Family carers managing personal budgets for adults with learning disabilities or autism

1.1 Background: There are a growing number of people with learning disabilities and autism who access personal budgets in the form of direct payments in England. Although they are often involved in decisions about their support, personal budgets are usually managed by someone else, typically a parent. This study examined the experiences of carers who manage personal budgets for adults with learning disabilities or autism with a particular focus on the challenges of securing suitable support and implications for their own well‐being. 1.2 Methods: This was a qualitative study using a descriptive phenomenological approach to investigate the lived experiences of family carers who manage personal budgets. We conducted semi‐structured interviews with 13 family carers. Interview transcripts were thematically analysed using the framework approach. 1.3 Results: Our analysis identified five main themes. The first theme relates to why carers decide to take up a personal budget in the first place and their initial expectations. The second theme, restricted choice, highlights the difficulties in securing adequate support and services in the context of what are often described as “complex needs.” The third and fourth themes relate to the tasks involved in managing a personal budget and the challenges associated with the dual role of the carer as a parent and a “professional.” The fifth and final theme, mixed emotions, describes the impact on the subjective well‐being of carers. 1.4 Conclusions: Family carers indicated that the benefits of personal budgets outweighed the difficulties and stress inherent in managing them. They need adequate support to ensure that personal budgets deliver personalised and self‐directed support and greater well‐being, and are sustainable arrangements

Distrustful Complacency and the COVID ‐19 Vaccine: How Concern and Political Trust Interact to Affect Vaccine Hesitancy

We test the hypothesis that COVID‐19 vaccine hesitancy is attributable to distrustful complacency—an interactive combination of low concern and low trust. Across two studies, 9,695 respondents from different parts of Britain reported their level of concern about COVID‐19, trust in the UK government, and intention to accept or refuse the vaccine. Multilevel regression analysis, controlling for geographic area and relevant demographics, confirmed the predicted interactive effect of concern and trust. Across studies, respondents with both low trust and low concern were 10%–22% more vaccine hesitant than respondents with either high trust or high concern, and 26%–29% more hesitant than respondents with both high trust and high concern. Results hold equally among White, Black, and Muslim respondents, consistent with the view that regardless of mean‐level differences, a common process underlies vaccine hesitancy, underlining the importance of tackling distrustful complacency both generally and specifically among unvaccinated individuals and populations

MOOCH Symposium: Engaging with care home managers

The challenges of engaging care homes in health and social care research is well reported (Bower et al., 2009; Patel et al., 2003). Managers and owners have competing pressures on their time (e.g. providing high quality and compassionate care, recruiting and retaining staff, complying with the requirements of the regulator, commissioners and their own auditing systems, liaising with family members and supporting informal carers). It is understandable that under these conditions, research is not always a priority. Mechanisms are being set up in the UK to help care homes become ‘research ready’ and guidelines for best practice are becoming available to facilitate engagement as much as possible (ENRICH website/reports). However, recruitment remains a significant challenge for many studies (Bower et al., 2009). Since 2015, the Measuring Outcomes in Care Homes Study (MOOCH) has successfully recruited 34 care homes (including nursing homes) and 293 residents, including those lacking the capacity to consent. The project faced numerous challenges early on, including local authority partners withdrawing from the research due to restructuring within their organisation. This paper shares our learning, reflecting on which strategies worked and which did not (and why), including; research ready homes, partnership working, payment to care homes, presenting at provider events, having support from CQC and local commissioning teams and providing care homes with feedback reports. We will also present the results from our care home manager debrief interviews, where managers were asked their motivations for taking part in the study and their experiences of being research participants

Engaging with care home managers

The challenges of engaging care homes in health and social care research is well reported (Bower et al., 2009; Patel et al., 2003). Managers and owners have competing pressures on their time (e.g. providing high quality and compassionate care, recruiting and retaining staff, complying with the requirements of the regulator, commissioners and their own auditing systems, liaising with family members and supporting informal carers). It is understandable that under these conditions, research is not always a priority. Mechanisms are being set up in the UK to help care homes become ‘research ready’ and guidelines for best practice are becoming available to facilitate engagement as much as possible (ENRICH website/reports). However, recruitment remains a significant challenge for many studies (Bower et al., 2009). Since 2015, the Measuring Outcomes in Care Homes Study (MOOCH) has successfully recruited 34 care homes (including nursing homes) and 293 residents, including those lacking the capacity to consent. The project faced numerous challenges early on, including local authority partners withdrawing from the research due to restructuring within their organisation. This paper shares our learning, reflecting on which strategies worked and which did not (and why), including; research ready homes, partnership working, payment to care homes, presenting at provider events, having support from CQC and local commissioning teams and providing care homes with feedback reports. We will also present the results from our care home manager debrief interviews, where managers were asked their motivations for taking part in the study and their experiences of being research participants

Changes in political trust in Britain during the COVID-19 pandemic in 2020: integrated public opinion evidence and implications

In this paper, we document changes in political trust in the UK throughout 2020 so as to consider wider implications for the ongoing handling of the COVID-19 pandemic. We analysed data from 18 survey organisations with measures on political trust (general, leadership, and COVID-19-related) spanning the period December 2019-October 2020. We examined the percentage of trust and distrust across time, identifying where significant changes coincide with national events. Levels of political trust were low following the 2019 UK General Election. They rose at the onset of UK lockdown imposed in March 2020 but showed persistent gradual decline throughout the remainder of the year, falling to pre-COVID levels by October 2020. Inability to sustain the elevated political trust achieved at the onset of the pandemic is likely to have made the management of public confidence and behaviour increasingly challenging, pointing to the need for strategies to sustain trust levels when handling future crises