Local Authority Staff Research Articles

Providing appropriate health and social care for people with dementia or mild cognitive impairment in the criminal justice system of England and Wales: a thematic analysis of prisoner and staff interview data

BackgroundThe number of older adults entering the criminal justice system is growing. Approximately 8% of older prisoners in England and Wales have suspected dementia or mild cognitive impairment (MCI) and experience difficulties in everyday functioning, and disruption to their daily life. At present, no specific dementia/MCI care pathway has been implemented that is applicable and appropriate for use across different prisons in England and Wales. The aim of this paper is to explore the experiences of older adults with dementia/MCI in prison, and a range of key stakeholders, around the day-to-day issues faced by people with dementia/MCI and prison, healthcare, and third sector staff regarding the delivery of support for individuals with dementia/MCI.MethodsThirty-two semi structured interviews were conducted with prison, local authority, and healthcare staff; peer supporters; third sector care providers; and individuals with dementia/MCI themselves, across five establishments, to provide multidimensional perspectives of dementia/MCI in criminal justice settings. The data obtained during interviews were thematically analysed.ResultsFrom the data, six key themes emerged: (I) ethical concerns around trial, sentencing and detainment for people with dementia/MCI; (II) An unforgiving prison system, providing physical and social environments incompatible with supporting individuals with dementia/MCI; (III) An unprepared workforce requiring training in dementia/MCI. (IV) A lack of collaboration leading to sub-optimum management of the support needs of people with dementia/MCI in prison; (V) Peer support ‘plugging the gap’; and (VI) staff ‘hands tied behind back’.ConclusionsResults point towards a pressing need to develop more appropriate support systems for individuals with dementia/MCI throughout the criminal justice system. Ethical concerns around the judicial process for individuals with diminished cognitive capacity must be considered. Prison governors should examine ways to make the living environment more appropriate for these individuals, and a joined-up collaborative approach to health and social care should be adopted. Staff must be appropriately trained to support and identify individuals with dementia/MCI. Peer support schemes require formal evaluation, and training/oversight of these schemes should be comprehensive.

Understandings of success for groups managing leisure facilities through Community Asset Transfers

Community Asset Transfer (CAT), where voluntary community groups form to manage local facilities in replacement for local authorities (LAs) has increased. This paper discusses how successful management of the facilities is understood. Factors for this success involve community capital and these capitals underpin understandings of successful CATs. The study reveals perspectives of successful CAT by examining qualitative case studies of two cases of CAT of leisure facilities. Both involve social enterprises forming to conduct the CAT. Interviews with local authority staff, board members, staff, and volunteers within the community organisations reveal the perspectives on successful CAT and what successful asset management involves. Two findings are explored; success concerning outcomes of CATs benefitting residents; and this not being understood across cases. The paper is useful for LAs responsible for CATs and for community organisations considering pursuing a CAT.

Stakeholders’ readiness in implementing regulation on affordable public housing: a case study in Pemalang Regency, Central Java

The lengthy licensing stage is becoming a problem in low-income housing development. Stakeholders’ readiness plays an essential role in the success factor of low-income housing. This study aims to identify the stakeholders’ readiness for regional autonomy in terms of policy implementation according to the Regulation of the Minister of Home Affairs Number 55 of 2017 concerning Low-Income Housing in Pemalang Regency. The research method adopted the policy model by Edwards III and the analytical hierarchy process (AHP). The determination of the criteria in this study was divided into four criteria: communication (human and financial) resources, implementers’ disposition/behaviour, and bureaucratic structure. These four criteria were analysed using the AHP method on eight respondents from one of the institutions related to the licensing stage. The findings suggested five strategies that could improve programs to accelerate the provision of low-income housing. The order of priority for those five strategies is: (1) capacity building of local authority staff; (2) improvement of the bureaucratic system and licensing services; (3) sanctions for parties affecting the licensing service process; (4) provision and dissemination of information; and (5) revision of regulations (Regulation of the Minister of Home Affairs).

Integrated working in local authority decision-making about air quality: a qualitative study in Southwest England.

Exposure to poor air quality is one of the most significant environmental public health challenges. In the UK, local authorities (LAs) are responsible for monitoring and managing air quality. This article explores the need and mechanisms for cross-departmental working in LAs to make decisions about air quality issues. Semi-structured qualitative interviews with public health, environmental health and transport staff from LAs within the Southwest of UK. Interviews were conducted between April and August 2021 and analysed using a thematic approach. In sum, 24 staff from 7 LAs participated. Local authority staff in public health, environmental health and transport teams recognized that managing air quality was a cross-departmental issue. To enable effective integrated working staff described four successful mechanisms: (i) policy commitments and political support; (ii) dedicated air quality steering groups; (iii) existing governance and oversight groups; and (iv) networking and relationships. This study has identified mechanisms that LA staff have found support cross-departmental and integrated working on air quality issues. These are mechanisms that have helped environmental health staff work towards achieving compliance with pollution limits, and that have helped public health staff get air quality considerations recognized as a wider health issue.

