Made available in DSpace on 2016-12-23T14:36:51Z (GMT). No. of bitstreams: 1 Anailza Perini de Carvalho.pdf: 2102005 bytes, checksum: 62338c30ce6b075a5a5d3f201bfa54f6 (MD5) Previous issue date: 2010-12-15 / Este trabalho tem como objeto as representações sociais da pobreza e do usuário pobre da assistência social existentes entre os profissionais que trabalham na implementação da Política de Assistência Social da Prefeitura de Vitória (ES). Seu objetivo principal é identificar e analisar tais representações. Como procedimentos metodológicos da investigação que o fundamenta, realizamos pesquisa bibliográfica, pesquisa documental, observação não participante, entrevista semi-estruturada com profissionais de diferentes categorias que atuam na implementação daquela política e análise de conteúdo, para o que foram de importância capital alguns eixos principais da Teoria das Representações Sociais. A partir do pressuposto de que as atividades desenvolvidas pelos profissionais, nas políticas sociais seja em sua formulação, seja em sua execução , são, em grande parte, fundamentadas em escolhas baseadas nos valores por eles adotados, de maneira explícita ou implícita, chegamos às seguintes conclusões: os profissionais entrevistados apresentam os Centros de Referência da Assistência Social como importante espaço de participação pelos usuários, mas, ao mesmo tempo, consideram existir limites a essa participação; manifestam conhecimento da assistência social como direito, mas parte deles ainda refere-se a ela com um linguajar que lembra a prática do favor; afirmam que o sistema capitalista e a própria história são responsáveis pela existência da condição de pobreza, mas, de maneiras diversas, a maioria deles acaba culpabilizando o pobre pela situação em que vive; representam os usuários a partir do pressuposto da falta, tendendo a vê-los, assim, como ―não sujeitos‖; devido a isso e a não representar os usuários da Política de Assistência Social em sua positividade concreta, podem, ainda que involuntariamente, contribuir para obstaculizar o protagonismo e a participação efetiva daqueles usuários na Política de Assistência Social e na luta por direitos / This study examines the social representations of poverty and of the poor users of social care services existing among professionals that implement the Social Care Policy in the City of Vitória, ES (Brazil). Its main purpose is to identify and analyze these representations. Bibliographical research, documental research, non-participant observation, semi-structured interviews with professionals of various categories that implement such policy and content analysis approach were carried out as methodological procedures to support this study. Some of the main lines of the Social Representation Theory were essential in this investigation. Based on the assumption that the activities performed by social policy professionals, whether in its planning or in its accomplishment, are mostly founded on choices based on the values explicitly or implicitly adopted by them, we concluded the following: the professional interviewed see the Social Care Reference Centers as important spaces for users participation, but, on the other hand, they consider that there are restrictions to such participation; the professionals acknowledge social care as a right, but some of them still refer to it as if it were a favor done; they claim the capitalist system and history itself are responsible for poverty, but in different ways they blame the poor themselves for their situation; because their representations of the users are based on the lack paradigm, they tend to see the users as ―non-subjects‖; for this reason and for not representing Social Care Policy users by taking into account their ―concrete positiveness‖, such professionals can, even though unintentionally, contribute to hindering users protagonism and their effective participation in Social Care Policy and in the fight for rights

The main topic of this thesis concentrates on the adolescents' leaving process from foster families in our Czech territory. The aim of the presented thesis is a deeper exploration of the leaving process preparation from foster families and circumstances connected with it. The theoretical part of this thesis is divided into three chapters. The first of them deals with the adolescence period with its developmental specifics. The second one describes foster care and its partition in the Czech legislative system. The same one also presents available Czech and foreign research. The last chapter focuses on the two topics: the leaving process of adolescents from foster care from a legislative point of view and how it names participants who contribute to this leaving process. At last, it shows some useful Czech social care services for adults. The practical part of the thesis presents a realised qualitative study with three groups who contributed on foster care in the Czech area. These involved groups were adolescents (16+), their foster mothers who share the same household and social workers. This research tried to bring answers for the questions about the adolescents' leaving process from long-term foster care and other similar topics which deal with it. The results of the research were deeply analysed...

