Risks to home care workers: Professional perspectives

Care at home is fundamental to community care policy, but the simultaneous growth of health and safety regulation has implications for home care services because of the duty of employers towards home care workers. This grounded theory study set in Northern Ireland used data from 19 focus groups and nine semi-structured interviews with a range of health and social services professionals and managers to explore perspectives on planning long term care for older people. Home care workers faced a wide range of hazards in the homes of clients, who themselves were faced with adapting their living habits due to their changing health and care needs and 'risks.' Creative approaches were used to ensure the health and safety of home care workers and simultaneously to meet the choices of clients. Staff experienced feelings of conflict when they judged it necessary to impose their way of providing home care and thus impose their values on clients to create a safe working environment. There was variation between and within organizations in terms of the staff focus on client needs or on their employer responsibility towards home care workers. The planning of home care services must take account of both the choices of clients and the hazards facing home care staff.

Professional perspectives on decision making about the long-term care of older people

With the increasing pressure on social and health care resources, professionals have to be more explicit in their decision making regarding the long-term care of older people. This grounded theory study used 19 focus groups and nine semi-structured interviews (99 staff in total) to explore professional perspectives on this decision making. Focus group participants and interviewees comprised care managers, social workers, consultant geriatricians, general medical practitioners, community nurses, home care managers, occupational therapists and hospital discharge support staff. The emerging themes spanned context, clients, families and services. Decisions were often prompted by a crisis, hindering professionals seeking to make a measured assessment. Fear of burglary and assault, and the willingness and availability of family to help were major factors in decisions about living at home. Service availability in terms of public funding for community care, the availability of home care workers and workload pressures on primary care services influenced decision 'thresholds' regarding admission to institutional care. Assessment tools designed to assist decision making about the long-term care of older people need to take into account the critical aspects of individual fears and motivation, family support and the availability of publicly funded services as well as functional and medical needs.

The effect of patient characteristics upon uptake of the influenza vaccination: a study comparing community based older adults in two healthcare systems

Background: Uptake of influenza vaccination represents a simple marker of proactive care of older people. However, many still do not receive the vaccine. To understand this challenge better, we investigated the relationship between patient characteristics (demographic, physical and psychological health, and health service use) and vaccination uptake in a sample of community-dwelling older people in two adjacent but differently structured healthcare systems (Northern Ireland (NI) and the Republic of Ireland (RoI)). Methods: 2,033 randomly selected community-dwelling older adults (65 years and older) were interviewed in their homes. Results: Rates of uptake were 78% in NI and 72% in RoI. Uptake was greater with older age (odds ratio (OR) 1.6, 95% confidence interval (CI) = 1.3-2.1, p

"Irish Perspectives on EC Law by Mary Catherine Lucey and Cathrina Keville (eds.), Dublin, Thomson Round Hall, 2003 (ISBN 1-85800-280-X)"

Book Review

Identifying families with multiple problems: Perspectives of practitioners and managers in three nations

Whilst child welfare systems in the United Kingdom, Australia and the United States may share a number of common goals, they are not designed to identify families with multiple problems. Where system output measures have been utilised as proxy measures to detect such families they indicate the presence of families in the population served by child and family social work. In interviews with practitioners and managers working within contrasting welfare systems, we explore how families with multiple problems are identiifed, what repsonses they currently recieve and how their needs might be better met.

Ascertaining the perspectives of young children in care: case studies using reality boxes

This article describes the use of an innovative method, reality boxes, to elicit the perspectives of children, ages four to seven years, in state care. Using examples from a broader research project based on children in Northern Ireland, which was concerned with their participation rights, the article considers how the children used the boxes to express their views. Informed by a child rights-based approach, the article highlights the processes and practices involved and concludes by stressing the potential importance of this method, used in the context of this framework, in social work practice with young children.

The perspectives of young children in care about their circumstances and implications for social work practice

Recent reviews of research regarding children in care have concluded that there remains little research which specifically focuses on young children. This paper presents the findings of research carried out with a sample of young children in care (aged 4-7 years) regarding their perspectives of their circumstances. The findings reveal that they have deeply held views regarding living with risk; removal from their families; unresolved feelings of guilt and loss; and not being listened to. This paper considers the implications of these findings for social work practice. It concludes by stressing the capacity of young children in care to express their perspectives, and the importance of practitioners seeking these views and incorporating them into assessment and decision-making processes.

Spatial Mobility, Workers and Jobs: Perspectives from the Northern Ireland Experience

Spatial mobility, workers and jobs: perspectives from the Northern Ireland experience,Regional Studies. How best to address local concentrations of worklessness is a key question for labour market, economic developmentand social inclusion policy. Historically, initiatives in Northern Ireland have focused on moving ‘jobs to workers’, butin changed political circumstances there is now greater emphasis on encouraging the movement of ‘workers to jobs’. A review of the Northern Ireland experience in the context of broader consideration of the geography and socio-institutional structure of local labour markets sheds light on the difficulties and successes in implementing both approaches. It is concluded that both have a role to play because labour market space is simultaneously ‘segmented’ and ‘seamless

A commentary on climate change, stone decay dynamics and the ‘greening’ of natural stone buildings: new perspectives on ‘deep wetting’

Environmental controls on stone decay processes are rapidly changing as a result of changing climate. UKCP09 projections for the 2020s (2010–2039) indicate that over much of the UK seasonality of precipitation will increase. Summer dryness and winter wetness are both set to increase, the latter linked to projected precipitation increases in autumn and spring months. If so, this could increase the time that stone structures remain wet and possibly the depth of moisture penetration, and it appears that building stone in Northern Ireland has already responded through an increased incidence of algal ‘greening’.This paper highlights the need for understanding the effects of climate change through a series of studies of largely sandstone structures. Current and projected climatic trends are therefore considered to have aesthetic, physical and chemical implications that are not currently built into our models of sandstone decay, especially with respect to the role played by deep-seated wetness on sandstone deterioration and decay progression and the feedbacks associated with, for example surface algal growth. In particular,it is proposed that algal biofilms will aid moisture retention and further facilitate moisture and dissolved salt penetration to depth. Thus, whilst the outer surface of stone may continue to experience frequent wetting and drying associated with individual precipitation events, the latter is less likely to be complete, and the interiors of building blocks may only experience wetting/drying in response to seasonal cycling. A possible consequence of deeper salt penetration could be a delay in the onset of surface deterioration,but more rapid and effective retreat once it commences as decay mechanisms ‘tap into a reservoir of deep salt’.