The continuity of social care when moving across regional boundaries

© The Author(s) 2018. Summary: This paper reports the experiences of adults in receipt of social care when relocating to new local authorities, and of family carers. While many matters need to be considered when moving, the study focused specifically on the ‘portability’ of social care. The study draws on data from semi-structured interviews conducted between July and November 2013 with 12 adults who had relocated between English local authorities. Data were collected prior to the implementation of the Care Act 2014; the potential impact of the Act in respect of relocation is considered. Findings: Although some positive experiences were identified, participants primarily reported challenges when moving with social care support. Five themes were identified, these related to the amount of organisation, planning and activity required; the need for a timely approach and the risk of delays and interruptions to care delivery; differences between the practices of local authorities; a lack of control and involvement; a negative impact on emotional and physical well-being. As a result of such difficulties, some experienced delays or interruptions to their care and support; lost all or some of their care package; experienced stress, anxiety and worry. Applications: The paper documents the experiences of people relocating with social care support, which have been little explored to date within the UK or internationally, and contributes to the evidence base in respect of relocation and portability of care. It highlights the importance of smooth transitions for those relocating between local authorities, and the potential for social workers to assist by addressing potential problems

Relocation, portability and social care practice: A scoping review

Summary The portability of publicly-funded adult social care across local authority boundaries received recent policy attention in England and was addressed in the Care Act 2014. This article presents the findings of a scoping review conducted between July–September 2012 that searched selected journals and online databases for relevant material. The aim of the review was to identify what is known about the experiences of adults entitled to publicly-funded social care who move between local authorities, and the support provided by social workers to those planning to relocate. The review focused specifically on disabled adults and carers, eligible for and in receipt of social care support, who relocate for work or education in England. Findings The review identified little direct research covering experiences of moving between local authorities. However, six specific barriers, challenges and facilitators to relocation were identified; these included the portability of social care support, variations in policy and practice between local authorities, and housing availability. The review concludes that the process of relocation may be complex, challenging, and uncertain, although individuals may experience benefits and positive outcomes. Applications The review outlines areas for good social work practice in supporting people using social care services to relocate. These include: ensuring the provision of information; close working between local authorities and social workers; the development of interim plans to address potential delays in setting up support; proactive and rapid monitoring and reassessment following a move to address potentially changed support needs arising from changed housing circumstances

Families' experiences of raising concerns in health care services: an interpretative phenomenological analysis

Background This exploratory study aimed to increase understanding of the experiences of families of people with intellectual disabilities when noticing and raising concerns in services. A qualitative design was employed. Methods Seven participants (all female) were recruited through local and national voluntary agencies; five were mothers of people with intellectual disabilities, one was the aunt and one the sister. Participants took part in semi structured interviews centred on their experiences of noticing and raising concerns, these were recorded and transcribed. The data was analyzed using Interpretative Phenomenological Analysis (IPA; Smith, 1996). Results The data was grouped into three superordinate themes: the nature and importance of concerns, relationships between families and staff and the process of raising concerns. A key and surprising finding was the importance of ‘the little things’. Conclusions This research highlights important implications for services such as the need to simplify the process of raising concerns, attend to the relationship with families and ensure advocacy services are identified for those without family

Abuse in care? A research project to identify early indicators of concern in residential and nursing homes for older people

Purpose: The purpose of this paper is to contribute to the prevention of the abuse of older people in residential and nursing homes, through the identification of "early indicators of concern". Such indicators support practitioners in identifying services in which older people are at risk of abuse, neglect and ill treatment. Design/methodology/approach: Semi-structured interviews were conducted with health and social care practitioners in two local authorities (in England and Scotland), who had visited services in which abuse or neglect had occurred. Practitioners were asked about the things that they had seen within the service which had caused them to become concerned. Findings: Over 90 early indicators of concern were identified. These indicators were grouped within six themes which identify key manifestations of service cultures which may promote the abuse of older people. Practical implications: Information and guidance has been developed to enable practitioners to recognise early indicators and identify services in which older people are at risk and in which actions are required to help prevent the onset of abuse. Originality/value: A range of studies have highlighted the importance of organisational cultures in promoting the abuse of older people. The early indicators identified through this research represent visible signs of such poor service cultures which can be observed by practitioners, enabling them to recognise services in which older people are at greater risk