Widely viewed as under-valued and under-paid, yet sentimentalized as working more for love than money, the social care workforce is a fundamental economic and social resource; the importance of which is growing in line with the rapidly aging, global and national population (Care Quality Commission, 2012; DoH 2009; International Helptheaged, 2013). Classic motivation theories, which focus on economic and individualistic work motives, fail to fully account for the high rates of satisfaction and commitment among care workers, (Skills for Care 2007, 2013; Stevens et al 2010). Yet a growing body of empirical research demonstrates that health and social care workers’ motivation is related to patient/client satisfaction and wellbeing (Maben et al., 2012). Moreover the quality of the relationship between the carer and client contributes to the motivation and the wellbeing of both (Wilson, 2009; Wilson et al., 2009). Therefore this thesis seeks to better understand the collective and relational aspects of care workers’ motivation. It does this by detailing a program of research which examines care workers motivations through a social identity lens that asks ‘what’s in it for us’ as well as ‘what’s in it for me’ (Haslam 2004). A social identity perspective on motivation focuses on how workers experience themselves and their work at a personal, relational and organizational level (Ashforth et al 2008; Ellemers et al., 2004). In doing so it offers a multi-dimensional, theoretical framework through which to understand the dynamics of care workers’ motivations. Moreover, this framework offers an empirically proven psychological framework for explaining why adopting a relationship-centered approach to care is pivotal for organizations to achieve a compassionate care culture. The first study explored care workers’ experience of work and inquired about what they did and why it mattered to them. Semi-structured interviews were conducted with 19 care workers who worked in residential and domiciliary care settings. A thematic analysis of the transcripts identified four overarching themes that contributed to care workers’ motivation, those of fulfillment’, ‘belonging’, ‘valuing’ and ‘pride’. These motives were found to be actualized in their shared experience of caring, particularly with clients and also with co-workers and as an organizational member. The findings of the study shed light on the content of care workers’ personal, relational and social identities and the interactions between them. Care workers primarily emphasized the meaningfulness of their work in terms of its caring nature. They expressed this is terms of their personal attributes, their relational role with clients and their perceptions of how the organisation treated them. This led us to hypothesize that their identification with the organisation is likely to increase to the extent they feel the organisation ‘cares’. Indeed to build on and harness care workers’ identities at work, the findings suggest that organisations need to place care workers’ relationships with clients at the heart of what they do. The second study was a longitudinal quantitative analysis of care workers’ motivations which consolidated and extended the findings of the first study. It had two parts, the first part was an examination of how care workers’ motivations are shaped by their sense of identity, and the second part tested how a professionalization intervention affected their motivation. To achieve this we administered an organisational survey at two time points, one year apart (T1 n = 643, T2 n = 1274, T1 & T2 n = 204). Analaysis of the survey responses assessed what it was that incentivized care workers (love and/or money), the relationship of this to work outcomes (i.e. job satisfaction, pride, stress, turnover intentions and positivity about professionalisation) and the extent to which it was affected by patterns of identification. We also examined variation in responses over time as a function of whether or not people had undertaken professional qualifications in the intervening period (so that, in effect, undertaking a qualification constituted an experimental treatment). This meant that the study had a quasi-experimental design in which we could examine the putative impact of exposure to a professionalisation intervention on organizational identification and motivation (for a similar logic see Lim & Putnam, 2010). In line with the five main hypotheses that were generated from the findings of Study 1 and from predominant findings in organisational and social identity research; the results showed first (H1), that care workers’ collective identification with different groups at work, was positively related to their motivation (Ellemers et al., 2004). More specifically, their work motivation was predicted by their identification with (a) the people they care for (client identification), and (b) the care organization they work for (organisational identification). Furthermore, although care workers indicated strongest identification with clients, it was their identification with the organisation that was the most proximal indicator of increased motivation. Second (H2 & H3), although care workers were most incentivized by their relationships with clients and the least incentivized by the pay; the extent to which either led to improved work outcomes was mediated by client and organisational identification. Where being incentivized by relationships with clients led to improved work outcomes, client identification predicted organisational identification, whereas client identification played a lesser role in mediating the likelihood of being incentivized by pay leading to improved work outcomes. In addition (H4), care workers’ identity varied as a function of the work context. More specifically, whether they worked in residential / nursing home care or in domiciliary care affected the nature and extent of their relational identification with their clients and the congruence between client identification and organizational identification (Ashforth et al 2008, Haslam et al 2003). Finally (H5), care workers’ motivations were enhanced by the professionalization intervention of undertaking a qualification, to the extent