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Purpose: This paper aims to outline the initial pilot use of the client complexity matrix (CCM), an outcome measure developed for an NHS Adult Intellectual Disabilities Intensive Support Team (IST) in the West Midlands of England. Design/methodology/approach: A mixed method approach was used to report the results and evaluate the use of the CCM within this IST. The CCM was trialled for six months between January 2022 and June 2022. CCM scores pre and post IST intervention were analysed via t-test, and qualitative feedback from clinicians is detailed. Findings: Analysis suggests the CCM captures service success showing a significant decrease in complexity and risk post-intervention. Qualitative comments from clinicians were generally positive; however, there were requested changes regarding specific presentations, use of labels/language and for a digital version. Research limitations/implications: The tool is not co-constructed with the client. Because of this IST's caseload, the sample size was small. Only one clinician was asked to complete the CCM pre and post intervention. Future use of the measure will encourage two clinicians to complete the measure to evidence its inter-rater reliability. Each client's specific presentation was not explicitly analysed here. Practical implications: The CCM will be updated using the feedback from clinicians and from the peer review process. Research that examines the generalisability of this measure to other IST services would be beneficial. Originality/value: The CCM appears to fill a gap in outcome measurements for this IST service which looks at breadth and depth of client complexity and risk. [ABSTRACT FROM AUTHOR]

Purpose: Allied Health Professionals (AHPs) are the third largest professional group in the National Health Service (NHS). This qualitative study aimed to establish the representation of AHPs at NHS Trust board level. Design/methodology/approach: Examination of public Trust board minutes and Care Quality Commission (CQC) reports from a sample of NHS provider Trusts in the West Midlands. One reviewer extracted data concerning all details pertaining to professional staffing groups. Findings: A stark picture of under-representation which is statistically significant emerges. AHP representation to Trust boards via public board meetings was 7% for AHPs, compared to 41% for doctors and 52% for nurses. There were similar results with CQC reports, with the representation of AHPs at 11%, whilst doctors and nurses were significantly higher at 42 and 47%, respectively. Research limitations/implications: The data gathered for this paper was from a small number of NHS provider Trusts in the West Midlands of England, which can be considered a limitation of the study. However, the results of this study are stark and provide a compelling snapshot of the significant under-representation of AHPs to those NHS Trust boards included. Practical implications: AHPs are a significant staff group within the NHS; their representation at board level is of benefit to the Trust boards both in terms of engaging with staff and in terms of managing quality and risk. Recommendations are made that Trust boards ensure they have a board member with responsibility for AHPs who actively engages with, understands and provides challenge, and that the CQC considers the inclusion of examples of AHP activity and staffing levels in their inspection, and that these are confirmed with senior AHPs in the organisation being inspected. Originality/value: This is an original paper and is the first to address the representation of AHPs at Trust board via consideration of board papers and CQC reports, providing a platform for further consideration. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present the views of people living with dementia in extra care housing (ECH). This is a model of housing with care and support aiming to support older people, including those with dementia, to live independently. Previous research identifies benefits but is predominantly derived from third-party accounts, with the voices of those living with dementia in ECH significantly absent. Design/methodology/approach: This study adopted a qualitative approach conducting 100 interviews across 8 ECH schemes in England. Over half of the interviews were conducted with people living with dementia and their families with the remainder involving staff and commissioners. Findings: Findings suggest there are a range of benefits including owning your own home, having a safe, age friendly location with flexible support, social interaction and continuing to live as a couple. Challenges included availability of staff, flexible resourcing, loneliness and the advancing symptoms of dementia. Research limitations/implications: Despite efforts to create an inclusive, diverse sample, the participants were all White British. Participants involved were identified by gatekeepers, which may present some bias in the selection. Practical implications: Whilst ECH offers benefits to people living with dementia, addressing the challenges is essential for effective dementia care. Improving staff training, promoting person-centred care and fostering an inclusive community are critical for enhancing residents' well-being and quality of life. Originality/value: This paper explored the lived experiences of residents and family members, providing new insight into the advantages and disadvantages of ECH for people living with dementia. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs. Design/methodology/approach: Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014. Findings: Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR. Research limitations/implications: The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues. Practical implications: Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks. Originality/value: This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs. [ABSTRACT FROM AUTHOR]

Purpose: Greener on the Outside for Prisons (GOOP) is a therapeutic horticulture programme targeting the high levels of complex health and social care needs in prisons in England. The COVID-19 pandemic and resulting lockdowns led to unprecedented disruption in prisons in England. This paper examines the experiences of prisoners both during and post-lockdowns in four prisons, to understand the effects of participation in GOOP on health and wellbeing after the disruption of restrictions, and identify implications for developing this programme further. Design/methodology/approach: The paper is based on original qualitative data gathered from in-depth narrative-based interviews and focus groups with prisoners and staff in four English prisons. Audio data was transcribed and subject to a thematic analysis, drawing from a realist-informed lens. Findings: Thematic analysis revealed five key themes: reimagining the GOOP context; increasing empathy between participants; building sense of coherence; reconnecting with nature and a joined-up connection with provider services. The main arguments centre on horticulture in prisons remaining under-utilised as a means of promoting good health and wellbeing, although there is enthusiasm from staff to provide green spaces for the most vulnerable prisoners and develop a range of mechanisms to connect people in prison with nature. Originality/value: This paper focuses on new knowledge arising from an unprecedented situation in English prisons, from key stakeholders on the frontline of garden activities. Accounts demonstrate the extent of the health and wellbeing benefits of participation in such activities in this challenging environment, which has implications for practice for prisons more widely. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges. Design/methodology/approach: This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study. Findings: Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people's mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the "surreal" experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement. Practical implications: The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language. Originality/value: As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine how faculty staff on health and social care programmes support students with mental health issues. Design/methodology/approach: The study used a qualitative survey design to gain in-depth information on faculty staff experiences. Seventy-one faculty staff at two universities in the South East of England out of an eligible population of 115 staff responded to an anonymous online questionnaire which were thematically analysed. Findings: The findings indicated that faculty staff faced uncertainties in providing support to students with mental health needs. They reported tensions between their academic, professional and pastoral roles. There was a wide recognition that supporting students was physically and emotionally demanding for faculty staff and especially challenging when their roles and expectations were unclear. This was compounded by lack of explicit guidelines and an apparent severed connection between faculty staff and student support services. Practical implications: A need for clearly defined roles and responsibilities for faculty staff in supporting students with mental health needs including a review of their pastoral role were identified. The study reinforces the need for effective collaborative arrangements and collective decision making and clearer procedures in the planning and implementation of students' personal support plans. A concerted effort into adopting a transpersonal approach which incorporates mental health staff awareness training, restorative spaces for reflection and supportive pathways for faculty staff are recommended. Originality/value: This paper provides rare empirical evidence of faculty staff views on their role in supporting students with mental health needs on health and social care programmes. [ABSTRACT FROM AUTHOR]

