THE ESSENCE PROJECT

NIHR School for Social Care Research (NIHR SSCR)

Evidence containing data sourced from NIHR School for Social Care Research (NIHR SSCR)

Bathing Adaptations in the Homes of Older Adults – The BATH-OUT Trial
Whitehead P University of Nottingham, Nottingham. 2017

The BATH-OUT study is a feasibility randomised controlled trial with nested qualitative interview study. It involves adults aged 65 or over, and their carers, who have been assessed by a social care occupational therapist and referred for an accessible showering facility. We want to investigate the impact of the accessible showering facility on disabled older adults and their carers.

Our long term aim is to evaluate the effect of these adaptations on quality of life, health and wellbeing and functional ability. We also want to investigate the impact on health and social care costs and whether waiting times lead to increased costs and poor outcomes. The first stage is this feasibility study which is being carried out within Nottingham City. If we show that it is feasible to use this method in our research we aim to plan a further study involving different areas of the UK.

The study is being led by Dr Phillip Whitehead from The University of Nottingham and is collaboration between the University and Nottingham City Council. It is funded by NIHR School for Social Care Research. Favourable ethical opinion has been given by the Social Care Research Ethics Committee (ref. 16/IEC08/0017).

Home Care in Dementia: Critical Components for Effectiveness
Challis D, Clarkson P, Sutcliffe C, et al Personal Social Services Research Unit, Manchester. 2019

Most people with dementia live in private households and promoting their wellbeing is a key policy objective. However, little is known about the most appropriate or effective forms of home care, taking into account the views of service users and their carers. Home care has become an area of increasing concern in recent years in terms of availability, quality, cost and effectiveness. This mixed methods study will investigate the effectiveness of home care for people with dementia. First, using data from an evidence synthesis of relevant literature, metrics relating to process and effectiveness will be calculated for specialist home care support for people with dementia, generic forms of home care and service receipt which is a mix of the two. Second, a naturalistic study will follow up people receiving different forms of home care over a 6-month period. Post-hoc analysis will estimate the relative effectiveness and cost by comparing each approach. Third, the views of carers about home care support to people with dementia will be canvassed using themes identified in the literature review. Data will be analysed both qualitatively and quantitatively. An established Public, Patient and Carer Involvement Group will contribute to the study.

Learning from International Models of Advance Care Planning to Inform Evolving Practice
Dixon J Personal Social Services Research Unit, London. 2017

Reform of end of life care in England has been a priority for some time, with a desire, amongst other things, to ensure that more people can have a ‘good death’ in line with their wishes for what this would be and where this might happen. Advance care planning (ACP) is a key element in this end-of-life care in England. An economic perspective policy, with an important role for social care envisaged. The complex interventions that research suggests are most effective and the social care role within them are, however, under-developed. While research evidence suggests that ACP interventions are associated with improved quality outcomes and potential acute-care cost savings, interventions are poorly described in the literature, and information on costs and cost drivers is almost entirely lacking. This project addresses these gaps, identifying and interrogating the activities and resources needed to deliver complex ACP interventions, drawing on the experiences of ACP programmes in the US and Australia, including Respecting Choices and four programmes adapting this approach. These programmes use (or, in Australia, are considering use of) social workers, allied professionals and volunteers as facilitators. We will use quantitative and in-depth qualitative methods to produce detailed descriptions of the programmes and their practices, develop a method for costing them, collect and compare cost data, and explore the main cost drivers and sources of cost variation. We shall also review the literature to identify, and ideally model, the likely economic and quality outcomes of such interventions in England. We will work with an expert advisory panel and facilitate a stakeholder workshop to comprehensively consider transferability into an English context.

Shared Lives Costs and Effectiveness (SLiCE)
Brookes N Personal Social Services Research Unit, Kent. 2018

In the Shared Lives model, an adult who needs support and/or accommodation moves in with or regularly visits an approved Shared Lives carer after they have been matched for compatibility. At present there is a limited evidence base for Shared Lives. The proposed research will mean that a thorough exploration of how successful the model is and whether it represents a good investment can be explored. An outcome evaluation will include: collection of data including service user characteristics, risks and needs, case management information, service use, quality of life and well-being measures; data collection from a comparison group of Shared Lives-suitable, non-participating service users; interviews with service users and Shared Lives carers focusing on outcomes; and use of other administrative and survey data.

Social care in prison: emerging practice arrangements consequent upon the introduction of the 2014 Care Act
Challis D, Tucker S, Hargreaves C, et al British Journal of Social Work, 48, 6, 1627–1644. 2018

This research will give local authorities’ a framework of evidence to inform the delivery of social care for prisoners, both while in prison and on release. In particular it will provide information on the nature and extent of prisoners’ social care needs and the range and cost of the services required to meet these. As such it has the potential to help councils deliver the Care Act reforms in an efficient manner and improve prisoners’ independence, well-being, rehabilitation and risk of re-offence. The overall study has three main strands. Strand 1 will scope prisoners’ social care needs via interviews with approximately 350 inmates in Lancashire. Stand 2 will use a Balance of Care approach (a strategic planning tool) involving staff workshops and cost modelling to identify the options for service provision. Strand 3 will constitute a national survey of local authorities in England to identify the arrangements councils have put in place to meet their responsibilities for prisoners under the Care Act, including how they identify prisoners with social care needs, deliver assessments, develop care and support plans and provide/procure services. The findings will be shared with a wide range of stakeholders via a multi- faceted knowledge exchange programme.

The Role of Adult Social Care in Improving Outcomes for Young People Who Provide Unpaid Care
Brimblecombe N Personal Social Services Research Unit, London. Due to complete 2019

There is increasing emphasis in social care policy and practice in England on the provision of formal support and services for the care-recipient to meet needs and improve outcomes for unpaid carers. This includes young adult carers for whom there are negative short and long-term outcomes in education, employment, mental and physical health, with associated individual and societal costs. Despite this, little is known about the role of social care services in alleviating young people’s need to provide unpaid care and improving outcomes, nor about the extent of services needed and the cost of providing them. This study aims to fill these gaps through analysis of large, nationally representative datasets and collection of primary questionnaire data from young carers and the adult they support. The study aims to investigate associations between outcomes for young adult carers aged 16 to 25 in England and provision of social care services for the adult they care for, needs for such services and costs of providing them. Young carers and adult social care users, practitioners and policy makers will be involved in the study design, implementation and knowledge exchange activities to keep the project policy and practice relevant and facilitate impact.

Vision Rehabilitation Services: Investigating the Impacts of Two Service Models
Rabiee P, Frances Birkes Y, Buckley HL, et al Social Policy Research Unit, York. 2018

The importance of rehabilitation to local authorities (LAs) is highlighted in the recent Care Act 2014. LAs are required to promote well-being and independence before people reach a crisis point. An area of increasing need is that of vision rehabilitation (VR). Evidence to support delivery of vision rehabilitation (VR) is limited. This effectiveness of two models of VR services in England (in-house and contracted- out). The project comprises three work packages (WPs). In WP1, we will collect data on support needs, use of services and outcomes for 500 people with sight loss using VR services. Data will be collected at four time points, over a period of six months. This will be complemented in WP2 by qualitative interviews with service managers, front line staff and service users for in-depth exploration of how these two models work in practice. In WP3, an economic evaluation of VR services will be undertaken to compare the two models of VR services. The findings from the research will be useful for commissioners, practitioners and managers, as well as services users and their carers to inform decisions about the effectiveness and cost-effectiveness of VR services.


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