Although our focus here at the Association for Dementia Studies is, understandably, dementia, we have been part of two projects that are not directly related to dementia. Here, we thought we’d tell you a bit more about them.
ASSET: Adult Social Care Settings and Environments
What was it all about?
Funded by the National Institute of Health Research; School for Social Care Research, the ASSET project took place between 2012 and 2014. It aimed to explore the views and experiences of people commissioning, delivering and receiving adult social care services in extra care housing and retirement villages. These two forms of ‘housing with care’ have become increasingly popular in the UK for a range of reasons, including the opportunities for social interaction, the availability of comprehensive facilities on site, and because the physical environment is purpose built to meet the needs of older people. However, despite a growing body of research focusing on this area, there is a lack of research into the provision of adult social care in housing with care settings. ADS worked on the ASSET project in partnership with the Housing LIN, the School for Policy Studies at the University of Bristol, and the Personal Social Services Research Unit to fill this gap in the research.
What did we do?
A mixed methods approach was used, starting with a literature review of existing evidence, and a survey to identify and map models of adult social care in housing with care settings. Nine extra care schemes were used as case study sites to explore advantages and disadvantages relating to the quality and cost-effectiveness of care delivered. The case studies involved interviews with residents, managers, care workers and commissioners, and a range of measures were completed for each resident to capture the effect of social care delivery on quality of life.
What did we find?
This research found that for some older people a move to housing with care is associated with a better quality of life when compared with living in mainstream housing. The housing with care model can support residents who are very diverse in terms of their abilities, needs and care packages, including those not receiving any planned care.
However, local authority approaches to commissioning adult social care can vary considerably in response to a complex range of drivers including public spending cuts, welfare reforms, the personalisation agenda and changing aspirations for later life. There is also an urgent need to provide better financial information to current and prospective residents and their families. This could include information on personal budgets, direct payments and charging arrangements.
Publications from the ASSET project include:
Atkinson, T.J., Evans, S., Darton, R., Cameron, A., Porteus, J. & Smith, R. (2014) Creating the asset base – a review of literature and policy on housing with care. Housing, Care & Support, 17(1), 16-25.
Evans, S., Atkinson, T., Darton, R., Cameron, A., Netten, A., Smith, R. & Porteus, J. (2016) A Community Hub Approach to Older People’s Housing. Quality in Ageing and Older Adults.
Smith, R., Darton, R., Cameron, A., Johnson, E., Lloyd, L., Evans, S., Atkinson, J. & Porteus, J. (2017) Outcomes-based commissioning for social care in extra care housing: is there a future? Housing, Care and Support, 20(2), 60-70.
ECHO: The Provision of Social Care in Extra Care Housing
(Ok, so the acronym isn’t quite as obvious as for the ASSET project, but we still like it!)
What was it all about?
Funded by the Department of Health; National Institute of Health Research; School for Social Care Research, the ECHO project took place between 2015 and 2017. It followed on from the ASSET work and explored how care is negotiated and delivered within extra care housing schemes whilst still allowing older people to maintain independence.
What did we do?
A longitudinal approach was used, visiting four extra care housing schemes on four occasions. As with the ASSET project, the visits involved interviews with residents, managers, care workers and commissioners. Although the focus was not on residents with dementia, one of the schemes was dementia specialist.
What did we find?
The research found that extra care housing is a complex, diverse and evolving model in terms of the commissioning, types of provision and funding approaches. There is also increasing pressure from local authorities to accept publicly-funded residents with different and higher care needs. Pressures also exacerbate a sense of disparity between how extra care housing works for publicly-funded and self-funded older people.
More information about the ECHO project and findings can be found through the following resources:
- An NIHR report on the findings
- A video clip on ‘Listening to residents in extra care housing: findings from the ECHO research project’
- A video clip on ‘Influencing policy and operations: outcomes from the ECHO research project’
- A series of presentations relating to the project and the findings
Publications from the ECHO project include:
Cameron, A., Johnson, E., Lloyd, L., Evans, S., Smith, R., Porteus, J., Darton, R. & Atkinson, T. (2019). Using longitudinal qualitative research to explore extra care housing, International Journal of Qualitative Studies on Health and Well-being, 14(1).
Evans, S., Atkinson, T., Cameron, A., Johnson, E., Smith, R., Darton, R., Porteus, J. & Lloyd, L. (2018). Can extra care housing support the changing needs of older people living with dementia? Dementia.
For more information about either of these two projects, please contact Teresa Atkinson or Dr Simon Evans.
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