Purpose: Suicide and suicide-related incidents have increased within women's prisons in the UK. This paper aims to synthesise the findings of qualitative literature, to gain a deeper understanding of the how women and staff in English prisons experience and explain the causes of their suicidal behaviours. Design/methodology/approach: A systematic search of five electronic databases, namely, MEDLINE, APA Psychological Information Database (Psycinfo), Cumulative Index to Nursing and Allied Health Literature (with full text – CINAHL), Psychology and Behavioural Sciences Collection and APA PsycArticles, was completed in January 2023. This study's search strategy returned 1,714 articles, 7 of which were included for review. To identify relevant themes within the data, Thomas and Harden's (2008) framework was applied. Quality appraisal was conducted by using Joanna Briggs' Institute Checklist for Qualitative Research (Joanna Briggs Institute, 2021). Findings: Four themes were determined, which describe the causes of suicidal behaviours in women's prisons in England; mental health and trauma, lack of support from services and staff, contact with family and self-harm as a coping strategy. Important sub-themes were also identified including the prison environment and poor relationships with staff. Practical implications: Further qualitative research is needed, however, the findings suggest greater support is required to aid positive mental health, including the provision of trauma informed coping strategies and improved staff training. Originality/value: To the best of the authors knowledge, this is the first systematic review conducted on the factors contributing to women's suicide in English prisons using qualitative literature. [ABSTRACT FROM AUTHOR]

Purpose: This paper discusses how professionally qualified cisgender lesbian, gay, bisexual or queer (LGBQ) women youth workers present their self. The research examined how youth workers consciously or unconsciously shared their sexual identity with young people with whom they worked. Whilst this research focussed on youth workers, issues discussed are relevant for practitioners from a range of professional backgrounds such as therapists, social workers, teachers and health care practitioners. The research focused only on the experiences of cisgender LGBQ women as the experiences of men and trans women are different and so requires separate research. Design/methodology/approach: This research taking a qualitative approach, used in-depth interviews to discuss how respondents shared information about their identity. Findings: Some of fifteen youth workers interviewed reported not having choices about being out with the young people as their sexuality had been leaked. Others were able to pass and so choose when, or if, to be out with young people. Their different strategies to sharing information regarding their sexuality used by these participants reflected different approaches to being out. Originality/value: Although there is evidence in the literature of how being out or closeted impacts on teachers there is little written about the effect on youth workers or other professionals. The little research that has been undertaken in this area focusses on the impact of identity on the clients rather than on the professionals. This article contributes to filling this gap in the literature. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present findings from a mixed-methods study on the impact that COVID-19 has had on adult safeguarding. The research sought to explore the challenges and opportunities presented by COVID-19 to both frontline and non-frontline professionals working in adult safeguarding. Design/methodology/approach: A mixed-methods project was undertaken comprising a literature review, survey, semi-structured interviews and a small number of freedom of information requests. This paper presents the findings predominantly from the survey and interviews. Findings: Unsurprisingly, COVID-19 has presented a variety of challenges for professionals working in adult safeguarding. The themes that occurred most often were the day-to-day changes and challenges, relationships across sectors, information and navigating the ethical questions in safeguarding. Originality/value: To the best of the authors' knowledge, the findings represent the first focused qualitative mixed-method study aimed at understanding more about the impact the pandemic has had on adult safeguarding through the eyes of those professionals working in that field. [ABSTRACT FROM AUTHOR]

Purpose: With the growth of entrepreneurship education adoption in higher education institutions (HEIs), the importance of assessments as a tool to gauge and enhance learning is of utmost importance. The purpose of this paper is to examine the influence and appropriateness of current assessment methods for engineering and technology students in Nigerian and British HEIs. Design/methodology/approach: The study employs a qualitative research method with a case study approach to investigate the impact and suitability of assessment methods currently used within entrepreneurship education in Nigeria and England. Findings: The results reveal that lecturers across both countries believed that assessment methods currently in use were appropriate, but were not uniform in its influence on learning. However, students were unanimous in that most assessment methods currently used were not effective at enhancing their learning, not very appropriate, and were not a good judge of their work and effort. The results were used in building a framework to understand the importance of assessment methods in entrepreneurship education. Originality/value: In light of the inadequate literature, this paper covers an acute gap in the field. This will allow policymakers and different interested parties to reassess the development of suitable assessment methods to involve students as key stakeholders. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the influence of research evaluation policies and their interpretation on academics’ writing practices in three different higher education institutions and across three different disciplines. Specifically, the paper discusses how England’s national research excellence framework (REF) and institutional responses to it shape the decisions academics make about their writing.Design/methodology/approach In total, 49 academics at three English universities were interviewed. The academics were from one Science, Technology, Engineering and Mathematics discipline (mathematics), one humanities discipline (history) and one applied discipline (marketing). Repeated semi-structured interviews focussed on different aspects of academics’ writing practices. Heads of departments and administrative staff were also interviewed. Data were coded using the qualitative data analysis software, ATLAS.ti.Findings Academics’ ability to succeed in their career was closely tied to their ability to meet quantitative and qualitative targets driven by research evaluation systems, but these were predicated on an unrealistic understanding of knowledge creation. Research evaluation systems limited the epistemic choices available to academics, partly because they pushed academics’ writing towards genres and publication venues that conflicted with disciplinary traditions and partly because they were evenly distributed across institutions and age groups.Originality/value This work fills a gap in the literature by offering empirical and qualitative findings on the effects of research evaluation systems in context. It is also one of the only papers to focus on the ways in which individuals’ academic writing practices in particular are shaped by such systems. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to outline qualitative research into what influences, maintains and reduces prolific self-harm within women's prisons across England. Design/methodology/approach: Semi-structured interviews were conducted with participants who were identified as engaging in prolific self-harm. Thematic analysis was applied to two data sets, and analyses were combined to generate final themes. Findings: Six overarching themes were identified which served to explain what influences the repetitive nature of prolific self-harm and also what helps to reduce it. The themes were reasons for self-harm, trauma, being in prison, support, other support and interventions: management and rehabilitative. Research limitations/implications: Owing to the sensitive nature of the research a stringent exclusion criteria was applied which limited the data sample from the original pool. Variance in detail was observed from the interviewer transcripts. The data sample was not large enough to examine the influence of protected characteristics. Practical implications: Responsivity in the support offered by staff is critical to a reduction in repetitive harm. A re-focus on staff training, plus support mechanisms for staff supporting people in women's prisons who self-harm prolifically has been recommended. Originality/value: This paper has focussed specifically on prolific self-harm within women's prisons. This has not been an area that has been investigated separately to the general self-harm literature in prisons. This paper provides insight into factors which influence, maintain and reduce prolific-self harm in women residing in prison. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters. Design/methodology/approach: A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software. Findings: BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed. Originality/value: Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system. [ABSTRACT FROM AUTHOR]

