Systematizing Knowledge of User Influence – A Study of User Advisory Boards in Substance Abuse and Mental Health Services

While there is a great deal of interest in, and literature describing user influence in mental health and substance abuse services at the individual level, there are fewer studies of collective user influence at the organizational level. This article presents the findings of a study of the development of user advisory councils in regional organizations providing substance abuse services, which were part of a national implementation project in Sweden. A survey of both users and professionals involved in the local projects, in addition to interviews with key actors at the national level, were completed and analyzed with reference to the results of a literature review. The overall aim of the study was to identify obstacles and success factors related to the development of collective user influence at the programme and system levels. The results indicated that there was an overwhelmingly positive attitude towards experience‐based knowledge and the potential for developing formal, collective user influence in these organizations. Users and professionals had common viewpoints regarding the obstacles and success factors, which included: addressing power relations, establishing legitimacy, assigning resources, investing in sustainability and planning for real participation. They were also substantially in agreement as to the strategies that would be needed in the future in order to move from ideology to action. These factors form the basis for a model that might be used to support the systematic implementation of this type of organized user influence.     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.     

A Joined-up Approach to User Participation in Public Services: Strengthening the "Participation Chain"

Participation has emerged as a key theme for social policy and administration in the UK. Public service providers are often keen to consult users, and users themselves want to make their voices heard. Despite this, however, there is a perennial problem in getting people to participate, and participation is often better supported in principle than in practice. The motivations of key actors are crucial, but are often poorly understood. This article attempts to build a more detailed understanding of the motivations to participate of one key group: service users. Using Mutual Incentives Theory, it shows the extent to which users are motivated by individualistic or collectivistic concerns. These “demand side” factors are then combined with others on the “supply side” in a model we call the “participation chain”. This model provides a systematic framework for understanding what makes public service users participate, and seeks to demonstrate that, while the question of participation requires a combination of answers, it is a combination that can be predicted, planned for and acted upon.     

Leadership and Listening: The Reception of User Voice in Today's Public Services

Over the last decade leadership has become a watchword in public service provision, especially in its association with the seemingly ubiquitous ‘delivery’ agenda. As leadership styles change in response to developments in the contemporary public service environment, it has become imperative for service providers to find ways to listen to service users. However, listening is itself widely recognized as an underdeveloped public sector competency. This article addresses the relationship between leadership and listening. Using findings from recent research, it identifies a ‘listening gap’ in public services, before pointing to ways in which this gap might be better understood and subsequently narrowed. In doing so, it seeks to present new ideas about the essential balance between ‘leadership’ and ‘listening’, and how this can be struck in today's public service environment. First, the nature of the user voice is examined. By talking to service users who have communicated their views in different ways in each of three different services (housing, social care and leisure), the article seeks to understand the nature of users' ‘projects’ in the expression of their views. These projects are compared with those of public service leaders. Second, the congruence (or incongruence) of these projects is considered through a comparison of the world views of both users and leaders. Finally, aspects of the context are considered in the discussion of the way public service organizations might go about defining the relationship between leadership and listening.     

Social Work Knowledge of Community-Based Services for Older Adults: An Educational Model for Social Work Students

Social workers are often the key link between older adults, their families and community-based services. Thus, knowledge about older adults and community-based care is imperative for social work practice. Evaluation data are provided on a national multisite effort (N = 353) from 35 schools to assure graduate social work student's competency related to community services for older adults. Results suggest that the educational model as described in this article sets forth positive outcomes in the education of aging savvy social workers. Ongoing social work education is needed to meet the burgeoning needs of the geriatric population.     

Risk Management Paradigms in Health and Social Services for Professional Decision Making on the Long-Term Care of Older People

Risk management systems and structures are developing rapidlywithin UK health and personal social services. However, therisk management strategies of organizations need to take intoaccount the conceptual frameworks used by professionals. Thisgrounded theory study used data from nineteen focus groups andnine semi-structured interviews (ninety-nine staff in total)to explore perspectives on risk and decision-making regardingthe long-term care of older people. Focus group participantsand interviewees comprised social workers, care managers, consultantgeriatricians, general medical practitioners, community nurses,occupational therapists, home care managers and hospital dischargesupport staff. Social work and health care professionals conceptualizedrisk and its management according to six paradigms that appearedto be in a state of reciprocal tension: (i) Identifying andMeeting Needs; (ii) Minimizing Situational Hazards; (iii) Protectingthis Individual and Others; (iv) Balancing Benefits and Harms;(v) Accounting for Resources and Priorities; and (vi) Warinessof Lurking Conflicts. The effective translation into practiceof risk management strategies needs to address the complex andoften contradictory issues facing health and social servicesprofessionals.     