that it built on and maintained meaningful work-related identities. In particular, the results showed that, care workers’ motivation increased as a result of undertaking a qualification to the extent that the training increased identification with the organisation and other groups at work (Pidd 2004). Study 3 further investigated the effects of identification on motivation, learning and performance by examining the likelihood of professionalisation training being transferred to the workplace. A 2 × 2 longitudinal study evaluated the effects of a new generic professionalisation (NGP) training program, that tapped into distal work identities, and a standard localized professionalisation (SLP) training program, which spoke more to localised identities, on participants’ identification and motivation at work. Overall the findings indicated that compared to the NGP, the SLP (H1) maintained and strengthened participants’ work identification. Furthermore compared to the SLP, the NGP was associated with (H2) a reduction in trainees’ perception of the relevance and usefulness of the training, (H3) a reduction in motivation to enact the training, and (H4) a reduction in trainees’ immersion in the program. Moreover the findings demonstrated that (H5) the reduction in motivation to transfer learning associated with the NGP relative to the SLP, was explained by the reduction in identification it engendered, which in turn reduced participants’ sense of relatedness within the training context. These findings imply that learning is more likely to be applied when it (a) has relevance to identities which are more meaningful to participants, in this case local identities, (b) is delivered by people with whom care workers identify, (c) is validated by others in the workplace environment with whom the participants’ identify. Taken together, this program of research demonstrates that care workers’ motivations can be understood through a social identity perspective that incorporates the collective, relational and personal dimensions of providing care. It concludes by considering how organisations can tap into, harness, strengthen and develop care workers’ identification at work as a means of enhancing their motivation and retaining professional care staff. Through bridging theoretical and applied concerns, this research has wide-reaching implications for developing and maintaining compassionate work cultures within care organisations and other helping professions.

Frailty poses a complex challenge for some people through their experience of ageing. In Wales, devolution requires organisations to use a whole systems approach with a model of partnership to deliver public services. An integrated care approach is offered to meet the service user focus or ‗value demand‘ which impacts on clinical, professional, organisational and policy levels within the system. Therefore, the aim of this study was to explore whether there was a difference between integrated health and social care day services and non- integrated health and social care day services. In doing so, answering the questions, how were these services different, what were the differences as perceived by the participants, why were they different, what could be learned from this study and how could health and social care services integrate in practice? The study utilized Gadamer‘s interpretative hermeneutics with a single intrinsic case study design. Using this approach ensured that the unique voice of the individual lived experience was heard and interpreted within the whole system of the study. The participants were service users, carers and staff in a day hospital, an outpatient clinic, day centre, reablement team and a joint day care facility. The methods included a survey questionnaire (SF12v2 and London Handicap Scale), in-depth interviews, observations; and historical and service documents; and reflective diary. Data collection occurred January 2005 to December 2006. Quantitative and qualitative data were analysed separately. The qualitative data was analysed using Gadamer‘s five stage approach developed by Fleming et al (2003) and Nvivo 7.0. The embedded quantitative data was analysed using SPSS version 13.0. Triangulation was achieved through the use of a meta matrix which merged the qualitative and quantitative data. The difference between integrated and non integrated services is expressed through the four themes, ‗the study participants‘, ‗commissioning and decommissioning integrated services‘, ‗the journey within day services‘, ‗navigating services and orchestrating care‘. The four themes were developed through a strategy used for interpreting the findings, which was to follow the study questions, propositions and ‗emic‘ questions. The differences between the integrated and non integrated services were in the meaning of their purpose, culture, level of integration, team orientation of practice and the model of service user/carer relationship observed within the services. The thesis identified challenges in respect of integrated working such as concept confusion, negative experiences of care for frail or older people, a vertical gap in knowledge transfer between strategic organisation, the operational services and service users. Mapping each service level of integration and team orientation to the model of service user and carer relationship, found that the level of team orientation and integration does not appear to be proportionate to the service user and carer relationship. The thesis concludes that in order to attempt to answer the question as to whether these day services can integrate in the practice, all levels of the system should focus on the service user/carer relationship. We need to understand service user diagnosis, how its characteristics and effect are interpreted by the service user, carer, professional and wider society in relation to independence and autonomy. It argues that knowledge emerges at this micro level (service user and carer relationship) and how we engage with this relationship and manage the knowledge we gain from it (both vertically and horizontally), will lead us to understand how we can ensure that integration occurs and that services in the future are person focussed.

