Guy Daly

Housing Stock Transfer in Birmingham and Glasgow: The Contrasting Experiences of Two UK Cities

ABSTRACT Housing stock transfer is arguably one of the more controversial aspects of New Labours housing policy. It was a policy originally pursued under the Conservative governments from the 1980s into the early 1990s and has gained pace under New Labour since 1997. Across Britain, the Westminster government, along with the devolved Scottish and Welsh administrations in Edinburgh and Cardiff, have all demonstrated a commitment of late to the use of stock transfer to reshape and reconfigure social housing provision. This paper considers some of the key aspects of stock transfer, not least the underlying national policy drivers of demunicipalization and use of private finance, and then explores the contrasting fortunes of stock transfer in the two largest local authority social housing authorities in Britain, that is Birmingham and Glasgow. In 2002 Birmingham tenants rejected stock transfer while in Glasgow, following a tenant vote for transfer, the citys entire council housing stock was transferred to a not-for-profit housing agency. The different experiences of the pursuance of stock transfer in these two cities together highlight some of the key questions and issues that are now being asked of this central component of New Labours approach to social housing.

Do direct payments improve outcomes for older people who receive social care? Differences in outcome between people aged 75+ who have a managed personal budget or a direct payment

ABSTRACT Direct payments – cash for people eligible for adult social care and spent by them on care and support – are claimed to enable care to better reflect user preferences and goals which improve outcomes. This paper compares outcomes of older direct payment users and those receiving care via a managed personal budget (where the budget is spent on the recipients behalf by a third party). The study adopted a retrospective, comparative design using a postal questionnaire in three English councils with adult social care responsibilities in 2012–13. Included in the study were 1,341 budget users aged 75+, living in ordinary community settings. The overall response rate was 27.1 per cent (339 respondents). Three validated scales measured outcomes: EQ-5D-3L (health status), the Sheldon–Cohen Perceived Stress Scale and the Adult Social Care Outcomes Toolkit (social care-related quality of life). The study found that direct payment users appreciated the control conferred by budget ownership, but in practice, for many it did not ‘translate’ into improved living arrangements. It also found no statistically significant difference in outcomes between direct payment and managed personal budget users. The paper argues that despite policy and other guidance and research evidence about effective implementation of direct payments for older people, the absence of evidence for better outcomes may at least in part be attributable to values underpinning policies relating to personalisation and personal budgets.

Case management of individuals with long-term conditions by community matrons: report of qualitative findings of a mixed method evaluation

AIM To consider findings from a study that evaluated case management of individuals with long-term conditions (LTCs) by a community matron (CM) service. The paper highlights issues related to the implementation of a new role and the impact this had on the experience of care across hospital and community settings for patients and their carers. BACKGROUND The introduction of the role of CM was intended to increase effective management of patients with complex comorbid LTCs through the introduction of case management, thereby reducing unplanned hospital admissions. METHODS The overall methodological approach was one of mixed methods. This paper reports the qualitative findings from CMs (n = 15); patients (n = 13); family carers (n = 8); and secondary care staff who interface with the CM service (n = 7). Data were collected between October 2009 and May 2010. FINDINGS A thematic analysis resulted in the identification of four themes: (1) visibility; (2) interpersonal relationships; (3) leadership; and (4) systems/professional boundaries. Patients enjoyed being seen as a whole and family carers appreciated the coordination aspect of the role. Difficulties arose from the limited understanding of the CM role and from a lack of a shared vision across healthcare professionals concerning the role and its goals.

The evolution of person-centred care to personalised care, personal budgets and direct payments in england: some implications for older users of social care services

The Westminster Government in the UK has implemented a series of significant changes to the way social care is organised and provided in England, including the use of personal budgets and direct payments. Advocates of this approach claim it will deliver more personalised care to budget holders. This paper examines key English policies underpinning these changes, reviewing social policy analysis and research evidence of their impact to consider implications for older social care users. It suggests that personal budgets and direct payments have partly been a response to demands for greater control over care from younger adults with disabilities and that policies and guidance often reflect the interests of this constituency rather than older people. Current research evidence tends to suggest that older people achieve less satisfactory outcomes from personal budgets than younger people. The paper argues for the re-discovery of person-centred care, rather than personalisation, as a way of addressing this important policy issue.

From Community Government to Communitarian Partnership? Approaches to Devolution in Birmingham

The article provides an analysis of recent attempts by a major local authority (Birmingham City Council) to devolve decision making and localise service provision. In recent years the council has developed a series of initiatives to promote devolution of decision making and localisation of service provision to sub-city levels. Utilising a model presented by Sullivan, we argue that the council has been moving from an approach initially informed by community government (after Stewart) to one based on communitarian-informed citizen governance (after Atkinson).

Loneliness amongst older people: findings from a survey in Coventry, UK

Purpose – The purpose of this paper is to investigate factors associated with loneliness amongst people aged 55 and over living in Coventry, a medium-sized city in the Midlands, UK. Design/methodology/approach – Quantitative community survey of residents, involving postal and online questionnaire and distribution of questionnaire to local community resources used by older people and “ballot boxes” for completed questionnaires in these locations. Findings – Using multivariate regression analysis the study found that living alone, not enjoying life, needing help with personal care and not being in touch with people as often as liked all predicted loneliness. Research limitations/implications – Survey was commissioned by a range of local statutory and voluntary sector providers and had a wider focus than loneliness. Some evidence of under-representation of males, minority ethnic groups and possibly people from lower socio-economic groups is reported. Further qualitative research is needed to better understan...

The impact of personal budgets on unpaid carers of older people

Summary This paper focuses on the impact of a personal budget – either in the form of a direct payment or managed personal budget – on the role of unpaid carers of older budget holders. Data were collected via postal survey of 1500 unpaid carers and semi-structured interviews with 31 carers. Findings Unpaid carers played a central role in supporting older budget holders irrespective of the type of budget received. The allocation of a personal budget may have decreased the amount of ‘hands-on’ care they provided, enabling them to do different things for and with the person cared for, but most did not relinquish direct involvement in care provision. Both kinds of personal budget provided greater flexibility to juggle caring tasks with other roles, such as childcare or paid employment. However, carers supporting direct payment users did experience higher levels of stress. This seemed linked to the additional responsibilities involved in administering the direct payment. Carers seemed relatively unsupported by their local Adult Social Care Department: the survey found that only one in five said they had ever received a carer assessment. Application The findings offer a detailed exploration of the impact of personal budgets on carers, suggesting that even in countries with relatively well-developed systems of support for carers such as England their impact remains overlooked. The paper may be of interest to social work practitioners, managers, academics and social work policy specialists working in countries that have, or are about to introduce, personal budgets or other forms of cash-for-care scheme.