Purpose: During the COVID-19 outbreak, clinical schools across the UK were forced to switch their learning from face-to-face to online platforms. This paper aims to describe the experiences of psychiatry teachers and medical students at Cambridge University of the online psychiatry case-based tutorials during the COVID-19 outbreak and the lessons learned from this implementation. Design/methodology/approach: The authors conducted qualitative focus groups with students followed by in-depth individual interviews with students and teachers. Findings: In a data-led systematic text condensation analysis, this study found seven themes: the COVID-19 context, the structure of the course, teachers' educational ethos, beyond the (teaching) script, possibilities for learning or teaching reflective practice, attitudes to online learning and suggestions for future development. The authors then applied the normalisation process theory (NPT) as the theoretical frame of reference. This model has previously been applied to the implementation of telemedicine in psychiatry, to understand how new technology can become embedded in clinical care. Originality/value: This study's results show how the NPT model can be modified to support the delivery of medical education online, including reflective learning and practice as an iterative process at every stage of the implementation and delivery of the teaching. [ABSTRACT FROM AUTHOR]

Purpose: Amongst other actions the Care Act 2014 emphasised the duties of local authorities (LA) to assess the needs of carers, as well as those they care for and to meet all eligible needs for support. This paper aims to report the findings of a study which explored the experiences of older carers of people with learning disabilities as they navigated LA assessment processes and personnel. Design/methodology/approach: Using an explorative design, 21 older carers were interviewed about their experiences. Interview transcripts were qualitatively analysed. Findings: Three main themes were identified, namely, needs assessments as ambitions, not outcomes; the effects of funding-cuts projected onto carers; and challenges with social care personnel. Originality/value: The study findings attracted a high level of engagement with public awareness and mainstream news and social media. The LA also immediately responded with interventions to address some of the findings, including carer "drop-in" sessions. They are also adapting their carer's needs assessment processes as a result of the study. It is hoped that the issues raised will be of interest to other social care providers and practitioners. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present an analysis of a "county lines" safeguarding partnership in a large city region of England. A critical analysis of current literature and practice responses to "county lines" is followed by the presentation of an analytical framework that draws on three contextual and social theories of (child) harm. This framework is applied to the partnership work to ask: are the interconnected conditions of criminal exploitation of children via "county lines" understood?; do interventions target the contexts of harm?; and is social and institutional harm acknowledged and addressed? Design/methodology/approach: The analytical framework is applied to a data set collected by the author throughout a two-year study of the "county lines" partnership. Qualitative data collected by the author and quantitative data published by the partnership are coded and thematically analysed in NVivo against the analytic framework. Findings: Critical tensions are surfaced in the praxis of multi-agency, child welfare responses to "county lines" affected young people. Generalising these findings to the child welfare sector at large, it is proposed that the contextual dynamics of child harm via "county lines" must be understood in a broader sense, including how multi-agency child welfare practices contribute to the harm experienced by young people. Originality/value: There are limited peer-reviewed analyses of child welfare responses to "county lines". This paper contributes to that limited scholarship, extending the analysis by adopting a critical analytic framework to a regional county lines partnership at the juncture of future national, child welfare responses to "county lines". [ABSTRACT FROM AUTHOR]

Purpose — This paper seeks to report selective findings of a wider study to identify the mechanisms that end users employ to overcome their information seeking failure on the web. Design/methodology/approach — Data collection was conducted by semi-structured and in-depth interviews. The study adopted a qualitative approach and was carried out based on grounded theory. The biology community at the University of Sheffield was selected as the research population. Findings — Identified coping strategies are divided into active and passive categories. Active strategies such as revising and help-seeking require further actions to obtain more satisfactory results. In contrast, passive strategies entail less action to modify the situation and mainly relate to accepting the existing circumstances. Web users prioritise their coping strategies according to the importance of the search topic and their determination to fulfill the search successfully. They develop coping strategies through training courses, using trial and error, knowledge sharing and employing pre-web coping strategies. Research limitations/implications — This study was limited to a small group of web users in academia that cannot be easily considered as an acceptable representative of the heterogeneous population of web users. Moreover, the collected data was based on web users' perception of their search failure rather than an objective measure of it. Originality/value — Most studies in this area are concerned with users' information seeking behaviour and focus on how people find what they want. However, this paper addresses an aspect of this process that has received little attention up to now. The paper explores users' reaction to, and conceptualisation of, information seeking failure and their coping strategies to overcome the failure in web searching. The findings provide us with a better understanding of users' information seeking behaviour on the web. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to illustrate the hostility many young women who are also mothers experience within their everyday lives.Design/methodology/approach The paper will draw on qualitative research, incorporating a narrative approach, to illustrate the hostility many young mothers experience on a daily basis. The research design included a focus group, semi-structure interviews and participant observations.Findings The paper reports the findings of a study that explored the experiences of young women who are also mothers. The author presents the findings that indicate that many young women, who are also young mothers, experience hostile reactions and interactions as part of their everyday lives.Research limitations/implications The small sample size means that this study cannot be generalised, but it does contribute to the growing body of qualitative evidence in relation to young mothers.Practical implications The findings suggest that there needs to be more recognition and acknowledgement of the hostility young women experience. Such hostility could have deleterious consequences on the young women, their parenting ability and also on the children.Originality/value This paper documents the experiences of young women who are also mothers and how they experience hostility as a daily occurrence. The hostility ranged from verbal to non-verbal and how they felt they were being treated, inferences about their sexuality to stereotyping. [ABSTRACT FROM AUTHOR]