Providing care services across several departments and care givers creates the complexity of the patient pathways, as it deals with different departments, policies, professionals, regulations and many more. One example of complex patient pathways (CPP) is one that exists in integrated care, which most literature relates to health and social care integration. The world population and demand for care services have increased. Therefore, necessary actions need to be taken in order to improve the services given to patients in maintaining their quality of life. As the complexity arises due to different needs of stakeholders, it creates many problems especially when it involves complex patient pathways (CPP). To reduce the problems, many researchers tried using several decision tools such as Discrete Event Simulation (DES), System Dynamic (SD), Markov Model and Tree Diagram. This also includes Direct Experimentation, one of techniques in Lean Thinking/Techniques, in their efforts to help simplify the system complexity and provide decision support tools. However, the CPP models were developed using a single tools which makes the models have some limitations and not capable in covering the entire needs and features of the CPP system. For example, lack of individual analysis, feedback loop as well as lack of experimentation prior to the real implementation. As a result, ineffective and inefficient decision making was made. The researcher also argues that by combining the DES and SD techniques, named the hybrid simulation, the CPP model would be enhanced and in turn will help to provide decision support tools and consequently, will reduce the problems in CPP to the minimum level. As there is no standard framework, a framework of a hybrid simulation for modelling the CPP system is proposed in this research. The researcher is much concerned with the framework development rather than the CPP model itself, as there is no standard model that can represent any type of CPP since it is different in term of its regulations, policies, governance and many more. The framework is developed based on several literatures, selected among developed framework/models that have used combinations of DES and SD techniques simultaneously, applied in a large system or in healthcare sectors. This is due to the condition of the CPP system which is a large healthcare system. The proposed framework is divided into three phases, which are Conceptual, Modelling and Models Communication Phase, and each phase is decomposed into several steps. To validate the suitability of the proposed framework that provides guidance in developing CPP models using hybrid simulation, the inductive research methodology will be used with the help of case studies as a research strategy. Two approaches are used to test the suitability of the framework – practical and theoretical. The practical approach involves developing a CPP model (within health and social care settings) assisted by the SD and DES simulation software which was based on several case studies in health and social care systems that used single modelling techniques. The theoretical approach involves applying several case studies within different care settings without developing the model. Four case studies with different areas and care settings have been selected and applied towards the framework. Based on suitability tests, the framework will be modified accordingly. As this framework provides guidance on how to develop CPP models using hybrid simulation, it is argued that it will be a benchmark to researchers and academicians, as well as decision and policy makers to develop a CPP model using hybrid simulation.

Safeguarding adults is a priority in adult social care, and training is one of the main ways in which policy and guidance around it is implemented. Training transfer refers to the use of new learning on the job, and while the transfer literature is well developed, it does not extend to safeguarding adults training. This research aimed to identify, develop and refine a programme theory of safeguarding adults training transfer by identifying factors that facilitate or inhibit the use of safeguarding adults training in practice, and the impact that the training has. A cross sectional mixed methods realist synthesis approach was used to evaluate two safeguarding adults training programmes provided in Cornwall, UK between 2009 and 2011. Realist synthesis aims to uncover what works, for whom, in which circumstances and how, and develops policy makers’ programme theories of interventions using evidence. A systematic review of training transfer generally, and then of health and social care transfer specifically led to a revision of the policy makers’ programme theory of training. Empirical research in the form of a factorial survey and narrative analysis of qualitative interviews was then undertaken, to further revise the programme theory to be specific to safeguarding adults training. Findings emphasise the importance of considering the effect of the training culture and transfer climate on safeguarding adults training effectiveness. Factors such as opportunity to use learning and supervisor support are important to transfer and the conflict between adult learning principles and mandatory training was explored. Safeguarding adults-specific supports were also highlighted, emphasising the importance of supporting practice using mechanisms other than training. Recommendations are provided regarding how the safeguarding related transfer climate can be improved. Limitations of the study include a high likelihood of sampling bias. The limitations of individual methods and problem of generalising findings obtained from a case study of Cornwall were reduced using the realist synthesis approach.