反腐败社会参与形式研究

社会参与是富有成效地推进反腐败工作的重要形式。在反腐败工作中,应充分发挥群众的主体作用,建立起反腐败工作的长效机制,使社会参与反腐败依法进行,保证积极稳妥推进反腐败工作进程。     

Current Developments in Social Care Services for Older Adults in the Czech Republic: Trends Towards Deinstitutionalization and Marketization

ABSTRACT

Deinstitutionalization and marketization of eldercare has been delayed by 20 years in the Czech Republic compared to Western Europe, and it takes place in a completely different context, characterized by the legacy of communism, a growing older population, and less generous public subsidies. This study is the first in the Czech Republic to examine how deinstitutionalization and marketization effect implementation of these principles on the availability and quality of eldercare services at regional and municipal levels. A mixed-method approach was used, combining several data sources (policy documents, administrative data, statistics, expert panel, and secondary use of qualitative data). The findings suggest that the support for and availability of home-based care has declined, despite the ever-increasing number of older adults and policy preference for deinstitutionalization. Furthermore, home-based services have failed to adjust to growing care needs of older adults (e.g., inflexible schedules, limited provision of time-demanding care, inadequate staff composition). This situation occasioned an unintended outcome: the emergence of nonregistered, semilegal, for-profit nursing homes offering low-quality care and poor working conditions, and subject to no quality control. The health and even lives of older adults are at risk if they choose such services. Research is needed to study older adult decision making and offer them tools to identify and avoid questionable services.     

论行政立法的公众参与机制

行政立法是19世纪以来西方国家为适应社会需要而发展起来的行政主体立法制度,为有效控制行政立法,美国确立了较完善的行政立法公众参与制度。目前,中国行政立法大量激增,但公众参与制度尚未真正建立起来,行政立法中公众参与的缺失产生了许多负面影响,因而有必要建立和完善我国行政立法的公众参与机制。行政立法公众参与机制应遵循行政立法主体主导、公众参与有效、可行、适当超前的原则。在具体制度建构上应赋予公众立法动议权,立法草案一般应经过通告、评议法定程序,立法案正式表决前可交付一定范围内公众先行表决以供立法主体参考,立法过程中公众参与情况应于立法案通过后予以公布。     

Disaster Preparedness among Older Adults: Social Support,Community Participation,and Demographic Characteristics

This study examined factors associated with disaster preparedness among older adults, with special attention paid to demographic characteristics, social support, and community participation. From a larger study about disaster preparedness of persons with disabilities, a total of 719 adults aged 55 years and older were used for this study. The results of the logistic regressions indicate that individuals who have higher levels of social support and more connections to community organizations are more likely to be prepared for disaster-related emergency situations. In another model, using resource preparedness as the dependent variable, an interaction effect between social support and income was found. Overall, higher income and higher informal support are related to a higher level of resources for disaster preparedness. However, the relationship between income and disaster preparedness is much stronger for those sub-groups receiving more informal support. The findings of this study expand knowledge regarding issues of disaster preparedness among older adults and demonstrates the importance of social resources and networks. This study suggests an intervention model for decision-makers and community leaders in terms of providing information and advice to members of their communities about how to adequately prepare for natural disasters.     

Promoting Personalization in Social Care Services for Older People

This article presents findings on 4 themes associated with the personalization of social care for older people: integration of health and social care services; initiatives that prevent the need for more costly interventions; services to maintain people at home; and systems that promote choice, control, and flexibility. The quantitative study utilized data from a national postal survey conducted in England. Findings suggest variable progress regarding the range and style of support available to older people. These are discussed in the context of service integration, community-based services, and consumer-directed care. Implications for service development and future research are highlighted.     

Identity work of welfare service users in participatory spaces

The popularizing user participation agenda has encouraged the creation of discursive spaces for collaborative decision‐making with the welfare service users. Despite the claim of partnership with the service users, these participative spaces do not always promise parity of participation. Based on a qualitative study conducted in Hong Kong, this paper discusses the manifestation and constitution of identity among the welfare service users who took part in organizational spaces for participatory management. The analysis uncovers the tensions and promises in participatory management with the welfare service users.     

The Effect of Financial Incentives and Access to Services on Self-funded Admissions to Long-term Care

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.     

Social work for vulnerable and marginalized people during COVID-19 in Japan

During the Coronavirus disease pandemic (COVID-19), working conditions became increasingly difficult for social workers, as they had to deal with new challenges and added workloads. This study describes the difficulties faced by social workers of the Self-Reliance Support System in Japan and clarifies the solution for each difficulty while conducting their duties to support vulnerable people during COVID-19. To this end, we conducted an open-ended questionnaire survey and an interview survey. The data were analyzed using qualitative coding. The results showed that the difficulties faced in consultation support work included supporting hitherto socially invisible groups such as sole traders and foreigners. Social workers also faced an ethical dilemma, as they could not provide support to clients who “did not try to solve their problems” or for whom “interventional attempts did not lead to counseling support” and who only sought benefits at the risk of becoming isolated and impoverished. Following this, consultants collaborated to resolve such difficulties while maximizing the use of various local resources. The study's findings clarify that it would be effective to understand the difficulties faced by social workers to obtain hints toward their resolution.     

