How Far Can a Short Leadership and Management Programme Address the Challenges for First Line Social Work Managers? An Evaluation of One of the Skills for Care Leadership and Management Demonstration Sites

2022

JICA

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PurposeThis study examined the contribution of adult social work in integrated teams in the UK.Design/methodology/approachThe study design was realist, evaluation research using a mixed methods approach. Data collection methods included interviews and focus groups. Types of social work activities were extracted from older adults' case records and used to calculate costs of care. The presence or absence of indicators of care quality was recorded using the same sample of case records. Data were collected from three primary care teams in which social work was integrated. They were compared with data from three social-work-only teams in the same districts. Narrative data was analysed thematically. Inferential and descriptive statistics were used to compare costs and care quality.FindingsWhen social work was embedded or attached to a primary care team, costs of care delivery were lower than in their social-work-only team and more indicators of good quality care outcomes were recorded. Results suggest that embedding social work in integrated primary care teams contributes to cost-effective, quality care for older people if certain conditions for integration are met.Originality/valueThis is the first study to triangulate three data sources to quantify the social work contribution to integrated primary health care teams for older adults.

Section: Methodsmentioning

confidence: 99%

Social work's contribution to integrated primary health care teams in the UK for older adults with complex needs

2022

JICA

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“…The framework combined levels developed by Warr et al (1970) [context and inputs] and Kirkpatrick (1994) [outcomes]. By combining these levels and testing them through previous research (Bailey, 2002(Bailey, , 2007Bailey and Littlechild, 2001), the framework has proven suitable for exploring the links between programmes of change and improvement in health and social care outcomes in a range of settings (Bailey & Kerlin, 2012& 2015and Ward & Bailey 2016.…”

Section: Designmentioning

confidence: 99%

Can a case lead approach deliver the “craft and graft” of integration?

2020

JICA

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PurposeThe aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation.Design/methodology/approachThe study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this.FindingsThe relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected.Originality/valueThe study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments.

“…The evaluation design was guided by Pawson and Tilley's [16] realistic evaluation methodology that takes ''heed of the different layers of social reality which make up and surround programmes of change'' (p4). The multi-level evaluation framework [17,18] combined levels from frameworks developed previously by Warr, Bird and Rackham [19] [context and inputs] and Kirkpatrick [20] [outcomes]. By combining these levels from both frameworks and refining these through previous research [21][22][23] this realistic evaluation design supported an in-depth exploration of the rehabilitation services.…”

Section: Evaluation Designmentioning

confidence: 99%

Using a Mixed Methods Approach to Examine the Effectiveness of Inpatient Rehabilitation Services Following a Programme of Planned Bed Closures

Motte

J. Psychosoc. Rehabil. Ment. Health

2020

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This study examined inpatient rehabilitations service in one area in England following a programme of planned bed closures in parts of the service. The study examined changes to admission rates and length of stay in the parts of the service that existed prior to and after the bed closure programme. A mixed method evaluation design was used. Quantitative data relating to admissions and length of inpatients stays bed days was compared for the 3 years up to the bed closures and for the 3 years afterwards. Similarly use of mental health sections for service users being admitted, and contacts with community mental health teams were also compared for the same 3-year pre and post period. Qualitative data from service users, carers of service users, and staff were analyzed thematically to provide an insight into any changes in rehabilitation service usage as a result of the closure programme. In the rehabilitation services that existed before and after bed closures in other parts of the service quantitative findings showed a significant reduction post-rehabilitation stay in all measures except contact with community teams. Qualitative analysis revealed that this is because rehabilitation enables a successful transition into the community and allows for effective relationships to be built between staff and service user. The reduction seen in service utilization suggests rehabilitation has the potential to reduce the revolving door to inpatient metal health care.