In the current policy, commissioning and delivery environments for services aimed at improving the lives of children and their families, increasing priority is placed on the ability to measure and demonstrate the effectiveness of social welfare intervention. This is particularly acute for voluntary sector services that increasingly provide services on behalf of local authorities and operate in a highly competitive environment in which the ability to demonstrate effectiveness and value for money can ultimately determine survival. However, social welfare intervention is delivered in the context of complex social systems in which a multiplicity of factors interplay between those individuals who are managing, providing and using social services. This complexity presents significant methodological challenges in terms of understanding the effect of intervention on individuals’ lives. Often the pressures to produce highly aggregated data about outcomes mean that the experience and the voice of those using services is overlooked and the connection between data and lived experience is lost. This thesis describes the evaluation of an approach to measuring outcomes known as Goal Attainment Scaling (GAS). This places the service user at the heart of measuring outcomes whilst collecting data that can be used to evaluate effectiveness within a service, or comparatively between services, or between service user groups. The approach was implemented with practitioners and young people within the context of a leaving care support service provided by a voluntary sector service. The GAS implementation was evaluated using a realist research strategy in order to understand the ways in which a complex policy and operating environment interplayed with the challenging contexts of transition for young people and their heterogeneous pathways in leaving care. For a variety of reasons, explained within this thesis, participation levels in the trial were low and therefore quantitative data regarding outcomes was too limited to be conclusive. Nevertheless the study represents a useful pilot of this approach and highlights the importance of context in determining results when introducing new approaches to outcomes measurement into practice environments. The findings that emerge from the evaluation betray a concerning picture of the pressures and constraints on practice experienced by a large leaving care service in the current climate of cuts to local authority funding and statutory services. As opposed to being an independent or somewhat removed undertaking, this study was concerned to frame ‘evaluation’ and ‘outcomes measurement’ as participatory and reflexive activities that should be embedded within service delivery. By so doing, it aimed to facilitate reciprocal or ‘bi-directional’ learning between providers and the users of services to underpin interventions, particularly with vulnerable populations of service users. Given that the support provided by leaving care services may represent the last intervention before young people disappear from the system’s view, this is particularly significant in supporting them to develop agency and self-determination to take them through the often compressed and accelerated journeys that characterise adolescence for this group.

Made available in DSpace on 2016-08-10T10:50:08Z (GMT). No. of bitstreams: 1 ELIANE ALVES DE OLIVEIRA.pdf: 3457090 bytes, checksum: ef177a1c13b542b27266f695a0d3a93a (MD5) Previous issue date: 2014-03-10 / Esta dissertação tem como objetivo avaliar a pós-ocupação do Residencial Buena Vista IV, Goiânia, Goiás, em relação ás condições que o ambiente construído oferece em bens e serviços, equipamentos comunitários e infraestrutura básica. O Residencial foi inaugurado em 2009, localizado na Região Oeste da capital, integrante do Programa de Habitação de Interesse Social (PHIS) para atender as famílias que residiam em assentamentos precários em áreas de risco, áreas públicas, privadas entre outras da cidade. Nesta perspectiva, investiga-se o programa realizado por meio da Secretária Municipal de Habitação (SMHAB) e parceiros, proporcionou um espaço de moradia digna ás famílias beneficiárias do programa, como uma política de inclusão social. Está pesquisa busca analisar o ambiente construído em uma visão mais ampla não apenas do espaço casa/teto , e sim das ruas, do bairro, da cidade. Se houve, porém as condições primordiais para o exercício da participação cidadã, com autonomia e a melhoria da qualidade de vida em relação ao Índice de Bem-Estar Urbano (IBEU), como um instrumento para a avaliação e a formulação de políticas urbanas.