Purpose - Service users very often interpret and respond to their experiences of death, dying and bereavement through a religious or spiritual lens. However, recent trends in religion and belief have influenced how professionals respond to indicators such as faith. Since the post-war years in Britain and due to the transfer of services from church to state, as well as the change in the religious landscape, language has largely secularized. When people start addressing religion and belief again, they lack the appropriate literacy to do so, this is termed religious literacy by Dinham (2015). The purpose of this paper is to explore how professionals in end of life (EOL) care respond to service user's religious and spiritual indicators, through the lens of religious literacy. Design/methodology/approach - The paper draws from an ethnographic study undertaken across hospices in England, UK. In this study, healthcare professionals (HCPs) were observed for one calendar year. Findings - Results show that lack of religious literacy on the part of HCPs may lead to subtle and unintentional microaggression. Three types of indications of microinvalidation have been noted: verbal, non-verbal and environmental. Originality/value - This paper innovates in offering a first-hand phenomenological interpretation of observations in the field. The research data capture visually the impact of lack of religious literacy, an achievement which adds to the dialogue about service user rights in EOL care. [ABSTRACT FROM AUTHOR]

Purpose: The article aims to argue that the concept of "distributed leadership" lacks the specificity required to allow a full understanding of how change happens. The authors therefore utilise the "Strategic Action Field Framework" (SAF) (Moulton and Sandfort, 2017) as a more sensitive framework for understanding leadership in complex systems. The authors use the New Care Models (Vanguard) Programme as an exemplar.Design/methodology/approach: Using the SAF framework, the authors explored factors affecting whether and how local Vanguard initiatives were implemented in response to national policy, using a qualitative case study approach. The authors apply this to data from the focus groups and interviews with a variety of respondents in six case study sites, covering different Vanguard types between October 2018 and July 2019.Findings: While literature already acknowledges that leadership is not simply about individual leaders, but about leading together, this paper emphasises that a further interdependence exists between leaders and their organisational/system context. This requires actors to use their skills and knowledge within the fixed and changing attributes of their local context, to perform the roles (boundary spanning, interpretation and mobilisation) necessary to allow the practical implementation of complex change across a healthcare setting.Originality/value: The SAF framework was a useful framework within which to interrogate the data, but the authors found that the category of "social skills" required further elucidation. By recognising the importance of an intersection between position, personal characteristics/behaviours, fixed personal attributes and local context, the work is novel. [ABSTRACT FROM AUTHOR]

Purpose: This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care. Design/methodology/approach: Data were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically. Findings: The integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently. Research limitations/implications: The study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews. Practical implications: The study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing. Originality/value: This paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe and discuss both the early implementation of a US mental health intervention for young children in the context of its introduction to a pilot site in a London borough and the progress made in establishing a randomised controlled trial (RCT). Design/methodology/approach: This paper describes an evaluation of a new intervention and the learning that followed in terms of its implementation and future evaluation. Qualitative data were collected from a range of stakeholders and practitioners through interviews and small group discussions. These interviews focussed on both of these issues, with particular reference to the proposal to conduct an RCT. Findings: The findings of this evaluation add to the evidence on how best to support new initiatives that have been introduced from other settings and countries to embed in a receiving site and the optimal timing and feasibility of conducting an RCT. At the end of the feasibility study, which took place within the year of the service being introduced and which was only open to clients for six months of this year the conclusion was that an RCT at that point was neither possible nor desirable. Over the following years, the commitment of the judiciary to examine if there was a way to make an RCT study in respect of this intervention meant that a template was established that may well have broader application. Research limitations/implications: At a time when there is an increasing demand for evidence on effective interventions this paper makes a valuable contribution to the development of RCTs in general and specifically in the family court arena. It also recommends that attention must also be paid to the time, which is needed to implement and establish interventions and then to test them. Practical implications: This paper highlights the need to establish realistic timescales not only around the implementation of initiatives but also for their evaluation. Originality/value: This study breaks new ground in considering implementation challenges in the court and children's services' context. It brings to the fore the important role of the judiciary in approving new processes. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach: An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings: This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications: The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications: This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value: Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the perceptions of key informants on a national support programme for the development of new care models (NCM) in England (2015/2016–2017/2018). It focuses on the perceived facilitators and barriers affecting the development and implementation of the NCM programme and offers some insight into the role of national level support in enabling local integration initiatives. Design/methodology/approach: A set of 29 interviews were carried out with a variety of respondents at the national level (including current and past programme leads, strategic account managers, advisors to the programme and external regulators) between October 2017 and March 2018, and analysed thematically. Findings: A set of facilitative elements of the programme were identified: the development of relationships and alliances, strong local and national leadership, the availability of expert knowledge and skills, and additional funding. Challenges to success included perceived expectations from the national Vanguard programme, oversight and performance monitoring, engagement with regulators, data availability and quality, as well as timetables and timescales. Crucially, the facilitators and challenges were found to interact in dynamic and complex ways, which resulted in significant tensions and ambiguities within the support programme. Research limitations/implications: While the sample was drawn from a range of different senior players and the authors ensured a diverse sample associated with the NCM support programme, it inevitably cannot be complete and there may have been valuable perspectives absent. Originality/value: The paper demonstrates that the analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex interplay among these factors create. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the barriers to accessing mental health support for people experiencing multiple disadvantage along with some potential solutions for attempting to overcome these. It draws on evidence and learning from 12 voluntary sector-led partnerships in England funded by the National Lottery Community Fund's Fulfilling Lives programme. Design/methodology/approach: Qualitative research was undertaken with frontline staff, senior leaders, volunteers, beneficiaries and stakeholders from Fulfilling Lives partnerships. This comprised focus groups (21 participants) and individual face-to-face interviews (41 participants), both of which explored barriers and local solutions to accessing statutory mental health services. Following a thematic analysis of transcripts, research participants and stakeholders were invited to a face-to-face workshop to review and validate emerging findings (34 participants). Findings: People experiencing multiple disadvantage face significant barriers in accessing support for their mental health. These include a complex system that is difficult to navigate, long waiting lists, high eligibility thresholds and models of support that lack flexibility. Fulfilling Lives partnerships have had the funding and the flexibility to trial different approaches. Promising solutions to barriers include the use of navigators, person-centred support and multi-agency networks and training. However, overcoming systemic barriers remains the most difficult challenge. Originality/value: Fulfilling Lives was a rare example of substantial and long-term (eight years) funding to work with people experiencing multiple disadvantage. This provided a unique opportunity to try different approaches and gather learning. The programme evaluation provides insights into the experiences of people facing multiple disadvantage and those who support them and offers evidence-based suggestions for policy and practice. [ABSTRACT FROM AUTHOR]

