Improving collaborative inter-agency systems and practice in self-neglect: a realist review and interview study.

Leading interagency collaboration

Purpose This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures. Design/methodology/approach A quantitative descriptive research design was used, using a cross-sectional study to explore occupational therapy staff views on the use of outcome measures. A 38-question survey was developed on Microsoft Forms. Recruitment occurred online over a three-week period in 2021 via the social media platform “Twitter”. Results were analysed using Excel using descriptive statistics and qualitative results used thematic analysis. Findings Participants (n = 20) used a range of outcome measures (13) in adult social care settings in the previous 12 months. Standardised measures were used by half the sample in the previous 12 months. The Therapy Outcome Measure and Barthel Index were in most use. The breadth of adult social care practice and practical factors such as caseload and lack of a meaningful tool were found to be barriers to outcome measure use. Facilitators included service improvement, accountability, use of audit and professional occupational therapy leadership. Research limitations/implications The overall use of outcome measures can be considered low in this setting, with manager support seen to be key to the use of outcome measures. Further research is needed to investigate nationwide use. Practical implications Training, time and manager support are key to use of standardised tests and outcome measures in the adult social care settings. The use of occupational performance measures should be considered to demonstrate unique professional impact. Originality/value This contemporary study reveals use of outcome measures within occupational therapy adult social care services in the UK, which is an under researched and under published area.

This new and very helpful text book is written by five highly experienced adult safeguarding practitioners and academics.In our safeguarding work, health and social care practice depends on the taking up of appropriately held personal, professional and institutional authority, informed and sustained by compassionate professional curiosity. Safeguarding Adults Reviews often comment on apparent deficits in professional curiosity. Yet, there is a scarcity of definitions and descriptions in the professional literature, and little information and guidance for practitioners. This text book amply fills that gap, providing a very important resource to the safeguarding adults community.The book has several potential audiences including students, and newly qualified and experienced practitioners in adult social work and social care, as well as in nursing and allied health professions. More broadly it will also be a helpful resource for those working in the criminal justice system, including police and probation. A key chapter in the book addresses the legal and policy context of partnership work in safeguarding adults, widening its usefulness even further, for example to agencies represented on Safeguarding Adults Boards.The book has a foreword by Dr Adi Cooper OBE, followed by an introduction, six substantive chapters and a final seventh summary conclusion chapter. Written in plain English, the seven chapters have interactive content with opportunities for readers to reflect and apply learning in their own environments. Each chapter begins with chapter objectives and ends with a summary of key points. Chapter content is illustrated with case studies, including from published Safeguarding Adults Reviews and Domestic Homicide Reviews (now known as Domestic Abuse Related Death Reviews). Although the book’s focus is on safeguarding adults, relevant learning from Children Safeguarding Practice Reviews is also woven in. In each chapter there are summaries of recent relevant research, as they apply to the chapter topic, as well as suggested further reading. The book is well indexed and contains a very up-to-date and extensive list of the references quoted in each of the chapters.The book helpfully addresses some broader changes in practice that have happened and continue to develop since the beginning of the COVID-19 pandemic in 2020. These include the more extensive use of virtual meetings and the opportunities and challenges some of these changes present when we are engaged in safeguarding work.Drawing on the work of Thacker et al. (2019) and Phillips et al. (2024), Chapter 2: Barriers to professional curiosity in safeguarding adults explores emotional, relational, structural and socio-systemic barriers in usefully detail. Personally, I would have welcomed some additional systems psychodynamics analysis such as that undertaken by Shoesmith (2016) in her account of the Learning from Baby P: The politics of blame, fear and denial. A systems psychodynamic perspective can help us to understand why to a greater or lesser extent we all are so easily and inevitably affected by wilful blindness, a concept developed by Heffernan (2011).That said, Chapter 3: Enablers of professional curiosity in safeguarding adults practice provides a range of very useful evidence-based pointers to enable practitioners and their managers to take care personally and organisationally to support personal and institutional professional curiosity.Chapter 5: The legal and policy context of partnership work in safeguarding adults is a very dense detail-packed chapter. It seemed to this reviewer that, subject to due attention to copyright issues, it could be used as an induction briefing for new Safeguarding Adults Board members who are less familiar with the context in which SABs work.This book is an excellent resource to have on your personal or institutional bookshelves. It will make a difference to how you develop and support your professional curiosity in your safeguarding work, filling an important gap in the current literature. At £19.99 in paperback, and a little less as an e-book format, you will get a lot of learning for your money.

