No / Carers make a considerable contribution to the health and social care of sick or disabled people, reducing the strain on health and social care systems. This has been recognised through support mechanisms, including (in the UK) a payment for caring (Carer’s Allowance – CA). This article draws upon data from a study of carers receiving CA. Utilising a citizenship perspective, it examines respondents’ perspectives on their role in the UK and shows how CA provides not only financial support but also contributes to normative conceptualisations of citizenship. The data highlight the primacy of paid work in UK citizenship, as well as the stigma associated with receiving welfare benefits. The article concludes by claiming that changes to the UK benefit system need to take into account a ‘recognition’ aspect, reformulating what is considered a worthwhile contribution to society.

Yes / Introduction We examined 3-month service use and costs of care for people with mild-to-moderate dementia in Great Britain. Methods We analyzed Improving the experience of Dementia and Enhancing Active Life cohort study baseline data on paid care, out-of-pocket expenditure, and unpaid care from participants with dementia (N = 1547) and their carers (N = 1283). In regression analyses, we estimated per-group mean costs of diagnostic and sociodemographic subgroups. Results Use of services apart from primary and outpatient hospital care was low. Unpaid care accounted for three-quarters of total costs (mean, £4008 [standard error, £130] per participant). Most participants (87%) received unpaid care equating to 36 hours weekly. Estimated costs for people with Parkinson's dementia were £8609, £4359 for participants with mixed dementia, and £3484 for those with Alzheimer's disease. Total costs were lower for participants with dementia living alone than living with others (£2484 vs. £4360); costs were lower for female than for male participants (£3607 vs. £4272). Discussion Costs varied by dementia subtype, carer status, and living arrangement. Policy makers should recognize the high costs of unpaid care for people with dementia, who do not always get the support that they need or would like to receive. / The first phase of the IDEAL program was funded jointly by the Economic and Social Research Council (ESRC, United Kingdom) and the National Institute for Health Research (NIHR, United Kingdom) through grant ES/L001853/2. “Improving the experience of dementia and enhancing active life: living well with dementia”.

Yes / Objectives: The aim of this national survey was to explore the impact of COVID-19 public health measures on access to social support services and the effects of closures of services on the mental well-being of older people and those affected by dementia. Methods: A UK-wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID-19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well-being. Results: Five hundred and sixty-nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t-tests and X2 -tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID-19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well-being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future. / National Institute for Health Research. Grant Number: ARC NWC. University of Liverpool. Grant Number: COVID‐19 Strategic Research Fund

Yes / The aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training. Cross-sectional survey study. Data collection occurred in 2017. Health and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes. All health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%). Knowledge, attitude and confidence of health and social care staff. Hierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01). The results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence. / NIHR Policy Research Programme (Understanding Effective Dementia Workforce Education and Training: A Formative Evaluation (DeWET Evaluation), PR-R10–0514-12006).

Yes / The drivers of costs of care for people with dementia are not well understood and little is known on the costs of care for those with rarer dementias. To characterise use and costs of paid and unpaid care over time in a cohort of people with dementia living in Britain. To explore the relationship between cohort members’ demographic and clinical characteristics and service costs. Methods: We calculated costs of health and social services, unpaid care, and out-of-pocket expenditure for people with mild-to-moderate dementia participating in three waves of the IDEAL cohort (2014-2018). Latent growth curve modelling investigated associations between participants’ baseline sociodemographic and diagnostic characteristics and mean weekly service costs. Results: Data were available on use of paid and unpaid care by 1537 community-dwelling participants with dementia at Wave 1, 1199 at Wave 2, and 910 at Wave 3. In models of paid service costs, being female was associated with lower baseline costs and living alone was associated with higher baseline costs. Dementia subtype and caregiver status were associated with variations in baseline costs and the rate of change in costs, which was additionally influenced by age. Conclusion: Lewy body and Parkinson's disease dementias were associated with higher service costs at the outset, and Lewy body and frontotemporal dementias with more steeply increasing costs overall, than Alzheimer’s disease. Planners of dementia services should consider the needs of people with these relatively rare dementia subtypes as they may require more resources than people with more prevalent subtypes. / The first phase of the IDEAL program was funded jointly by the Economic and Social Research Council (ESRC, United Kingdom) and the National Institute for Health Research (NIHR, United Kingdom) through grant ES/L001853/2.