Purpose: Sustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances. Design/methodology/approach: Documentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically. Findings: The study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress. Research limitations/implications: The findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs. Originality/value: This study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the effectiveness of reablement as an outcome-focussed commissioning model within the English domiciliary care market from the perspective of two private domiciliary care agency (PDCA) managers/owners within one local authority (LA) in the North West of England. Specifically, it focusses on owner/managers' perceived ability to effect change from a dependency to a reablement model within the English domiciliary care market. Design/methodology/approach: Qualitative interviews with two contrasting owners/managers of PDCAs within one LA in the North West of England were carried out. Explorative analysis followed a constructionist grounded theory methodology. Findings: Findings revealed how two main factors interacted to effect change from a dependency model to a reablement model of domiciliary care: internal organisational structure and individual emotional investment of the owners/managers. Additionally, fiscal and external organisational systems impact on these drivers, and are perceived to act as potential barriers to the adoption of a reablement model of domiciliary care by PDCAs. Originality/value: Although based on only two idiographic accounts, the findings shed light on the policy and practice of commissioning models of domiciliary care within England and suggest further studies in this area of practice. [ABSTRACT FROM AUTHOR]

Purpose: Teachers are often the first contact for students with mental health difficulties. They are in an ideal position to identify students who are struggling and frequently support them using different approaches and techniques. The purpose of this paper is to investigate secondary school teachers' experiences of supporting the mental health of their students. Design/methodology/approach: Seven secondary school teachers from state-funded schools in the UK participated in face-to-face semi-structured interviews. Interpretative phenomenological analysis was used to understand and structure the data into themes. Findings: Five superordinate themes emerged from the data analysis: perceived role of teacher, nature of relationship, barriers to helping the child, amount of training and resource, and helplessness and satisfaction. Participants described the lack of training, resource and clarity about their role to be causes of frustration. Internal and environmental factors often influenced participants' feelings of helplessness. Research limitations/implications: The findings from this study cannot be readily generalised to the wider population due to the nature of qualitative interviews. Practical implications: This study has led to a greater understanding of the experiences of teachers within a school setting. It is crucial that mental health training for teachers directly meets their needs and abilities. Originality/value: This paper finds value in recognising the lived experience and difficulties faced by teachers supporting students' mental health problems. A theoretical model is presented based on this analysis that can help inform best practice for schools. [ABSTRACT FROM AUTHOR]

Purpose Managerial quality improvement (QI) in terms of accountability management has become central to healthcare institutions. Yet, managerial QI is largely considered irrelevant by healthcare professionals. In consequence, the implementation of managerial QI implementation is hampered. Knowledge brokering is discussed as a means to foster the implementation of (QI) knowledge in healthcare. Yet, the benefit of knowledge brokering for managerial QI has so far been neglected. Therefore, this research asks how knowledge brokering can support the implementation of managerial QI.Design/methodology/approach This article builds on a single case study approach as a unit of analysis. Qualitative data collection comprises 21 semi-structured interviews at the managerial and clinical levels, 220 h of participant observation and document analysis.Findings This paper identifies three strategies of how brokers implement managerial QI into a hospital by means of knowledge brokering: prioritizing, obscuring and redefining. The strategies help to transform multiple external QI demands into one managerial QI strategy. Yet the strategies also reduce non-managerial perspectives on QI, which generates frustration among healthcare professionals.Practical implications The paper works out the benefits and costs of managerial knowledge brokering. This allows to spell out practical implications for managers, nurses and clinicians who have to deal with managerial QI in healthcare organizations.Originality/value This paper fulfils an identified need to study managerial knowledge brokering practices as a means to implement managerial QI into healthcare organizations. By doing that, the article adds to the body of research on knowledge translation in healthcare. [ABSTRACT FROM AUTHOR]

Purpose Children’s health and life chances are affected by many factors, with parents and schools holding influential roles. Yet relatively little is known about parental engagement in school-based health education and specifically, from the perspectives of health and education professionals. The purpose of this paper is to examine professionals’ perspectives on parental engagement in school-based health education.Design/methodology/approach An exploratory qualitative study was conducted with ten health, education and local authority professionals from a socio-economically deprived area in England. Semi-structured interviews explored the role of professionals within the school health curricula, roles that parents played in school health, and barriers and enablers to parental engagement in school health education.Findings Reported barriers to engagement related to assumptions about parents’ own health behaviours, impacts of funding and inspection regimes, and protected time for health within the school curriculum. Enablers included designated parental support workers based in the school, positive role modelling by other parents, consultation and engagement with parents and a whole school approach to embedding health within the wider curriculum.Practical implications Findings from this study suggest the importance of building meaningful partnerships with parents to complement school health education and improve child health outcomes.Originality/value This paper addresses an important gap in the research on parental engagement in school-based health education from the perspectives of health and education professionals. Effective partnerships with parents are crucial to the success of school health education. [ABSTRACT FROM AUTHOR]

