Suchergebnisse

Cover -- Half Title -- Title Page -- Copyright Page -- Contents -- Acknowledgements -- List of Contributors -- Foreword -- 1 Costing Community Care: The Role of this Book -- 1 The need for cost information -- 2 The organisation of this book -- 3 Conclusion -- Part I: The Costing Process -- 2 Background Theory -- 1 Opportunity costs -- 2 Examples of opportunity costing -- 3 Costs and outputs -- 4 Conclusion -- 3 Costing Services: Ideals and Reality -- 1 The principles of costing -- 2 Ideals, reality and acceptable compromises -- 3 Practice -- 4 Costing facility-based services -- 5 Costing peripatetic staff -- 6 Hidden costs -- 7 Conclusion -- 4 Costing Informal Care -- 1 Defining informal care -- 2 Types of cost -- 3 Direct financial expenditure -- 4 Costing time -- 5 Future cost -- 6 Space and privacy -- 7 Conclusion -- Part II: The Uses of Cost Information -- 5 Principles of Applied Cost Research -- 1 Basic principles -- 2 Comprehensive costs -- 3 Exploring and exploiting variations -- 4 Like-with-like comparisons -- 5 Merging costs and outcomes -- 6 Conclusion -- 6 Proceed With Caution: The Use of Official Sources of Cost Information in Social Services Departments -- 1 Constructing unit cost estimates from official government sources -- 2 The validity and reliability of official sources of unit costs estimates -- 3 Costs and services planning after the purchaser-provider split -- 4 Conclusion -- 7 Costs, Prices and Charges -- 1 Price or charge? -- 2 Pricing and charging objectives -- 3 The pricing environment -- 4 Pricing and charging strategies -- 5 Conclusion -- 8 New Policies and Old Logics: Costs Information and Modal Choice -- 1 The traditional logic -- 2 Implications of changes in policy ends and means -- 3 Begged questions: some needed developments in logic and evidence -- Part III: The Application of Costs

The focus of this article is the measurement of quality within the context of a new approach to measuring government-funded social care services. The approach builds on principles set out in a UK review led by Professor Sir Tony Atkinson. At its heart are the concepts of capacity for benefit, describing the potential benefit to users from services, and quality, reflecting the extent to which the benefit is realized. We report on a study designed to explore the suitability of a weighted user satisfaction measure to measure quality, examining in particular its sensitivity to changes in the quality of social care over time. The study finds some problems with using weighted user satisfaction. We discuss potential reasons for these problems, including the possibility of gaming and the specification of the measure, and discuss a way forward in the context of the requirement to draw upon routine sources of data. Points for practitioners The article describes a practical approach to measuring and monitoring outcomes and productivity in social care. Routine measures are used as far as possible, weighted to reflect outcomes for services users. The concepts of Capacity for Benefit and quality in this context potentially allow commissioners and managers to distinguish the impact on productivity of: the potential of services as they are currently configured, the dependency of service users, and the quality of delivery. The article identifies key issues and problems in using measures of satisfaction both as performance indicators and monitoring quality of services in the proposed approach.