BackgroundAn ageing population and limited resources have put strain on state provision of adult social care (ASC) in England. With social care needs predicted to double over the next 20 years, there is a need for new approaches to inform service planning and development, including through predictive models of demand.ObjectiveDescribe risk factors for long-term ASC in two inner London boroughs and develop a risk prediction model for long-term ASC.MethodsPseudonymised person-level data from an integrated care dataset were analysed. We used multivariable logistic regression to model associations of demographic factors, and baseline aspects of health status and health service use, with accessing long-term ASC over 12 months.ResultsThe cohort comprised 13,394 residents, aged ≥75 years with no prior history of ASC at baseline. Of these, 1.7% became ASC clients over 12 months. Residents were more likely to access ASC if they were older or living in areas with high socioeconomic deprivation. Those with preexisting mental health or neurological conditions, or more intense prior health service use during the baseline period, were also more likely to access ASC. A prognostic model derived from risk factors had limited predictive power.ConclusionsOur findings reinforce evidence on known risk factors for residents aged 75 or over, yet even with linked routinely collected health and social care data, it was not possible to make accurate predictions of long-term ASC use for individuals. We propose that a paradigm shift towards more relational, personalised approaches, is needed.

Background Adults facing complex health and social care challenges require intervention through the adult social care system. Adult social workers play a vital role in facilitating these interventions to support care delivery and improve outcomes for social care service users. The interactions between adult social workers and service users are central to the provision of social care; however, the impact of these interactions on outcomes remains inadequately understood. This realist review aims to investigate how, why, for whom, and under what circumstances interactions with an adult social worker influence service users' well-being, quality of life, and other essential outcomes in the United Kingdom. Methods We will search databases for relevant peer-reviewed articles that explore the perspectives of adult social care users in the United Kingdom. Grey literature will be identified through organisational websites, Overton, Dimensions, and advanced Google searching. Included studies will be assessed for relevance, richness and rigour. Diverse stakeholders, including adult service users, will be consulted to strengthen the depth of understanding and applicability. An interpretative, cross-case comparative approach will guide synthesis, identifying recurring patterns and developing context, mechanism, and outcome configurations. We will follow five iterative steps of conducting a realist review and the Realist and Meta-narrative Evidence Syntheses: Evolving Standards. Expected result and conclusion We will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users. Through evidence synthesis and engagement with stakeholders, we will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users and present a programme theory that explains its influence on health and well-being outcomes. This review aims to inform evidence-based practice, offering practical and in-depth insights for policymakers, social workers, and the social care system to improve service delivery and outcomes for service users. PROSPERO - CRD420256520

Background Adults facing complex health and social care challenges require intervention through the adult social care system. Adult social workers play a vital role in facilitating these interventions to support care delivery and improve outcomes for social care service users. The interactions between adult social workers and service users are central to the provision of social care; however, the impact of these interactions on outcomes remains inadequately understood. This realist review aims to investigate how, why, for whom, and under what circumstances interactions with an adult social worker influence service users' well-being, quality of life, and other essential outcomes in the United Kingdom. Methods We will search databases for relevant peer-reviewed articles that explore the perspectives of adult social care users in the United Kingdom. Grey literature will be identified through organisational websites, Overton, Dimensions, and advanced Google searching. Included studies will be assessed for relevance, richness and rigour. Diverse stakeholders, including adult service users, will be consulted to strengthen the depth of understanding and applicability. An interpretative, cross-case comparative approach will guide synthesis, identifying recurring patterns and developing context, mechanism, and outcome configurations. We will follow five iterative steps of conducting a realist review and the Realist and Meta-narrative Evidence Syntheses: Evolving Standards. Expected result and conclusion We will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users. Through evidence synthesis and engagement with stakeholders, we will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users and present a programme theory that explains its influence on health and well-being outcomes. This review aims to inform evidence-based practice, offering practical and in-depth insights for policymakers, social workers, and the social care system to improve service delivery and outcomes for service users. PROSPERO - CRD420256520