The aim of this thesis was to investigate what an intervention comprising systematic discussion groups meant in the context of conflicts and cooperation between social care staff and nursing staff, over a period of 7–15 months. The intervention was carried out in four experimental dwellings in special types of housing for elderly and disabled people and in comparison with four similar reference dwellings. Results are based on 27 interviews prior to the intervention and 29 after. The interviewees were managers, registered nurses, enrolled nurses and care assistants and concerned their experiences regarding problematic situations that occurred in their everyday work. The questionnaires (before n=84 and after intervention n=93) used were: sense of coherence, job-satisfaction and burnout and were aimed at investigating staff experiences of working climate and the influence of the intervention. The issues were investigated both before and after the intervention. Observations were used to determine whether they could provide further knowledge about the intervention and thus extend our understanding of the marginal differences in the complementary studies. The phenomenological hermeneutic interpretation of the narratives in the interviews shows that the intervention was important to the experiences of being in problematic situations. The results before the intervention and in reference dwellings are equivalent and elucidate staff members' struggle to retain their self-esteem and to be confirmed by their colleagues. The experimental dwellings narratives show a change from rejecting to confirming communication among colleagues. Moreover, subtle changes are present which point to an emotional closeness where attempts have been made to understand colleagues' perspective and reactions where the residents are the central concern in the narratives. An analysis of the content of the interviews after intervention shows equivalent changes in experimental dwellings and reference dwellings. The analysis shows that the staff's view of problematic situations had been softened and that they viewed their colleagues as less of a hindrances. There were no mentions made of the previously indicated conflicts between social and nursing staff. The results also show that staff members are not afraid to stand by their own ideas of how they should act in various situations. The staff experience of the working climate was positive both before and after the intervention and no significant differences could be seen. What stands out from the observation study is that the groups have different cultures and thus different prerequisites for the intervention. In two of four groups the intervention seemed to give rise to positive meanings regarding the staffs´ understanding of each other, necessary for their successful cooperation, but when the groups are in the ”basic assumption phase” other additional strategies are probably also needed. The marginal differences shown in the other complementary studies can be understood in terms of two of the four groups not perceiving the intervention to any large extent. When the internal group processes are of great importance it is essential to pay attention to culture of the staff groups before the intervention is implemented.

The thesis set out in this submission is drawn from six of the candidate’s publications, based in turn on empirical findings from four research studies of adult social care in England spanning the period 1992 2006. As a body of work, it interrogates the validity of Lipsky’s (1980) conclusions about the origins and nature of ‘streetlevel bureaucracy’ in the wake of subsequent welfare restructuring. The earlier studies pay particular attention to the impact of managerialisation on frontline assessment practice amongst adult social work teams following implementation of the 1990 National Health Service and Community Care Act. Later studies tackle a further challenge to Lipsky’s thesis of street-level bureaucracy, that is, the potential for a change in the nature of the exchange relationship between street-level bureaucrat and client in the light of the insertion of service user involvement, empowerment and rights into governance arrangements after 1990, including adult social care. The candidate argues that the ethnomethodological approach adopted in three out of the four studies has yielded rich data on frontline practice of a type screened out by much contemporaneous research on the impact of social care reforms. Taken together with the span of the research studies over some fifteen years, this has supported not only a detailed analysis of the relationship between the micropolitics of assessment practice and key features of the differing environments within which they occur but also their articulation with changing modes of welfare governance. Discourse analysis of interview findings from the remaining study has permitted insights into the way social workers integrate thinking about human and social rights into their everyday assessment practice. The candidate summarises her threefold contribution to the literature in a taxonomy derived from the research findings which serves, firstly, to articulate the relationship between core dimensions of the policy and practice environment and the differing forms of frontline discretion to emerge after 1990; secondly, to explore the impact of user empowerment and rights on the distribution of resources; and, thirdly, to evaluate the continuing relevance of ‘streetlevel’ bureaucracy for understanding frontline social work practice. She concludes by sketching out possible future directions for her work.