Purpose – The problems experienced by young people when looking for information are significantly under-researched and this paper aims to attempt to expand the fragmented knowledge base. It concentrates on action taken by English high schoolers to meet academic information needs. Design/methodology/approach – The work draws on qualitative data elicited via an online questionnaire administered in October and November 2006. Thirty-five participants contributed data on the problems they had encountered. Findings – Inductive coding of the data revealed that over 20 individual problems were apparent. The most frequently mentioned was an inability to locate the desired information. Some of the other issues related to information use, rather than information-seeking. Research limitations/implications – The project was small scale, with data collected from pupils in only one school. It relied solely on self-reported data and insight into information-seeking problems was gained purely in terms of behaviour to satisfy academic information needs. A future project may consider issues that develop when youngsters are intent on meeting leisure-oriented needs. Practical implications – The findings have implications for the improvement of Web filters and the teaching of information skills, especially with respect to the effective use of search engines and the training of learners in information-seeking methods beyond the use of the Internet. Originality/value – The paper is unusual in exploring information-seeking problems entirely from the perspective of information users. It is envisaged that the research will be of use to academics interested in information behaviour, teachers in secondary schools and information professionals who work with young people. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present a thematic analysis of student nurses' experiences of an innovative collaboration between a mental health Recovery College and a nursing faculty, where Recovery College trainers' expertise in co-production and peer facilitation were foregrounded. The aim of this study is to understand how nursing students experienced being peer facilitators of well-being workshops for fellow students following training with Recovery College trainers. Design/methodology/approach: Thematic analysis of qualitative data from eight semi-structured interviews and a focus group with 15 participants. Findings: The overarching theme that emerged was "The process of being a student Peer Facilitator". Six themes emerged from the data: "What we brought"; "Conceptualisation"; "Adaptation"; "we're giving them the tools"; "What we gained"; and "Development". Practical implications: Mental health nurse educators could forge collaborative relationships with Recovery College colleagues with a broader remit than service users' "lived experience" of mental distress. Student nurses should be given opportunities to be peer facilitators and draw on their lived experience as student nurses as means of addressing their and their peers' mental health. Originality/value: Original findings were that the student experience of being a peer facilitator was different to their other experiences in education and clinical practice. They drew on their lived experience throughout and found that they learned skills to address their well-being through supporting other students to improve theirs. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the extent, range and nature of literature concerning the mental health inpatient care of the young adult population (16-25 years) who have been admitted to adult mental health wards. This paper reports the findings and positions these in the context of the broader nature to adult inpatient care, evaluates the quality of the evidence and identify gaps in the literature.Design/methodology/approach This paper uses an adapted scoping review methodology, allowing for a broad search but utilised established steps that allowed for a structured, rigorous approach to be used. CINAHL, Cochrane Library, MEDLINE, PsycINFO, Google Scholar, plus a secondary hand search were conducted resulting in eight papers, of quantitative, qualitative and mixed methods papers.Findings Findings show admissions follow similar paths as to adults; admission reasons are largely unknown beyond simple descriptors; admission lengths are unknown whilst on adult wards; staff feel confident yet lack resources; young people feel the transition from CAMHS ward to adult ward can be beneficial if done sensitively; young people have positive experiences of adult wards, including factors that may not be present on CAMHS wards, e.g. role modelling by older patients; young people feel scared and vulnerable, including when excluded from decision making; however, involving young people can cause stress and be confusing if not done sensitively.Research limitations/implications The scoping review identified a limited amount of research evidence for the care of young people admitted to adult wards. The research methods used in these papers were varied and none was of a high-quality standard. All studies contained methodological gaps which detract significantly from their findings and conclusions. The studies go some way to fill the gaps in knowledge and evidence base for this group, although in doing this scoping review was to unearth more gaps in knowledge.Originality/value This scoping review collates findings from the literature regarding young people’s admissions to adult mental health wards. This sensitive and controversial area of mental health care is shown to be lacking in high-quality research. Young people are being admitted to adult wards in increasing numbers year on year in the UK, yet little research has been conducted to identify when and where treatment has been appropriate. This review provides a start to understanding what is known about admission and treatment for this group and what is not known so that these gaps may be investigated in future research. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the impact of hospital discharge on the wider wellbeing of older people, drawing out implications this can have on mental health.Design/methodology/approach This paper is based on research from the Healthwatch England Special Inquiry into hospital discharge. The paper focuses on the experiences of 1,300 older people, with the majority of the research being undertaken by the local Healthwatch network. The 58 local Healthwatch who submitted evidence on the experiences of older people as part of the inquiry were autonomous in how they were able to carry out the research, with results being analysed through use of a qualitative framework.Findings Older people often felt they were not ready for discharge due to not feeling involved in planning of their discharge, being discharged without the information they need and having difficulties accessing aftercare support. This paper examines the impact these issues can have on the mental health and wellbeing of older people, their carers and specifically patients with dementia both during and after discharge from hospital. Through examination of these issues the discharge process can be viewed from the perspective of the individual, and start to conceptualise where the hospital discharge process could further support older people’s mental health and wellbeing.Research limitations/implications This paper examines these issues in detail through case studies collected regarding older people, and exposes the impact poor discharge can have on physical and mental wellbeing for older patients. The paper presents a number of issues which have implications for policy and practice in both health and social care, and the integration of the two services.Originality/value This is the first Special Inquiry conducted by Healthwatch England in conjunction with the local Healthwatch network and presents a large scale piece of research led by the experiences of older people. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to analyse in detail the findings from 40 serious case reviews (SCRs) involving adults who self-neglect, and to consider the commissioning and reporting of such inquiries in the context of accountability that also involves the Coroner and the Local Government Ombudsman. Design/methodology/approach - This study comprised a cross-case analysis of 32 SCRs, using a four-layer design of the adult and their living context, the team around the adult, the organisations around the team, and the Local Safeguarding Board around the organisations. Findings - Available reports tend towards description of events rather than appraisal of what influenced practice. They highlight the challenges in cases of self-neglect practice, including person-centred approaches, capacity assessment and securing engagement. Familiar themes emerge when the spotlight turns to professional and organisational networks, namely information-sharing, supervision, recording and compliance with procedures and legal rules. Some Local Safeguarding Adults Boards found the process of conducting and then using serious case reviews for service improvement challenging. Research limitations/implications - The cross-case approach to thematic analysis focuses on reports into situations where outcomes of professional and organisational intervention had been disappointing. Nonetheless, the themes derived from this analysis are similar to other research findings on what represents best practice when working with cases involving self-neglect. Practical implications - The paper identifies learning for the effective commissioning and conduct of SCRs, and for service improvement with respect to practice with adults who self-neglect. Originality/value - The paper offers further detailed analysis of a large sample of SCRs that builds the evidence-base for effective practice with adults who self-neglect and for efficient management of process of commissioning and conducting SCRs. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to discuss whether the use of outcome-focused homecare improves the subjective well-being of the familial carers of older people with dementia. It also discusses familial carers’ perception of whether this intervention has improved the well-being of their relative. Design/methodology/approach – This qualitative study followed the familial carers of 20 service users suffering from dementia over a six-month period. Semi-structured interviews were undertaken at three intervals during the six months. The carers were asked to assess their subjective well-being at the start, middle and end of the study. Findings – The key findings were that all 20 familial carers expressed an improvement in their subjective well-being and that of their older family member, who appeared more settled as a result of this model of care. Practical implications – The need to consider the use of outcome-focused care as an intervention strategy for older people living alone in the community. The need to provide supportive environments for the carers of older people with dementia to limit their sense of isolation. The prioritising of outcome-focused care in the most complex and chaotic cases. Originality/value – This study provides an insight into the effectiveness of outcome-focused homecare with older people experiencing dementia as perceived by their familial carers. Previously, research has established that outcome-focused care increased the subjective well-being of non-dementia sufferers. This study dovetails neatly with this in demonstrating the same effect on dementia sufferers as perceived by their familial carers. Additionally, this study also demonstrated that this model of outcome-focused care also improved the subjective well-being of the familial carers themselves. These finding will help practitioners consider the use of this model of homecare as a potential alternative or a delaying strategy to residential care. [ABSTRACT FROM AUTHOR]

