Viewpoint 66: What is the Housing with Care ‘Offer’ and who is it for?

Published to coincide with the International Day of Older Persons, this viewpoint explores some of the findings from Adult Social Services Environments and Settings(ASSET), a research project that was funded by the NIHR School for Social Care Research from February 2012 to April 2014. The project explored how adult social care services are commissioned and delivered in extra care housing and retirement villages. It is a timely paper, coming hot off the heels of the recent Commission on Residential Care, chaired by former Care Services Minister, Paul Burstow MP. This recommended greater clarification on what constitutes housing with care.

A Community Hub Approach to Older People’s Housing

Purpose. This paper explores the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators. Design/methodology/approach. Data is presented from the ASSET project (Adult Social Services Environments and Settings) which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews. Findings. Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public. Originality and Value. This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

ILS and RTP: Support to Researchers Provided by Information and Learning Services as Part of the Research Training Programme at the University of Worcester, Past, Present and Future.

The purpose of this article is to investigate the involvement of Information and Learning Services staff in the delivery of the Research Training Programme at the University of Worcester, UK with a focus on researcher receptivity. I believe that by constantly reflecting on the development of that part of the programme delivered by ILS and by examining feedback from the sessions, it is possible to improve and increase the level of researcher receptivity. It is hoped that such examination and reflection will be of value and relevance to the IL community since by reflecting on success and failure in a local context and by mapping this reflection to existing research enables librarians to improve the support provided to researchers within their institutions. This article outlines the support given to research students at the University of Worcester in the past, examines the changes leading to present programme delivery and reflects on considerations for future support. The article is underpinned by reference to current research undertaken in international (albeit Western-centric) contexts. I note that the rationale behind changes is embedded in current adult learning and teaching theory. In an increasingly competitive research environment where funding is dependent on a statistically monitored research output, the aim of such support is to integrate any IL contribution into the wider research training programme. Thus resource discovery becomes part of the reflexive research cycle. Implicit in this investigative reflection is the desire of the IL community to constantly strive towards the positive reception of IL into research support programmes which are perceived by researchers as highly valuable to the process and progress of their work.

How has the Personalisation of Social Care Impacted on Service Users with Dementia?

The personalisation agenda is a government initiative aimed at transforming adult social care through giving service users choice and control over the care they receive. A key part of this agenda is the provision of direct payments; cash payments made to individuals eligible for social care services which allow them to manage their own care. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However very few people with dementia currently access direct payments. The objective of this research was to explore the social care experiences of people with dementia in relation to their access to and use of direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers, and focus groups held with two community social work teams. It was found that direct payments tended to be seen as a fall-back option, for example as the only alternative to residential care, or as a solution to problems with traditional services. Direct payments appeared to afford particular benefits to people with dementia in terms of flexibility, continuity of care and access to local facilities. It is therefore important that this group are enabled to access direct payments. The second (ongoing) phase of this research comprises the design and pilot testing of an intervention aimed at improving access to direct payments by people with dementia.

Hydrogenated Fat Diet Intake during Pregnancy and Lactation Modifies the PAI-1 Gene Expression in White Adipose Tissue of Offspring in Adult Life

We examine whether feeding pregnant and lactating rats hydrogenated fats rich in trans fatty acids modifies the plasma lipid profiles and the expression of adipokines involved with insulin resistance and cardiovascular disease in their 90-day-old offspring. Pregnant and lactating Wistar rats were fed with either a control diet (C group) or one enriched with hydrogenated vegetable fat (T group). Upon weaning, the male pups were sorted into four groups: CC, mothers were receiving C and pups were kept on C; CT, mothers were receiving C and pups were fed with T; TT, mothers were receiving T and pups were kept on T; TC, mothers were receiving T and pups were fed with C. Pups' food intake and body weight were quantified weekly and the pups were killed at day 90 of life by decapitation. Blood and carcass as well as retroperitoneal, epididymal, and subcutaneous white adipose tissues were collected. Food intake and body weight were lower in TC and TT, and metabolic efficiency was reduced in TT. Offspring of TT and TC rats had increased white adipose tissue PAI-1 gene expression. Insulin receptor was higher in TT than other groups. Ingestion of hydrogenated vegetable fat by the mother during gestation and lactation could promote deleterious consequences, even after the withdrawal of the causal factor.