Transformation of Social Care Services for the Elderly in Slovakia

ABSTRACT

The main objective of this article is to present a theoretical framework for the relevant historical, economic, demographic, and political factors influencing the transformation of social care services for the elderly in Slovakia. A major restructuring of the social care services for the elderly is necessitated by the aging of the Slovak population (demographic reason), the path dependency of the current Slovak elderly care system (historical reason), the growing purchasing power of older people and the general population (economic reason), and new requirements formulated by the European Union and the general public (political reason). Historical documents, legislative acts, strategic documents, international project documents, and statistics were reviewed, and 34 open-ended interviews within the framework of two case studies were carried out in order to obtain qualitative and quantitative data. The theoretical framework and the results based on those interviews indicate that the Slovak social care service for the elderly may turn out to become more similar to the advanced Central European systems, but also that prompt legislative and financial changes are required. Nevertheless, the future direction can only be more precisely identified when more case studies can be compared with one another.     

Investing in Community Participation to Receive Social Support

ABSTRACT

According to the investment theory of social capital, the investment of valuable resources in social activity leads to the reception of social support. This theory is applied in examining the contribution of community participation to expected social capital. A survey of 1,523 mothers in low-income neighborhoods of Hong Kong, China, suggests that community participation was not generally conducive to expected social support. However, community participation tended to contribute to expected social support when coupled with family resources such as the employment and income of the mother and her partner.     

Good Intercultural Practices in Social Services Projects

ABSTRACT

This article reflects part of the results obtained from a wider research project aimed at the elaboration of a “Map of Good Intercultural Practices” in several areas of social intervention in Andalusia, Spain. It also reports the results obtained from the analysis portion related to the participating projects within the social services. Intercultural assessment was conducted at the level of institutional intervention through a 32-item questionnaire that was sent to 139 intercultural project-leading institutions measuring intercultural sensitivity. A definition of the fundamental concepts of “interculturality” and “good practice” is given to support the foundations of “good intercultural practice” (GIP). Such definitions help in the design and validation of a GIP Scale that was used in the analysis of 60 social services projects with an intercultural component. The results obtained underline the relevance of aspects such as intercultural empathy and show significant differences between the social services and other intervention sectors. Future research is proposed that studies GIP scale in other intervention sectors such as the private and public sector. Also, the transferability of the instruments and methodology used makes it possible that the research presented in this article is conducted in other geographical areas.     

English Local Authority Powers, Responsibilities and Guidelines for Managing the Care Home Closure Process

In England, the majority of older people living in care homesare publicly funded and the majority of publicly funded placesare purchased from the independent sector. While the sectoris subject to regulation, there is currently no statutory guidanceaimed specifically at how care home closures are managed. Thisarticle reviews the powers and responsibilities of councilsand the rights of residents during care home closures, beforedescribing the prevalence and content of existing council guidelines.Just over a third of councils in England responded to inquiriesand, of these, two-thirds reported having guidelines. This suggeststhat a considerable proportion of councils have no guidelinesin place. Existing guidelines also varied. Differences includedapproaches to allocating responsibilities and providing help,and assessment to self-funding residents. The large number ofarrangements and activities described suggest that some sortof plan or guidance is warranted to support the task of frontline care managers. At the national level, the variation foundin the guidelines combined with the lack of national guidancespecific to closures suggests that clarification of councils’legal responsibilities and powers during a care home closureis needed. Clarification of the role and responsibilities ofthe national regulatory body would also be useful.     

Participation of Disabled Children and Young People in Decision Making Within Social Services Departments: A Survey of Current and Recent Activities in England

A survey of all social services departments in England was undertakenin order to identify and investigate current work concerningthe participation of disabled children within decision makingregarding their own care and in service development. Developinga culture of, and good practice in, children’s participationis integral to government policy. Results demonstrate that disabledchildren are being involved in a range of decision-making areas;however, participation is not yet embedded or sustained acrossall social services departments, and the involvement of disabledchildren at a higher strategic level is still rare. The participationof disabled children needs further development including moreevidence on which factors can support and promote disabled children’seffective participation.     

United We Stand? Partnership Working in Health and Social Care and the Role of Social Work in Services for Older People

The concepts of ‘partnership’ and ‘collaboration’have become amongst the most critical themes of ‘new’Labour’s social policy, particularly in respect of thedelivery of health and social care. Although the terms are rarelyprecisely defined and hence have become problematic to analyse,in most understandings successful partnerships rely upon goodsystems of inter-professional collaboration. Through revisitingthe extensive literature on the sociology of the professions,and the nature of inter-professional working, this paper willargue that effective collaborative working within health andsocial care is hard to achieve, particularly in the light ofthe vast differences in power and culture between various occupationalgroupings, and the inherently competitive nature of professionsjostling for territory in the same areas of activity. It suggeststhat these issues cannot be resolved unless they are properlyunderstood; a rhetorical appeal to the unmitigated benefitsof ‘partnership’ alone will not produce more effectivejoint working. In addition, it notes that an appropriate rolefor social work in the context of partnership working has yetto be defined and proposes specific tasks and values that distinguishthe social worker from other related professionals.