Purpose: This paper asks how the introduction of "smart" digital technologies might affect the goals that can be attributed to telecare for older people, by those coordinating its provision. Design/methodology/approach: A total of 29 in-depth, qualitative interviews were conducted with local authorities, housing associations and other organisations coordinating smart telecare provision, as well as telecare manufacturers and suppliers. Interviews were analysed by using qualitative thematic analysis. Findings: The analysis reveals discrepancies between the goals and outcomes of smart telecare provision, according to those coordinating service delivery. This study concludes that the goal for smart telecare to be preventative and cost-efficient may be complicated by various organisational and operational challenges associated with coordinating provision. Originality/value: New, "smart" telecare technology for older people stands apart from earlier, user-activated or automatic devices. It may have distinct and under-researched organisational and ethical implications. [ABSTRACT FROM AUTHOR]

Purpose: As part of their inspection of care homes in England, the statutory inspector (the Care Quality Commission [CQC]) makes a judgement on the quality of the home's leadership. Their view is critical as it is intended to inform consumer choice and because the statutory nature of inspection means these views hold considerable authority. The purpose of this paper is to look at the content of a selection of reports and seek to determine what the CQC understands by the concept of "good leadership". Design/methodology/approach: A purposive sample of recent CQC inspection reports was selected and subjected to a qualitative content analysis. Inspections are structured around five main questions. The resulting themes describe areas of focus within the section of reports that feature the question "Are they well-led?". Findings: Inspection reports were found to focus on four main themes: safety and quality of care; day-to-day management of staff; governance and training in the home; and integration and partnership working. In the discussion section, the authors reflect on these themes and suggest that the CQC's view of leadership is rather limited. In particular, while an emphasis is placed within the literature and policy on the importance of leadership in delivering change and quality improvement, little attention is paid to this within the leadership section of inspection reports. Research limitations/implications: The authors' research is based on a small-scale sample of inspection reports; nevertheless, it suggests a number of avenues for further research into the way in which leadership and management capabilities are developed and monitored in the sector. Originality/value: The analysis in this report offers a view of how the inspection regime implements its own guidance and how it assesses leadership. The reports, as public-facing documents, are artefacts of the inspection regime and critical not just as evidence of the practice of inspection but as influence on care home operations and the choices of care home residents and their families. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care. Design/methodology/approach: A qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi's (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC. Findings: This study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working. Originality/value: This study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the "voice of the workforce" as a key enabler to integration developments, only then can IC be a fully collaborative approach. [ABSTRACT FROM AUTHOR]

Purpose: Research has shown that informal carers of people living with dementia (PLWD) can be resilient in the face of caregiving challenges. However, little is known about resilience across different kinship ties. This study aims to update and build on our previous work, using an ecological resilience framework to identify and explore the factors that facilitate or hinder resilience across spousal and adult daughter carers of PLWD. Design/methodology/approach: This study conducted in-depth qualitative interviews with a purposive sample of 13 carers from North West England and analysed the data using a constructivist grounded theory approach (Charmaz, 2003). Findings: Adult daughters were motivated to care out of reciprocity, whereas spouses were motivated to care out of marital duty. Spouses had a more positive and accepting attitude towards caregiving and were better able to maintain continuity, which facilitated their resilience. Research limitations/implications: Resilience emerged on multiple levels and depended on the type of kinship tie, which supports an ecological approach to resilience. The implications of these findings are discussed. Originality/value: This paper makes a novel contribution to the literature as it uses an in-depth qualitative methodology to compare resilience across spousal and adult daughter carers of PLWD. This study adopts an ecological approach to identify not just individual-level resilience resources but also interactive community- and societal-level resources. [ABSTRACT FROM AUTHOR]

Purpose The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.Design/methodology/approach Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.Findings Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.Research limitations/implications The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.Practical implications The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.Social implications The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.Originality/value This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper was to undertake a review of selected adult safeguarding policy and guidance documentation to establish the level of guidance provided in relation to financial abuse; identify similarities and differences between the guidance given to professionals working in different contexts; and report gaps or inconsistencies in the guidance given. Design/methodology/approach – Qualitative documentary content analysis was undertaken to identify key issues and themes in documents selected from 25 local authorities in England. Findings – Little variation was found in the content of the documents, which were all heavily influenced by "No Secrets" guidance. The victim and perpetrator were largely invisible and there is no reference to the possible medium to long-term impact of abuse on individuals. There is no research evidence underpinning the use of the notion of "significant harm" when used in the context of adults. In addition, there is no means of comparing safeguarding decisions across different local authorities to evaluate consistency of decisions and outcomes. Research limitations/implications – The lack of any mechanisms to compare safeguarding decisions and outcomes across local authority areas is a serious limitation of the way safeguarding works. Also, the failure to address the aftercare and support of victims means they are left to manage the psycho-social consequences. Practical implications – Safeguarding boards should evaluate the outcomes of interventions in a standardised way to enable comparison. They should also do more to ensure the longer-term wellbeing of victims. Social implications – The paper raises awareness of elder financial abuse. Originality/value – This is the only policy review that focuses specifically on financial abuse. [ABSTRACT FROM AUTHOR]

