The role of adult social care in the prevention of intensive health and care needs: a scoping review

Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs. Implications: Greater investment in research in this field will help policy makers and families target scarce resources and invest in the most effective prevention services. We emphasise the impact of prevention services can take several years to realise, which must be reflected in research design and social care funding

Identifying Regional Stakeholder-Informed Priorities for Adult Social Care Research: A Mixed-Method Study in Kent, Surrey, and Sussex

Context: There is an urgent need for sustainable change in the social care sector, and research plays an essential role in the identification of priority areas. Thus far, there have been few priority setting exercises within adult social care research. The current study explores regional priorities for adult social care research in Kent, Surrey, and Sussex. Stakeholders were consulted from the starting point of the project, ensuring that the identified research priorities were fully informed by the people that the subsequent research will have an impact on. Objectives: Our main aim was to identify research priorities for adult social care within the region, and more specifically, relevant activities within these priority areas that could benefit from evaluation. Methods: We employed a mixed-method design using online focus groups with social care professionals (N = 37) and members of the public (N = 7), and an online survey following the focus groups (N = 28). Focus group discussions were informed by themes based on The Care Act 2014. Findings: Content analysis was used to analyse discussions, which yielded a list of 46 actionable research questions. Rankings of discussion themes were produced to establish order of importance. Limitations: We approached the ranking of priorities only at a higher-order theme level, and not at the level of the specific questions. Implications: The extensive list of research questions produced in this study supports social care researchers to conduct studies that address pressing issues for care systems and the public

Measuring safety in older adult care homes: A scoping review of the international literature

Background: Safety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted. Objectives: The aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes. Sources of evidence: Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Eligibility criteria: Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Charting methods: Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. Results and conclusions: Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. The findings indicate that there are a range of available safety measures used for quality monitoring and improvement in older adult care homes. These cover all five domains of safety in the SMMF. However, there are potential gaps. These include user experience, psychological harm related to the care home environment, abusive or neglectful care practice and the processes for integrated learning. Some of these gaps may relate to challenges and feasibility of measurement in the care home context

Reflections on the Use of Synchronous Online Focus Groups in Social Care Research

Focus groups are an extensively employed research method for the collection of qualitative data. Recent developments in teleconferencing platforms have produced a substantial increase in online research, including online focus groups. The current study is the first to discuss methodological reflections on the conduct of online focus groups in adult social care research. Previously reported research on the use of online focus groups in healthcare research cannot readily be applied to the significantly distinct social care sector. Unique characteristics of the social care sector, such as the dispersion of social care services, the significant funding gap, ongoing recruitment and retention issues, and an ageing population becoming increasingly reliant on social care have consequences for the design, conduct and appropriateness of the online focus group method. In this article, we review the use of synchronous online focus groups in social care research. We conducted six online focus groups with social care professionals (total N = 37). The online focus group method is evaluated by analysing and reporting data from a participant experience survey and researcher reflection logs. Additionally, this article reviews Microsoft Teams as a platform for online focus groups. It is concluded that the benefits of increased accessibility and representation significantly outweigh the limitations related to online social communication. We suggest that the use of the online focus groups method could enhance the relatively scarce research capacity in social care, and we provide practical recommendations for the design and conduct of online focus groups in social care research

The scope of safety in English older adult care homes: a qualitative analysis of Safeguarding Adult Reviews

Purpose: This paper aims to explore the content of Safeguarding Adult Reviews (SARs) from older adult care homes to understand how safety is understood and might be measured in practice. Design/methodology/approach: SARs relevant to older adult care homes from 2015 onwards were identified via the Social Care Institute of Excellence SARs library. Using thematic analysis, initial inductive coding was mapped to a health-derived safety framework, the Safety Measurement and Monitoring Framework (SMMF). Findings: The content of the SARs reflected the dimensions of the SMMF but gaining a deeper understanding of safety in older adult care homes requires additional understanding of how this unique context interacts with these dimensions to create and prevent risks and harms. This review identified the importance of external factors in care home safety. Originality/value: This study provides an insight into the scope of safety issues within care homes using the SARs content, and in doing so improves understanding of how it might be measured. The measurement of safety in care homes needs to acknowledge that there are factors external to care homes that a home may have little knowledge of and no ability to control