It can still happen here: systemic risk factors that may contribute to the continued abuse of people with intellectual disabilities

Purpose – The purpose of this paper is to reflect on the response to the scandal of abuse in services for people with intellectual disabilities in the light of research evidence and analysis. Design/methodology/approach – Critical reflection and review of literature. In particular, recent research into possible indicators that a service is at risk of becoming abusive is used to test the hypotheses and implied solutions that are currently being adopted. Findings – That some of the responses to recent scandals are necessary but not sufficient to prevent future harm. Furthermore, some of the proposed solutions may actually increase the likelihood of further abuse. Prevention of abuse requires a broader and more evidence-based response. Originality/value – The synthesis of research and analysis presented here has not been presented previously in the published literature

Abuse in care? The identification of early indicators of the abuse of people with learning disabilities in residential settings

Although No Secrets suggests that adult protection practices should seek to prevent abuse, it can be argued that such practice predominately focuses on pursuing effective responses to abuse that has already happened, rather than preventing the onset of abuse. This research sought to contribute to the prevention of abuse, through the identification of ‘early indicators’. Early indicators were identified, and this knowledge has been applied to equip families and practitioners to report concerns at an early stage and seek protective responses

An uncertain practice: social work support for disabled people and carers moving across local authority boundaries in England

© Policy Press 2019. This article reports on a study of social work practice with care recipients choosing to relocate between English local administrative units. Data were collected from interviews with 20 social work practitioners from three areas, seeking their views through the use of vignettes. Participants reported that supporting relocation: requires time and planning; is conceptualised as a key transition for those moving; and exposes practitioners (and care recipients) to local variations and the potential for risk, and therefore uncertainty. New legal rights for care recipients may decrease the problems, but local variations will remain

Families’ experiences of raising concerns in health care services: An interpretative phenomenological analysis

Background This exploratory study aimed to increase understanding of the experiences of families of people with intellectual disabilities when noticing and raising concerns in services. A qualitative design was employed. Methods Seven participants (all female) were recruited through local and national voluntary agencies; five were mothers of people with intellectual disabilities, one was the aunt and one the sister. Participants took part in semi-structured interviews centred on their experiences of noticing and raising concerns, these were recorded and transcribed. The data were analyzed using interpretative phenomenological analysis (IPA; Smith, 1996). Results The data were grouped into three superordinate themes: the nature and importance of concerns, relationships between familes and staff and the process of raising concerns. A key and surprising finding was the importance of “the little things.” Conclusions This research highlights important implications for services such as the need to simplify the process of raising concerns, attend to the relationship with families and ensure advocacy services are identified for those without family

The identification of environments and cultures that promote the abuse of people with intellectual disabilities: a review of the literature

Background The present paper examines the literature regarding abuse within long-stay hospitals and community-based residences for people with intellectual disabilities. Methods Research and policy developments are reviewed, and concerns regarding the reactive nature of much current guidance are noted, highlighting a need for research and strategies which promote greater protection from the onset of abuse. Results and conclusions It is argued that much current thinking attributes abuse to individual deviancy and culpability; however, a greater recognition of the range of causes of abuse and the circumstances in which abuse flourishes is required if we are to develop a full understanding of preventative strategies. This review is concerned with the significance of environments and cultures in increasing vulnerability to abuse. Seven aspects of environments and cultures which promote vulnerability are outlined, offering insights into the processes by which services may deteriorate and abuse becomes established

An Investigation into Injector Architecture for Sub-Newton Monopropellant Propulsion

This paper presents an exploration of injector architecture candidates, including orifice and Poiseuilletype injectors, for sub-newton monopropellant thrusters. While the work here is specific to High Test Peroxide, it is expected to be applicable to other monopropellants. This methodology presented here seeks to underpin the fluid mechanics through flow characterisation and hot firing of each injector, with analytical, experimental and computational methods. Experimental results broadly follow calculations and simulations, although do not fully agree. Further work is required to fully understand the microscale fluid dynamics, especially as chugging may not be as significant for sub-newton scale monopropellant thrusters