Yes / Aim This aim of this scoping review was to undertake a detailed review of the pertinent literature examining strategic workforce planning in the health and social care sectors. The scoping review was tasked to address the following three questions: 1. How is strategic health and social care workforce planning currently undertaken? 2. What models, methods, and tools are available for supporting strategic health and social care workforce planning? 3. What are the most effective methods for strategic health and social care workforce planning? Methods The scoping review utilised the five-stage scoping review framework proposed by Arksey and O’Malley (2005). This includes identifying the research question; identifying relevant studies; study selection; charting the data and collating, summarizing, and reporting the results. The search included a range of databases and key search terms included “workforce” OR “human resource*” OR “personnel” OR “staff*”. Relevant documents were selected through initially screening titles and s, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and screening, 654 were identified as potentially relevant. Screening of full texts resulted in 115 items of literature being included in the synthesis. Both national and international literature covers strategic workforce planning, with all continents represented, but with a preponderance from high income nations. The emphasis in the literature is mainly on the healthcare workforce, with few items on social care. Medical and dental workforces are the predominate groups covered in the literature, although nursing and midwifery are also discussed. Other health and social care workers are less represented. A variety of categories of workforce planning methods are noted in the literature that range from determining the workforce using supply and demand, practitioner to population ratios, needs based approach, the utilisation of methods such as horizon scanning, modelling, and scenario planning, together with mathematical and statistical modelling. Several of the articles and websites include specific workforce planning models that are nationally and internationally recognised, e.g., the workload indicators of staffing needs (WISN), Star model and the Six Step Methodology. These models provide a series of steps to help with workforce planning and tend to take a more strategic view of the process. Some of the literature considers patient safety and quality in relation to safe staffing numbers and patient acuity. The health and social care policies reviewed include broad actions to address workforce planning, staff shortages or future service developments and advocate a mixture of developing new roles, different ways of working, flexibility, greater integrated working and enhanced used of digital technology. However, the policies generally do not include workforce models or guidance about how to achieve these measures. Overall, there is an absence in the literature of studies that evaluate what are the most effective methods for strategic health and social care planning. Recommendations The literature suggests the need for the implementation of a strategic approach to workforce planning, utilising a needs-based approach, including horizon scanning and scenarios. This could involve adoption of a recognised workforce planning model that incorporates the strategic elements required for workforce planning and a ‘one workforce’ approach across health and social care.

Social care and health services for older people in Cambridgeshire have been integrated since April 2004. This study examines the effect of the integration programme on service users. Previous research into health and social care integrations predominantly centre on process issues and pay much less attention to outcomes. No study has evaluated the impact of fully-integrated care services for the whole user group of older people. Theory-led programmatic approach was used in this study. Multi-method data collection and analysis were employed to uncover and examine the causal links, the contextual conditions, the implementation process, causal mechanisms, and intended and achieved outcomes of the integration programme. This study reveals an improvement in the physical functioning of one in three occupational equipment users; a rise in the level of satisfaction of 85% of occupational health and 82% of physiotherapy users; older people with complex problems and high-level needs were able to be helped to live at home; and waiting time for both assessment and for services within two weeks and four weeks were below the national achievement and the ministerial targets. It also reveals a lack of change outcomes in social care, and service users’ low level of satisfaction with social care services, which appear to be associated with the privatisation of long-term social care and the predominant aim in social work of achieving maintenance and prevention outcomes. The integration programme’s goals—unifying the care system, easier and simpler access to services and a single and quick assessment—were not fully reached, mainly because of users’ low awareness of the integration, incompatible ICT systems and lack of funding. This study contributes to knowledge on how the total integration in Cambridgeshire has benefited users and how theory-led programmatic approach can be used in this area and in the study of this kind of complex social programme.

This study is going to focus on professional bias of pedagogical staff and social services workers in facilities with disadvantaged clients, particularly those with mental handicap. Such bias can limit work efforts of workers, and thus effect quality of life of disadvantaged clients. The research gathers and describes general knowledge of bias and its influence on men's life. The study mentions chosen professional bias of workers, documents it and compares degree of its influence on behaviour and approach to clients of both pedagogical staff and social services workers. The research attempts to search for connection between workers' biased behaviour and their education. Last of all, the study aims to search for suggestions and possible solutions of given situations that may be beneficial to quality of life of disadvantaged clients.