Résumé Cet article s'intéresse à la mesure de la qualité dans le cadre d'une nouvelle approche en matière de mesure des services sociaux financés par l'État. L'approche se base sur les principes définis dans une étude britannique dirigée par le professeur Sir Tony Atkinson. Celle-ci se fonde sur la notion de « capacity for benefit », qui décrit l'utilité potentielle pour les utilisateurs des services, et sur la notion de la qualité, qui illustre la mesure dans laquelle cette utilité est concrétisée. Nous examinerons une étude visant à évaluer la pertinence d'une mesure pondérée de la satisfaction des utilisateurs afin de mesurer la qualité et d'examiner plus particulièrement sa sensibilité aux évolutions dans la qualité des soins sociaux au fil du temps. L'étude épingle certains problèmes dans l'utilisation de la satisfaction pondérée des utilisateurs. Nous allons examiner les raisons possibles de ces problèmes, y compris la possibilité de « jeu » et la définition de la mesure, et analyser la voie à suivre dans le cadre de l'obligation d'utiliser des sources de données ordinaires. Résumé à l'intention des praticiens Cet article présente une approche pratique pour mesurer et contrôler les résultats et la productivité dans les soins sociaux. Les mesures ordinaires utilisées sont pondérées dans la mesure du possible afin d'illustrer les résultats pour les utilisateurs des services. Les notions de « capacity for benefit » et de qualité dans ce contexte peuvent permettre aux commissaires et aux gestionnaires de distinguer l'impact du potentiel des services tels qu'ils sont actuellement configurés sur la productivité, la dépendance des utilisateurs de services et la qualité de la prestation. Nous épinglons les principaux problèmes et questions qui se posent dans l'utilisation des mesures de la satisfaction d'une part en tant qu'indicateurs du rendement et d'autre part, afin de contrôler la qualité des services dans l'approche proposée.

If we are to be able to reflect the cost implications of changes in the nature, quality and productivity of long-term care interventions in future projections, we need an approach to measurement that reflects the value and quality of care. This paper describes a theoretically based but pragmatic approach to identifying the welfare gain from government expenditure on social care and illustrates an application in projecting the costs of long-term care used in the Wanless review of future needs of social care for older people in England.

Abstract Raising standards is one of the key objectives of the British government's Modernizing Agenda. The quality of life of vulnerable older people who are being maintained at home is fundamentally dependent on the quality of the home‐care services they receive, so raising standards of home care is clearly central to this agenda. This paper draws on a small‐scale study of service users and providers to examine the aspects of quality of home care of importance to older people, their experiences and barriers to improvement. Six key aspects of quality were investigated: reliability, continuity, flexibility, communication, staff attitudes and skills and knowledge. If performance indicators are to have the desired effect, more work needs to be done to ensure they reflect key aspects of quality from the user perspective. We identify potential areas for improvement in commissioning and organization but these all have resource implications that will need to be met if home care is to realize its full potential in maintaining and improving quality of life for older people.

Abstract With the growth in the numbers and proportion of older people in the population the funding and incentive structures around long‐term care are of international concern. A study of the circumstances of self‐funded admissions to care homes allowed the comparison of self‐funders with publicly funded admissions to care homes in the UK, the influences on self‐funders in their decision to move into a care home and resources on which they were able to draw. These findings contribute to our understanding of the impact of current policy on self‐funders and our thinking about the way that future policy and practice changes could improve the way we use society's resources in the provision of long‐term care.

ABSTRACTThe social production of welfare provides a theoretical framework for the analysis of the consumption of social services and the impact of welfare policies. Based on the new home economics, it represents the unit of consumption as a unit of production of commodities. With the advent of disability this unit extends from the household to the informal care network. Social care agencies become involved when the production of basic commodities, such as nutrition and personal care, fall below threshold levels which threaten the survival of the informal care network. The social production of welfare allows comparisons across systems and provides the starting point for the development of tools for empirical analysis.

Using a theoretical framework derived from the social reproduction of welfare, the consumption of social services & the impact of welfare policies on recipients are examined. From a neoclassical & new home economics perspective, the consumption of goods is analyzed, & findings are applied to the consumption of social services, resulting in a transparent specification of the unit of consumption & the concept of care. In light of these specifications, the role of social care agencies is discussed. It is concluded that for national social welfare programs to be effective across cultures & national boundaries, a better understanding of consumers & their contexts is needed; the social production of welfare approach goes some way in achieving this goal. 36 References. Adapted from the source document.

Extra care housing enables older people to remain in their 'own home', while providing appropriate housing and access to health and social care services that are responsive to their needs. This type of provision is very much in line with the government policy of fostering people's sense of control and independence, and is a priority area for expansion. We explored the current levels of development and expansion of extra care housing in terms of the numbers of schemes and places and factors that contributed to and were problematic in its development.