Background Adults facing complex health and social care challenges require intervention through the adult social care system. Adult social workers play a vital role in facilitating these interventions to support care delivery and improve outcomes for social care service users. The interactions between adult social workers and service users are central to the provision of social care; however, the impact of these interactions on outcomes remains inadequately understood. This realist review aims to investigate how, why, for whom, and under what circumstances interactions with an adult social worker influence service users' well-being, quality of life, and other essential outcomes in the United Kingdom. Methods We will search databases for relevant peer-reviewed articles that explore the perspectives of adult social care users in the United Kingdom. Grey literature will be identified through organisational websites, Overton, Dimensions, and advanced Google searching. Included studies will be assessed for relevance, richness and rigour. Diverse stakeholders, including adult service users, will be consulted to strengthen the depth of understanding and applicability. An interpretative, cross-case comparative approach will guide synthesis, identifying recurring patterns and developing context, mechanism, and outcome configurations. We will follow five iterative steps of conducting a realist review and the Realist and Meta-narrative Evidence Syntheses: Evolving Standards. Expected result and conclusion We will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users. Through evidence synthesis and engagement with stakeholders, we will identify CMOCs that describe the impact of social workers' contact with adult social care services on service users and present a programme theory that explains its influence on health and well-being outcomes. This review aims to inform evidence-based practice, offering practical and in-depth insights for policymakers, social workers, and the social care system to improve service delivery and outcomes for service users. PROSPERO - CRD420256520

Re-envisaging professional curiosity and challenge: Messages for child protection practice from reviews of serious cases in England

BackgroundDelirium is a neuropathological syndrome that is characterised by fluctuating impairments in attention, cognitive performance, and consciousness. Since delirium represents a medical emergency, it can be associated with adverse clinical and economic outcomes. Although nursing home residents face a high risk of developing delirium, health care professionals in this field appear to have limited knowledge of delirium despite the critical role they play in the prevention, diagnosis, and treatment of delirium in nursing homes.ObjectiveThe purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes.MethodsThis realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium.ResultsFrom a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication.ConclusionsEducational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals’ interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff.Trial registrationThis review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3

Migrant-origin families may have a pronounced need for psychosocial support and healthcare services, but they face barriers in using services. To ensure the timely use of services, it is important that families understand how service systems work and trust care providers. Thirty-two migrant-origin mothers living in Finland participated in five focus-group interviews and shared their wishes for social and healthcare professionals on how trust and understanding can be increased. The data were analyzed with Qualitative Content Analysis. We identified six main themes related to the use of services and professionals’ behavior. These were the need for professionals to justify and explain questions, to meet each family as individuals, the importance of non-verbal communication, the need to talk about racism and discrimination, the importance of cultural sensitivity in services, and a discussion of positive aspects of life after migration and children`s strengths. To foster trust and mutual understanding in social and healthcare services, professionals should be aware of potential cultural differences in family life, while avoiding pre-conceived ideas. Misunderstandings can rise from language barriers and unclear or intimidating questions. It is important that professionals explain what they do and justify why they might inquire about a family’s personal matters. Working with interpreters is necessary when professionals and parents do not share a common fluent language. Professionals should also pay attention to their non-verbal communication and to being friendly. Finally, it is important to show interest in families’ experienced hardships such as racism as well as their strengths.

This article reports on a study of perceptions of Chinese and expatriate personnel on a Sino‐British English teacher training programmme on a range of issues with regard to the programme. Semi‐structured one‐to‐one interviews were conducted to gather information from 17 Chinese and three British project participants. It was found that there existed convergences and divergences in the two sides’ views. This article argues that the convergences may have been induced by the project implementers’ collaborative work experience on the programme and the advantages of the top‐down approach adopted for this programme, whilst the divergences may have been caused by cultural differences, the lack of communication between the two sides, and the drawbacks of the top‐down approach. This study suggests that perception gaps can occur between local and expatriate personnel and that it is necessary for both sides to adapt to and support each other in order to enhance mutual understanding and collaboration.

