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A major element of modernising English adult social care is the introduction of individual, user-directed budgets. The Social Policy Research Unit (SPRU) led a major, multi-method and multi-centre research programme evaluating the Individual Budget (IB) pilot projects in England; and a linked study of the impact of IBs on family carers. Through this, SPRU has influenced: the content of the Department of Health's (DH) good practice guidance for personal budgets; the DH's approach to piloting and evaluating NHS Personal Health Budgets; the Department for Work and Pensions (DWP) piloting and evaluation of `Right to Control' trailblazer projects; and, the agenda for an Audit Commission investigation into financial management of personal budgets. Most importantly, it has helped shape the agenda for national and local organisations striving to successfully implement personal budgets, particularly for older people.
Quality of care for the increasing numbers of frail older people is an issue of international concern. Led by Professor Meyer at City University London, in partnership with Age UK and Dementia UK, My Home Life (MHL) is a collaborative movement of people involved with care homes for older people. It was established to improve the quality of life of everyone connected with care homes for older people and has become the recognised voice for the sector. The original underpinning research and ensuing projects all focused on knowledge translation, in particular the factors that enhance quality improvement in care homes. MHL actively works with care homes to progress quality improvement and share the lessons learned throughout the system. The programme has had a significant impact on both policy and practice in health and social care, influencing Government policy and supporting practice improvement across national and international borders.
Research on residential care- and extracare-supported housing conducted by Swansea's Centre for Innovative Ageing (CIA) has impacted on the development and reconfiguration of supported housing services in Wales. Our research on care home closures has directly led to Welsh Government (WG) consultation on guidance regarding `escalating concerns' for care home closures, and the Independent Advisory Group on Local Authority Closure of Care Homes has recommended that our amendments to escalating concerns should be adopted in relation to care home closures due to strategic/policy reasons. Work is now underway by the WG to publish revised guidance in relation to care home closures based on our research. Three local authorities (Swansea, Vale of Glamorgan and Wrexham) have used our research on the challenges associated with extracare provision to inform the development of future services.
The Personal Social Services Research Unit (PSSRU) at the University of Manchester (UoM) has run a programme of research examining community care of older people since 1996. The findings have informed key government decision-making around two important national policy initiatives between 2008 and 2013: (1) the development and implementation of Personal Budgets in Social and Health Care and (2) National Strategies to improve Dementia Services. This has affected the national provision of social care for older people and other adult social care users. In 2011-12, there were over 1.2 million people in England receiving social care affected by these policy changes (over 800,000 aged 65+), with a cost of £6,600m spent on their care (NHS and Social Care Information Centre).
This research improved policy-makers' and practitioners' understanding of well-being among residents of social care facilities by identifying the factors contributing to residents' quality of life. This research resulted in the development of the Adult Social Care Outcomes Toolkit (ASCOT), whose use is rapidly increasing both in the UK and internationally. Evidence from beneficiaries including policy-makers, experts and service practitioners, as well as interviews with service users, indicates that ASCOT captures aspects of well-being that are highly valued by service users and policy-makers alike.
The importance of person-centred social support has been recognised by successive governments as central to the development of effective and supportive social care services. The research led by Brunel and funded by the DoH and the Joseph Rowntree Foundation, made a substantial contribution to the enhancement of UK social care policy and practice in relation to the personalisation agenda. Parliamentary committees and policy consultation used the research to develop new social care policy. Standards of service care delivery were developed and implemented in partnership with service users; these were adopted at a policy and practice level. The development and use of evidence based practice guides, training programmes and web resources facilitated the successful adoption and implementation of person-centred support nationwide. In summary, public debate was influenced, equality and empowerment for service users was advanced, national policy and practice enhanced, health and welfare improved and economic impacts achieved.
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A key challenge for UK Government is to identify how older generations can continue to live independently in their own homes. The UK's changing demographics, recent increases in the cost of institutional care coupled with its declining availability make this a priority for policy makers. A twelve stage research programme undertaken by Professor Tinker has investigated how improved home care and assistive technologies including aids and adaptations could be employed to enable older people to remain at home longer. It examined and costed these options and provided recommendations on how they, and other specialised housing types such as sheltered housing, could be provided. Central government, local authorities and housing associations have employed her findings in revising their approaches to housing support for this rapidly growing population. Her findings have recently been employed by governments in Europe, Canada, the USA, Australia and the Far East in their reappraisals of policy on assisted living in later life.
In a context of austerity and shrinking public provision, developed societies are turning to new technologies such as telecare for health/social care provision, and biosensors to facilitate citizens' active self-care. Maggie Mort, Celia Roberts and Adrian Mackenzie's research explores the overlooked ethical and social aspects of this trend focussing on ageing, reproduction and genetics. Through innovative engagements with policy makers, industry, citizens, health experts and practitioners, we provide empirical intelligence about how remote care for older people living at home (telecare) and providing users with bodily data (biosensing) work in practice. Because the views and experience of users and citizens underpin our research, our interventions confer much-needed legitimacy on subsequent decisions about health care technologies and provision. Our recommendations are adopted in local authority service re-design and have shaped corporate decision-making about product development.
The research has had significant impact in the UK on the development of social and spiritual support for people at the end of life and their families. With Professor Holloway as Social Care Lead on the National End of Life Care Programme (NEoLCP) since 2009, the research has underpinned the launch of a framework for the delivery of social care at the end of life which is now in its second phase of implementation. The framework is endorsed by the Association of Directors of Adult Social Services and has led to local and regional Action Plans and social care practice initiatives. The research on spirituality has led to scoping and training initiatives in healthcare practice and in the funerals industry within the UK and internationally.