Jo Moriarty

Inequalities in quality of life among older people from different ethnic groups

British research on the quality of life in old age has neglected the increasing ethnic diversity of the older population, and although studies of health and income inequalities have highlighted the contribution played by racism, analyses of the factors influencing the quality of life have rarely considered its effects. This paper discusses inequalities in quality of life among older people from different ethnic groups using data from a cross-sectional survey of 203 White British, Asian, Black Caribbean, Black African and Chinese people aged 55 and more years living in England and Scotland. They were interviewed face-to-face in the language of their choice using a semi-structured schedule. Consistent with the existing literature, the study found differences in health, income and social support among the ethnic groups. The paper suggests, however, that future work should examine disparities in health and income within as well as between minority ethnic groups, and that a greater appreciation is required of the way in which such disparities may be accentuated by variations in health expectations, in the distribution of income within households, and in the willingness to discuss financial difficulties. The cumulative effects of health and material disadvantage and the experience of racism have implications both for future quality of life research and for government policies that aim to raise social inclusion and reduce inequalities.

Helping others or a rewarding career? Investigating student motivations to train as social workers in England

• Summary: Understanding why people want to be social workers is important both for developing social work education and for the profession as a whole. This article presents evidence about the motivations of students enrolled on social work degree programmes in England and draws on data from 3000 responses of three successive intakes of students responding to six online surveys and 26 focus group interviews involving 168 students from nine different social work programmes in six case study sites. The article locates these data in the context of earlier studies of social workers’ motivations, the changing policy context and the changes introduced by the new degree. • Findings: Similar to previous studies, the current analysis shows that altruistic motivations dominated, but students were also influenced by career issues and the day-to-day aspects of social work. The data highlight continuities with the former qualification in social work in the UK (the DipSW) and provide evidence that the introduction of the social work degree has not dramatically changed the underlying motivations of social work students. • Applications: Understanding student motivations is important in terms of recruitment to social work qualifying programmes and subsequent retention within the profession. Social work educators and employers need to pay attention to the consequences of mismatches between motivations and expectations about what professional practice involves.

Support workers in social care in England: a scoping study

This paper reports the findings of a scoping study designed to describe the evidence base with regard to support workers in social care in the United Kingdom and to identify gaps in knowledge. Multiple bibliographic databases were searched for studies published since 2003. The results revealed that the support worker role, though not well-defined, could be characterised as one aimed at fostering independence among service users, undertaking tasks across social and health-care, and not being trained in, or a member of, a specific profession. The studies identified were predominantly small-scale qualitative projects which considered issues such as role clarity, training and pay, worker satisfaction, service user views and the amount of time support workers are able to spend with service users compared to other staff. The review concluded that the research base lacks longitudinal studies, there is definitional confusion and imprecision, and there is limited evidence about employment terms and conditions for support workers or about their accountability and performance. The desirability and value of training and how it is resourced need further analysis. It is concluded that moves to self-directed support or personalisation and the increased reliance on and use of support workers, in the form of personal assistants, call for closer scrutiny of the role.

‘We are not blaming anyone, but if we don't know about amenities, we cannot seek them out’: black and minority older people's views on the quality of local health and personal social services in England

ABSTRACT Improving access to culturally-appropriate services and enhancing responses to the needs of older people from black and minority ethnic backgrounds were among the aims of the National Service Framework for Older People (NSFOP) that was introduced in England in 2001. Progress in meeting the aims of the NSFOP was evaluated by a mid-term independent review led by the Healthcare Commission, the body responsible for regulating health-care services in England. This paper reports the consultation with older people that underpinned the evaluation. It focuses on the views and experiences of older people from black and minority ethnic (BME) groups and of the staff that work in BME voluntary organisations. A rapid appraisal approach was used in 10 purposively selected local councils, and plural methods were used, including public listening events, nominal groups and individual interviews. In total 1,839 older people participated in the consultations and 1,280 (70%) completed a monitoring form. Some 30 per cent defined themselves as of a minority ethnic background. The concerns were more about the low recognition of culturally-specific and language needs than for the development of services exclusively for BME older people.