Convergence (i.e., mutual understanding) between an organization's CEO and CIO is critical to its efforts to successfully exploit information technology. Communication theory predicts that greater communication frequency and channel richness lead to more such convergence. A postal survey of 202 pairs of CEOs and CIOs investigated the effect of communication frequency and channel richness on CEO/ CIO convergence, as well as the effect of convergence on the financial contribution of information systems (IS) to the organization. Convergence was operationalized in terms of the current and future roles of information technology (IT) as defined by the strategic grid. Rigorous validation confirmed the current role as composed of one factor and the future role as composed of three factors (i.e., managerial support, differentiation, and enhancement). More frequent communication predicted convergence about the current role, differentiation future role, and enhancement future role. The use of richer channels predicted convergence about the differentiation future role. Convergence about the current role predicted IS financial contribution. From a research perspective, the study extended theory about communication frequency, media richness, convergence, and the role of IT in organizations. From a managerial perspective, it provided direction for CEOs and CIOs interested in increasing their mutual understanding of the role of IT.

The educational institutions basically need Public Relations which aims to gain goodwill, trust, mutual understanding and a good image from the public. Increased competition among tertiary institutions makes each tertiary institution challenged to form a positive image to the public. Prospective students will have a special interest in campuses that have a positive image. The problem in this research is what is the role Public Relations Muhammadiyah University of Lampung in Improving Positive Image. The research methodology is a qualitative constructivism approach with the case study method which is carried out in its entirety, comprehensively and in depth using a variety of data sources. The results of the research show that there are four main roles required of a Public Relations namely, as Communicator, Public Relations Communicate intensively through media and community groups, Relations, Public Relations capabilities building positive relationships between institutions represented and internal and external public, backup management, carry out management support or support departmental activities other in tertiary institutions for the creation of common goals, good image makers, create positive college image and publicity.

This study explores the concept of digital partnering among construction organisations, focusing on the essential factors that contribute to successful partnerships and their impact on achieving digital transformation. To gather quantitative data, a survey was conducted with construction professionals engaged in projects throughout South Africa. The data analysis employed a comprehensive six-step methodology, including mean item scoring, Kruskal- Wallis H-Test, exploratory factor analysis (EFA), and multiple linear regression (MLR). The findings from the EFA indicated that the effectiveness of digital partnering hinges on three critical elements: a supportive partnering environment, trust and mutual understanding, and management support. The MLR analysis further validated these factors as crucial for attaining digitally transformed construction organisations. Given the competitive and often adversarial nature of the construction industry in developing countries like South Africa, the study recommends that organisations pursue collaborative partnerships both within and outside the industry to facilitate digital transformation. This can be achieved by fostering an environment that nurtures trust, understanding, and strong management support for developing digital capabilities through collaboration. The study offers empirical insights into the key factors necessary for successful digital partnering, an area that has been largely overlooked in discussions surrounding construction digitalisation.

To assess healthcare professionals' perceptions of patient safety culture and to examine variations across clinical units in Eastern Ethiopian public hospitals. A cross-sectional study was conducted using the Hospital Survey on Patient Safety Culture (HSoPSC 2.0) tool. Analysis of variance and ordinal logistic regression analyses were performed. Results were presented as mean differences and an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and statistical significance was set at a p-value < 0.05. Content analysis was performed for data provided through the open-ended response option. A total of 582 questionnaires were returned, yielding a response rate of 85%. Overall positive patient safety culture score was 47% (95% CI: 41-53%). Intensive care units (ICUs) scored significantly lower on patient safety culture dimensions compared to other clinical units. Factors contributing to the patient safety ratings included Midwives (AOR = 0.20, 95% CI: 0.06-0.71, p = 0.013), Organisational learning and continuous improvement (AOR = 1.35, 95% CI: 1.04-1.76, p = 0.025), Supervisor, manager, or clinical leader support for patient safety (AOR = 1.41, 95% CI: 1.06-1.89, p = 0.02), and Hospital management support for patient safety (AOR = 1.28, 95% CI: 1.00-1.63, p = 0.049). The challenges in ensuring patient safety included the absence of patient safety incident reporting systems, severe resource constraints, limited awareness regarding patient safety, ineffective communication, poor management support, and a blame-oriented organisational culture. Significant improvement in patient safety culture in Ethiopian public hospitals, especially in the ICU, is critically needed to mitigate healthcare risks and ensure patient safety. Addressing these issues requires targeted patient safety training, strong leadership support, and adequate resource allocation. Further exploration of ICU-specific patient safety insights and validation of the HSoPSC 2.0 tool within the Ethiopian healthcare context should be undertaken to ensure cultural and contextual relevance.