Purpose Policy has identified the need for integrated dementia services for older people. However, the role of the formal cater within an integrated framework of service delivery has not been well articulated in practice. The aim of this paper is to understand the experiences of formal carers working with the context of an integrated dementia service by exploring findings from a research-based evaluation. Design/methodology/approach - The evaluation captured the experiences of formal carers working within the service via observations, semi-structured interviews and focus groups. Findings - Working with an integrated service brings about individual, social and organisational challenges to the role of the formal carer, in terms of: delivering flexibility and responsiveness, providing continuity of care, ensuring cross-organisational working and acquiring skills, knowledge and expertise. Originality/value - To facilitate the successful delivery of integrated care, the emerging role of the formal carer needs to be more clearly articulated and supported within a service context. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to review the impact of design and specification decisions for major works during post-occupancy processes; the routine maintenance and management of school premises. It also seeks to explore the relationship between the main stakeholders and how this impacts decision-making and the post-occupancy operation of school buildings. Design/methodology/approach – In addition to a literature review, qualitative data were also obtained through a focus group; a steering group. The steering group consisted of stakeholders tasked with delivering and managing school premises in the Sussex County. Findings – The findings contribute to understanding the impact of design decisions on post-occupancy processes in schools. A basic model is also presented as a guide for requirements and decision mapping in post-occupancy design decision processes in schools. Research limitations/implications – The study was conducted with the participation of a representative sample of stakeholders. There may be the need to investigate the issues further in a localised context before detailed solutions are proposed. Practical implications – The paper reports findings based on the needs, requirements, and preferences of the stakeholders as well as the opportunities and constraints to improving the quality of design processes which in turn will improve post occupancy processes. Originality/value – The paper highlights the complexity of design decision-making in schools, presents the viewpoint of stakeholders, and proposes a basic model to ensure performance for post-occupancy processes to inform the next stage of the research. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to examine the role of health and wellbeing boards in the context of the Government's reforms introduced by the Health and Social Act 2012 and the fundamental challenges facing the NHS and local government; it also aims to assess evidence from the early experience of shadow boards and considers what factors will most influence their success. Design/methodology/approach – The paper draws on an analysis of the policy literature and on structured telephone interviews with lead representatives of 50 health and wellbeing boards randomly selected from a representative cross section of English local authorities; it also draws on case study material, some of which has been written up for other articles in this Special Issue. Findings – Early experience of the boards in shadow form indicates there is considerable optimism about their prospects to achieve greater success in achieving integrated services but they face formidable challenges arising from a hostile financial climate and unchanged national policy fault lines that have hindered effective integration to date. Poor engagement with providers will limit progress. Five factors that are likely to determine the effectiveness of boards are identified. Their biggest single challenge arises from the role of local government in delivering strong, credible and shared leadership which engages people in transforming local services. Research limitations/implications – Current knowledge is based on the operation of shadow boards at a very early stage in their development and in the context of complex organisational change in which there is major uncertainty about emerging roles of new bodies. Originality/value – There is very little systematic research evidence about the development of health and wellbeing boards other than the work reported in this paper, illustrated by the linked articles which follow it. [ABSTRACT FROM AUTHOR]

Purpose - University College London (UCL) ran a research project over 12 months in 2008-2009, funded by the UK Arts and Humanities Research Council, which examined what the impact of the UK Freedom of Information (FOI) Act 2000 had been on records management services in local government. This paper aims to report on some of the findings of the study, with a focus on the practical records management issues. Design/methodology/approach - The research considered the three perspectives of records managers: institutional FOI; policy managers; and FOI requestors and user communities. Following an extensive literature review, qualitative research methods were used to gather data, specifically semi-structured interviewing of 27 individuals from 19 different institutions in London and the South East of England and with 11 requestors. Findings - The findings reported in this paper focus on records services in local government, in particular their organisational location and status, and aspects of the management of current and non-current records, including those in digital formats. Research limitations/implications - This paper is one of the outputs of a grant-funded project, which documents the results of research in FOI from a records management perspective and makes a contribution to the wider debate about access to information. It attempts to survey user responses, which has been an overlooked aspect of other FOI and records management research. Practical implications - There are some implications for good practice in records management policy and systems and in the location of records functions in local government. Originality/value - Local government is an under-researched field in respect of information management and FOI, when compared with other parts of the public sector, and this is therefore a significant contribution to knowledge in this field. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the extent of their dementia. Dementia was viewed by the care workers primarily as a memory disability. Design/methodology/approach: A short qualitative study of the communication techniques of care workers in England, who had received training in dementia care and some training in the SPECAL® method (Specialised Early Care for Alzheimer's),was conducted through semi-structured interviews. Resulting data were analysed using a constructivist grounded theory approach. Findings: Continued application of the SPECAL techniques appeared to reinforced clients' sense of well-being and produced benefits for care workers' own well-being. Research limitations/implications: This small qualitative study suggests there can be beneficial effects for both clients and the care team when care workers tailor their communication behaviour to the needs of people with dementia. Further research on communication techniques in dementia care is needed and how these benefits might be translated into institutional settings. Originality/value: Few research studies have been made of the SPECAL dementia care method, and this study was the first to look explicitly at the communication techniques that the care workers used with clients. Public health professionals are less likely to be aware of the SPECAL method. [ABSTRACT FROM AUTHOR]

Purpose: The study was based around the following three research questions: What factors affect teacher well-being and mental health? How does teacher well-being and mental health impact on the progress of students? What resilience strategies are used by highly effective teachers with poor mental health to ensure that their students thrive? The paper aims to discuss this issue. Design/methodology/approach: The research study was qualitative in nature and involved ten primary schools in England. Teachers and head teachers were interviewed. Each school visit also included a pupil discussion group with children from Years 3. In total, the research team interviewed 35 education professionals and 64 pupils. Findings: Teachers reported a number of work-related stress triggers including busy times of the year, such as assessment periods, the pressure of extra curricula activities, the unexpected, keeping up with the pace of change and changes in school leadership. Children were attuned to their teacher's mood and could usually pick up when they were feeling stressed, even if teachers tried to hide it. Originality/value: No studies have used pupil voice to explore pupil perspectives of the impact of teacher mental health on their learning and progress. This is the first study of its kind. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to evaluate the current service provision offered by a mental health service in a young offenders institute (YOI) in England. Design/methodology/approach: A qualitative exploratory approach was adopted. Five prison officers (POs) (four male and one female) with direct experience supporting young people through mental health intervention were interviewed using semi-structured interviews. Data was analysed using thematic analysis (Braun and Clarke, 2006), which allowed evaluation of the current mental health provision to evolve. Findings: Five overarching themes (process of referrals; intervention and its impact; role and function of the health and well-being team; collaboration and involvement; and feedback, communication and intervention) were found to be highly salient when evaluating service provision. Notably all themes interrelated with one another, demonstrating that changes or improvements made to the service need to consider all factors individually and collectively. Research limitations/implications: This study was based on a small sample of POs in only one YOI in England, and therefore cannot be generalised to the entire prison estate. However, it does offer a rich insight into local service provision from the perspective of a group whose opinion is rarely sought. Practical implications: POs' perspectives of service provision are important in informing service developments. Lessons can be learnt from their unique insight into how prison mental health services are run to improve processes and collaborative working in the management of young offenders with mental health difficulties. Originality/value: This preliminary and exploratory study is, to the best of the authors' knowledge, the first study evaluating service provision by using the perspectives of POs. The findings suggest that POs make valuable contributions to the service development and should be involved in similar evaluations in future. [ABSTRACT FROM AUTHOR]