Outcome of referral to social services departments for people with cognitive impairment

The objective of this study was to determine how the entry into long term care of people assessed by their local social services department (SSD) under the National Health Service and Community Care Act 1990 is predicted by the severity of their cognitive impairment, care provided by family members, and the receipt of community care services. The design involved a cohort study of people over one and a half years following referral (min–max: 1–2 years) from three SSDs (county council, metropolitan and inner London boroughs). Consecutive recruitment of 141 people with cognitive impairment aged 65 and over took place over a 4 month period. The main outcome measure was survival analysis of time taken from referral to entering long term care at follow‐up. The receipt and intensity of community care services increased the probability of remaining at home. People with mild or moderate cognitive impairment were more likely to remain at home if they had a spouse or daughter carer. Analysis of the interaction between three main effects predicting entry to long term care (severity of cognitive impairment, access to a carer, and the receipt of home care or day care) suggests that while carers are central in determining whether older people with cognitive impairment are able to remain living in the community, there are limits to the care they can provide. Copyright

Applications to Social Work Programmes in England: Students as Consumers?

One of the most resounding impacts of the introduction of the new social work degree in England in 2003 has been an increase in the number of applications to social work courses. However, the processes used by applicants to reach decisions about where to study social work are little understood. This article reports data from six preparatory focus groups and four interviews (n = 38), 17 focus group interviews with first year students (n = 112) from nine social work programmes run in six universities, and 2,606 responses to three online surveys administered to first year students, which were collected as part of the national Evaluation of the New Social Work Degree in England funded by the Department of Health. They show that students use a range of sources to find out about social work education, with rising reliance on electronic media as an information resource. Although the majority cites convenience of location as the chief reason for selecting a particular university, academic reputation appears to be growing in importance. Observations from these data are discussed in the context of consumer behaviour in higher education and in social work education at a time when universities are developing marketing strategies to compete for students.

User and Carer Experiences of International Social Care Workers in England: Listening to their Accounts of Choice and Control

Abstract This paper develops a typology of people using social care services’ preferences for care workers and satisfaction with social care services from a large multimethod study that explored international recruitment to the English social care sector (home and health care, including residential homes). We developed this typology with two questions in mind: (a) what led to satisfaction of care and (b) what led to preference and satisfaction with workers? Data were collected from face-to-face interviews with 35 people who were using social care services and carers (2007–2009) and these data were used to develop the typology. Using the theoretical concept of homophily, we explored contentions that people might prefer to receive care and support from individuals resembling themselves. We observed that preferences for care workers and satisfaction with social care services may be linked, but highlighted that the concept of meeting a preference is personal to the individual. The implications of users’ preferences for certain care workers at a time where policy is promoting greater consumer-led care or self-directed support are discussed.

Working with older people from black and minority ethnic groups who have depression: From margin to mainstream

Despite the growing evidence base about depression and anxiety and its application to service settings and practice, we are short of practice examples about what works and for whom. This applies to older people in general but particularly to groups, such as people from black and minority ethnic backgrounds. This article discusses policy and legislative encouragements to think about equality of access and diversity issues in mental health services and wider mental health promotion activities. It analyses recent research and policy documents in the context of demographic change and practice. It argues that the context of personalisation in England may provide new opportunities to consider what older people will find most acceptable and effective in meeting their needs, but notes the challenges that this will bring to community‐based organisations and specialist services.

Parkview House: A garden for people with dementia – in a care home:

decreased levels of agitation and benefit from taking part in physical exercise and the sense of companionship engendered by being in the garden together. However, it is also important to accept that their willingness to be involved in the garden varies from day to day and it cannot be assumed that their enthusiasm will be consistent. The carers involved in the garden feel that it has helped raise their self-esteem and decreased their levels of depression. For staff, the scope of their work has been extended, making it more satisfying. Taken together, the Grange garden represents an example where people with dementia, their carers and staff have all worked together to create an environment in which the quality of life for everyone has been improved.

Designing a garden for people with dementia — in a public space

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