey in order to support the patients’ post-discharge recovery at home.

Prior research has focused on information collection constrained by pre-determined limitations and barriers of system design. This work has not considered the information provided by multiple sources during the whole patient journey as a mechanism to reshape the discharge process to become more person-centred. Using a novel combination of research techniques and theory, the authors have shown that patient information collected through multiple channels across the patient care journey may significantly extend the quality of patient care beyond hospital discharge. Although not assessed in this study, rich, person-centred discharge information may also decrease the likelihood of patient readmission.

The purpose of this paper is to discuss how the signs of safety and wellbeing practice framework offers a practical and logical reinforcement for the Making Safeguarding Personal programme within the practice context of the Care Act. The new practice framework orientates safeguarding practice to be person led and person centred while reinforcing an outcomes focus.

The principal social worker co-led the design and pilot programme where the new practice framework was developed and trialled.

A practice framework that houses the policy and practice updates needed to deliver the Care Act and Making Safeguarding Personal agenda is logical and necessary for the practitioners. An outcomes focus is encouraged because safeguarding practice is goal orientated and outcome focused.

A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services.

A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services.

Despite popular portrayals of women's current success in public accounting, labour force statistics indicate that few women actually advance to partnership level positions. Accounting research on the scarcity of female partners tends to approach this issue from a person‐centred perspective and to focus on the characteristics of women as an explanation for their occupational status. Demonstrates that a situation‐centred perspective provides a useful contribution in understanding the scarcity of women partners. The findings are based on a survey of 188 male and 184 female accountants.

The purpose of this paper is to provide a viewpoint on what needs to be done to develop competent residential services for people with intellectual disabilities and challenging behaviour.

This article draws on previous accounts of the actions required. Whilst these have been available for decades and are still valid, they have not been fully implemented, hence the theme of “Back to the future”.

The need to continue developing small‐scale, community‐based services that have a clear value base and are committed to taking person‐centred action is highlighted. The paper focuses on the need to enhance service quality through the dissemination and implementation of Positive Behavioural Support and discusses some key issues regarding this with reference to recent work in Wales.

This paper makes a timely contribution to the current debate and highlights some practical actions and tools developed in Wales that may be of wider interest.

The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration.

The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice.

Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care.

Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic.

Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors.

The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise.

This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

The purpose of this paper is to ascertain what efforts Adult Safeguarding Leads (ASLs), generic advocates, and Independent Mental Capacity Advocates are making to involve service users in decisions about protective measures, and to investigate whether the Adult Safeguarding service is delivering outcomes, which are valued by its users.

Semi-structured interviews with a sample of key stakeholders.

ASLs are making efforts to involve service users in the complex and demanding process of safeguarding. These efforts, however, are shaped by their understandings of the difference between “residential” and “community” settings.

The study is based in a single County Council, albeit in a large county, and involves a limited number of service users.

Clarification is needed of what it may mean to adopt a person-centred approach to adult safeguarding, and the responsibilities of ASLs when individuals with capacity to make decisions about this aspect of their lives are unwilling to engage with the safeguarding process.

The findings improve the understanding of how ASLs understand their responsibilities towards the users of their services and endeavour to involve them in the adult safeguarding process. Based on this understanding, those with responsibility for managing Adult Safeguarding services should be better able to support improvements in professional practice.

The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person‐centred care (PCC) for patients with chronic heart failure.

Surveys were sent out to 170 nurses. The survey included two instruments – the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC).

The results indicate that a culture with a dominating focus on social competence decreases “routine seeking behaviour”, i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well‐defined framework.

An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes.

Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units – i.e. the health workers in different hospital wards – was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.

The purpose of this paper is to describe the Making Safeguarding Personal (MSP) programme undertaken in 2013/2014 and summarises the learning and messages from this phase of work. This informed both the subsequent mainstreaming of the programme to all councils, and national policy on safeguarding adults in England.

Following the “test bed” phase in 2012/2013, MSP pilots were developed in 53 councils. They adopted a new outcomes focused and person led approach to adult safeguarding practice. Supported by the Local Government Association and partners, these councils changed their safeguarding practice and how adults were involved in safeguarding processes. Adults’ wishes were identified at the early stages of investigation, and reviewed during and at the end of the safeguarding process. In total, 43 councils provided impact statements on work undertaken, mainly between December 2013 and February 2014.

Key findings from the impact statements evidenced that adopting a personalised approach made safeguarding more effective and provided opportunities for developing social work practice. A range of challenges were encountered and overcome. The experiences of the MSP pilot sites informed the Care Act guidance issued in October 2014.

The MSP programme has stimulated an innovative culture change in safeguarding adults’ practice. It provides a means for Safeguarding Adults Boards to ascertain the effectiveness of local services in achieving the desired outcomes of vulnerable adults at risk of abuse or harm. Practitioners, managers and others will have an interest in this major change.

The purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focused approach to safeguarding.

Three adult social care teams volunteered to take part in the MSP pilot for four months, November 2014-February 2015. They were closely supported through telephone conferencing, bespoke training and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation.

The findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased awareness of cross-cutting subjects related to adult safeguarding, such as domestic abuse and working with coercive and controlling behaviours. Permission to exercise greater professional discretion to make responses more considered, rather than the need to adhere to time-limited imperatives, was received positively. Staff felt that this enhanced discussions about resolution and recovery with adults at risk although it required greater expertise, more extensive managerial support, and more time. These were available in the pilot.

The MSP pilot was confined to three teams and took place over four months. The numerical data reported in this paper are provided for illustrative purposes and are not statistically significant. As with other evaluations of implementation, the data provided need to be set in the local contexts of population profiles, care settings and the reporting source. The pilot also took place during the early implementation of the Care Act 2014 which affected the context of practice and training. The views of adults at risk were not collected. There is a risk of bias in that participants may have wished to convey positive views of MSP to their colleagues.

The paper indicates a need for the roll out of MSP philosophy and MSP approaches to be communicated with other agencies supporting adults at risk and for project support of some form to continue. It will be important to see if the overall enthusiasm, support and motivation reported by the pilot teams when taking a MSP approach in practice extend beyond a pilot period during which the staff received substantial support from a dedicated Professional Standards Safeguarding Team. Many of those staff participating in the pilot perceived the MSP approach as a return to core social work principles and welcomed putting these into practice.

The paper provides details of one pilot in which the feasibility of the MSP approach was tested by supporting three frontline teams working in different contexts. The pilot suggests that the level and type of support offered to the pilot teams were effective in a variety of practice settings. It draws attention to the need for the MSP concept and approach to be shared with other agencies and for implementation support to continue beyond initial pilot period.

Given the rise of individuals who have complex communication needs (CCN), it is important to identify appropriate assistive technology systems that can support the individual's communication needs. Augmentative and alternative communication (AAC) systems can serve as a means to assist individuals to communicate independently. The goal of AAC is to enhance or replace the individual's current and limited verbal or written communication skills. This chapter focuses on feature matching, aided communication and the selection process for aided communication systems including low to high technology systems. It also emphasises other key considerations pertaining to person-centred planning such as conducting preference assessments and trial periods to minimise system abandonment.