Made available in DSpace on 2016-04-29T14:17:56Z (GMT). No. of bitstreams: 1 Solange Silva dos Santos Fidelis.pdf: 19440012 bytes, checksum: 96f027392e08f7ae6a632ddb2ad28e57 (MD5) Previous issue date: 2009-10-09 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This research aimed to understand how it has developed the process of implementation and deployment of CRAS in western Parana, considering the political administrative division of the State, the SETP by the Regional Office of Cascavel. First constructed a table with the profile of the municipalities that make up the coverage area of the ER in Cascavel, and from the data listed was established methodological procedures with clipping by intentional sampling by setting 7 of a total of 34 municipalities. It involved 10 professionals working in CRAS, 4 professionals in the management of municipal social care policy and 1 professional as the representative of the State Authorities in the region. In the data collection technique was used semi-structured interview in order to enable the construction of the profile of CRAS: conditions of physical infrastructure and human; the actions taken and the conditions that have been carried; conception of persons involved directly with the public social care as the SUAS and the CRAS; the relationship of CRAS and social care network in this context, considering also the conditions for the development of social care policy. It was then possible to view the progress made after initiating the deployment of SUAS, the limitations in that process and the challenges to the achievement of the advocates that the National Policy for Social Care/SUAS. It was possible from direct contact with the subjects, systematize and is currently regarded as the SUAS towns in the region, considering the different realities set in PNAS/SUAS at the rate of population municipalities, large and small porte I, and level of full and basic management. Considering the variety of realities and different degrees of development of social care policy, the research presented common issues, among which stands out: the lack of full team of human resources, physical structure and equipment inadequate; the vulnerable identity of CRAS, an issue exacerbated as installed in the same structure as previously established services, absence of social diagnosis to support interventions; wide emergency demand assuming seconded volume of actions taken hindering the advancement of social-educational work, and allocations of CRAS finally settled, especially as regards the relationship with the social care network in the territory. Finally, this work contributes to trigger the debate about the actual conditions for the deployment of CRAS as an innovative and essential proposal to the success of SUAS, which represents a breakthrough for social care policy / Essa pesquisa teve como objetivo conhecer de que forma tem se desenvolvido o processo de implementação e implantação dos CRAS na região oeste do Paraná, considerando a delimitação político administrativa do Estado, pela SETP através do Escritório Regional de Cascavel. Inicialmente construiu-se um quadro com o perfil dos municípios que compõem a área de abrangência do ER de Cascavel, e a partir dos dados elencados estabeleceu-se os procedimentos metodológicos com recorte por amostragem intencional, definindo 7 de um total de 34 municípios. Foram entrevistados 10 profissionais que atuam nos CRAS, 4 profissionais da área de gestão da política de assistência municipal e 1 profissional da SETP enquanto representante do órgão gestor do Estado na região. Na coleta de dados foi utilizada a técnica de entrevista semi-estruturada, de forma a possibilitar a construção do perfil dos CRAS; as condições de estrutura física e humana; as ações desenvolvidas e as condições em que têm sido realizadas; a concepção dos sujeitos envolvidos diretamente com a assistência social pública quanto ao SUAS e ao CRAS; a relação entre CRAS e a rede socioassistencial; nesse contexto, considerando também as condições de desenvolvimento da política de assistência social. A partir daí foi possível visualizar os avanços alcançados depois de iniciada a implantação do SUAS, as limitações encontradas nesse processo e os desafios a fim de que se alcance o que preconiza a Política Nacional de Assistência Social/SUAS. Foi possível a partir do contato direto com os sujeitos da pesquisa, sistematizar como está se constituindo o SUAS nos municípios da região, considerando as distintas realidades estabelecidas na PNAS/SUAS, pelo índice populacional dos municípios, em grande porte e pequeno porte I, e os níveis de gestão plena e básica. Diante da variedade de realidades locais e de graus distintos de desenvolvimento da política de assistência social, a pesquisa permitiu identificar alguns problemas comuns, entre os quais, destacam-se: a falta de equipe completa de recursos humanos; a inadequada estrutura física e de equipamentos inadequadas; a fragilizada ou por se constituir - identidade do CRAS, questão agravada quando instalado na mesma estrutura que serviços anteriormente estabelecidos; ausência de diagnóstico social para dar suporte às intervenções; ampla demanda emergencial assumindo destacado volume das ações realizadas e dificultando o avanço do trabalho socioeducativo; as atribuições do CRAS por se estabelecerem, principalmente no que se refere à relação com a rede socioassistencial no território. Por fim, essa dissertação vem contribuir para desencadear o debate acerca das condições concretas de implantação dos CRAS, enquanto proposta inovadora e essencial para o sucesso do SUAS, que representa um grande avanço para a política de assistência social

Social care services in a certain region are highly affected by the demographic development. To evaluate the demand for social care services, the population, age structure, life expectancy, natality and mortality should be considered. There are 1691 inhabitants living in Vlachovo Březí as at 31 December 2008. Most social care services for the town residents are provided by other municipalities of the Prachatice district. The thesis was aimed at document analysis and a subsequent statistical procedure which, together with future demographic development, formed a basis for the prognosis of the demand for social care services in Vlachovo Březí at the age groups 0-7, 15-18 and 65+ years during the 2010-2020 period. The other goal was to find out the use of social care allowances by beneficiaries and financial costs of the allowances for 65+ age group in Vlachovo Březí. Based on the prognosis for single age groups and the evaluation of the current social services, the findings are as follows: As an early years child care service (0-7 years) does not exist in the district, a necessity of setting up such a facility, which will serve this age group in the district centre (Prachatice), can be expected. Social care services for the age group between 15-18 years are currently insufficient so to build a low-treshold facility should become a priority. The age group 65+ is supposed to grow. A senior home has not been established in Vlachovo Březí and the surroundings. There is a possible way in setting up a nursing home with a simultaneous enhancement of community care services. In addition, the research helped us discover the fact that expenses on the social care allowances are not spent effectively and financial costs of them will increase 1.5 times in the next 10 years. The future revaluation of a current system of the allowance payment or a dependancy rate of the beneficiaries seems to be necessary. There are 1184 beneficiaries in the Prachatice municipality with extended competence as at 31 December 2009. This thesis can serve as a draft plan of social care services in the region. It can also be helpful in further research into this topic and the dissemination of the research findings.