The Role of Adult Social Care in the Prevention of Intensive Health and Care Needs: A Scoping Review

Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs

Unit Costs of Health and Social Care 2023 Manual

Knowing the cost of specific health and social care services is crucial information for making decisions about what support is provided to those who need help, assisting service providers to plan for the future of their services, and more generally for allocating scarce resources and budgets. To support resourcing decisions, the Unit Cost Programme has been carried out by the Personal Social Services Research Unit (PSSRU) at the University of Kent. They produced the annual cost estimates for the delivery of health and social care services for 29 years. Lesley Curtis, a Senior Research Fellow at PSSRU led the Unit Costs of Health and Social Care programme, alongside Jennifer Beecham, Ann Netten and Amanda Burns. In 2020, Karen Jones, Co-Director of PSSRU, led the programme for two years. The annual publication is freely available online. The work is underpinned by three key principles: 1. The provision of robust, consistent estimates of costs based on economic theory and reflecting the long-run marginal opportunity cost. 2. Comprehensive coverage of available health and social care services, reflective of new service developments. 3. Clarity and accessibility in the presentation of cost estimates. The annual volume included nationally-applicable costs for around 80 health and adult social care services (NHS, local authority, private and voluntary) as well as at least three articles by academics and practitioners each year. Unit costs represents the total expenditure incurred to produce one unit of output in health and social care. For example, the cost of one hour of a nurse or GP’s time, or a face-to-face appointment with a social worker or perhaps a speech therapist. It could also be a week in a residential care or nursing home or the cost of a day care attendance. The consistency, comprehensiveness and robustness of what was produced over time has seen the volumes become a cornerstone of economic evaluations and a resource to inform deliberations among decision-makers

Unit Costs of Health and Social Care 2022 Manual

Knowing the cost of specific health and social care services is crucial information for making decisions about what support is provided to those who need help, assisting service providers to plan for the future of their services, and more generally for allocating scarce resources and budgets. To support resourcing decisions, the Unit Cost Programme has been carried out by the Personal Social Services Research Unit (PSSRU) at the University of Kent. They produced the annual cost estimates for the delivery of health and social care services for 29 years. Lesley Curtis, a Senior Research Fellow at PSSRU led the Unit Costs of Health and Social Care programme, alongside Jennifer Beecham, Ann Netten and Amanda Burns. In 2020, Karen Jones, Co-Director of PSSRU, led the programme for two years. The annual publication is freely available online. The work is underpinned by three key principles: 1. The provision of robust, consistent estimates of costs based on economic theory and reflecting the long-run marginal opportunity cost. 2. Comprehensive coverage of available health and social care services, reflective of new service developments. 3. Clarity and accessibility in the presentation of cost estimates. The annual volume included nationally-applicable costs for around 80 health and adult social care services (NHS, local authority, private and voluntary) as well as at least three articles by academics and practitioners each year. Unit costs represents the total expenditure incurred to produce one unit of output in health and social care. For example, the cost of one hour of a nurse or GP’s time, or a face-to-face appointment with a social worker or perhaps a speech therapist. It could also be a week in a residential care or nursing home or the cost of a day care attendance. The consistency, comprehensiveness and robustness of what was produced over time has seen the volumes become a cornerstone of economic evaluations and a resource to inform deliberations among decision-makers. Acknowledgements: The Unit Cost of Health and Social Care contract was completed in 2022. We would like to thank our previous Advisory Group (Ross Campbell, Adriana Castelli, Ciara Donnelly, Sebastian Hinde, Tracey Sach, James Shearer, Adam Storrow and Jonathan White) for their input at our meetings. We would also like to thank colleagues from the Department of Health and Social Care, NHS Digital and the Department of Education who shared the relevant datasets so we can estimate the unit costs. In addition, we received invaluable assistance from Anna Peckham, Sarah Godfrey, Alan Dargan and Ed Ludlow from the University of Kent. Thank you to you all. The Unit Costs of Health and Social Care Programme (2022-2027) In 2022, PSSRU and the Centre for Health Economics (CHE) at the University of York began a new five-year collaboration to continue to estimate unit costs for health and social care and to deliver an annual volume