‘What I really want is academics who want to partner and who care about the outcome’: findings from a mixed-methods study of evidence use in local government in England

Background:Local government (LG) is ideally placed to influence the determinants of public health (PH) and reduce inequalities, but opportunities are routinely missed. Aims and objectives:The aim of the Local Authority Champions of Research (LACoR) study was to explore ways to embed a culture of evidence use in LG. Methods:Five linked work packages were undertaken using mixed methods. In this paper, we report data from semi-structured interviews with UK local authority (LA) staff (n=14). Findings:Findings show a changing culture of LG: embedded researchers can enhance connectivity and interaction, build linkages, use levers of influence, and learn alongside LG navigators. Understanding the diverse microcultures of evidence use in LG is critical. Research champions can help to navigate the social, financial, political and regulatory context of LG and academia, influencing change dynamically as opportunities emerge. Discussion:Changing organisational subcultures is ambitious and unpredictable given the complexities of, and variability in, local contexts. Cumulative changes appear possible by recognising existing assets, using relational approaches to respond to LG priorities. In-house capacity remains underestimated and underutilised in efforts to embed evidence use in LG decision making. Co-located embedded researchers can use contextually specific knowledge and relationships to enhance evidence use in LG in collaboration with system navigators. Conclusions:There is a need for academics to adapt their approach, to take account of the context of LG to achieve meaningful health and social impacts with LG and test the contribution of embedded approaches to wider system change.

Examining what factors affect inter-agency working in missing children investigations

Abstract Despite responsibility for missing children belonging to multiple agencies, police perceive this to be falling heavily on their shoulders, placing substantial demand on finite resources. Drawing on thematic analysis of 24 interviews conducted with police, local authority, social service, and care home staff from across three UK boroughs, the following study seeks to identify what factors facilitate and hinder inter-agency working in the prevention and response to missing children and why. Findings highlight that inter-agency working is facilitated by having ‘direct points of contact’ across agencies to facilitate information sharing. Inter-agency working is hindered by ‘inconsistent definitions of missing’, limited ‘understanding of roles and responsibilities’, ‘service demand’, ‘technological issues’, ‘fear’, and ‘discrepancies in responses to missing’. Evidence suggests that partnership working would be facilitated by improving shared understanding of missing, roles and responsibilities, and having direct points of contact across agencies.

Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework.

Behavioural science and its contribution towards improving public health is receiving increased recognition. Yet, the translation of these insights into public health practice is under-researched. This study explored the factors influencing the use of behavioural science within public health at a local authority level. Fourteen local authority staff (n = 13 female) in the south of England participated in semi-structured interviews, which were analysed inductively to identify key themes. These were later mapped deductively to the COM-B model and Theoretical Domains Framework. Nine themes were identified as factors that influence the use of behavioural science in local authority public health: (1) "Limited past experience," (2) "Narrow understanding," (3) "Perceived value of behavioural science," (4) "Translational gap from theory-to-practice," (5) "No protected time," (6) "Old ways of working," (7) "Political influence and organisational culture," (8) "Relationships with key stakeholders," (9) "Access to behavioural science resources". Deductive mapping of these themes revealed that five of the COM constructs (excluding Physical Capability) and eleven of the TDF domains influenced behavioural science use, with "Social influences" and "Knowledge" being the most prominent. Use of behavioural science within local authority public health practice is limited and inconsistent. For it to be successfully implemented, there must be an understanding of its role and value, alongside strategies to overcome a translational gap from theory to practice. Public health teams would benefit from protected time to enable application and strategies to break old habits of using a common-sense approach. System-wide buy-in, particularly related to senior leadership and system partners is needed, which would benefit from organisational and political culture change. Training opportunities, practical resources and expert in-house support should be considered a priority across public health teams.

Mental health and child refugees

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom.

Knowledge and awareness of water quality protection issues within local authorities

The EU Water Framework Directive’s (WFD) ambition to achieve good ecological status for waters is an ambitious target due to the complexity of water management governance. Usually, multiple institutions are responsible for water management, often operating within a hierarchical structure, in which each level has different responsibilities. It is essential that knowledge and awareness of plans and policies associated with water management are effectively transferred through the hierarchical structure to the staff responsible for day-to-day activities. This study investigates the level of knowledge and awareness of water quality issues among Local Authority (i.e., local government) staff within Ireland and the extent to which water protection measures are implemented within core functions of local government. There is relatively good knowledge or awareness related to high level issues, including institutions responsible for water management, awareness of WFD and river basin management plans. Knowledge and awareness levels are considerably lower on more specific details, including on water quality status and protection measures being implemented within their jurisdictional areas. Overall, the study suggests that there is considerable scope for improvement in knowledge and awareness, and outlines a series of recommendations to improve priority for water quality protection among Local Authority staff.

Organizational challenges of public housing management in the Global South. A systems assessment of Ghana

Public housing has contributed tremendously to addressing housing deficits in many countries. Notwithstanding the shift towards neo-liberalism, public housing is still relevant in the Global South. Ghana’s response to the neo-liberal call was to sell-off most of the public housing stock and transfer some of the remainder to local authorities. Despite its contribution to labour mobility and productivity, Ghana’s public housing conditions are poor largely due to ineffective management and maintenance. The paper aims to use systems theory to identify the organizational challenges for management that has resulted in poorly maintained public housing. The study interviewed housing experts, local authority staff and tenants; and finds that the organizational structure is poorly defined; irregular financial resource flows impede maintenance, and there is low tenant involvement in housing management. It recommends that housing management activities should be concentrated at the municipal level with defined roles. Mechanisms for tenant participation in management should be introduced to ensure that outcomes meet tenants’ expectations.

Local authority research systems: a qualitative study to inform the development of a South Gloucestershire Council-wide research system

BackgroundThe co-location of expertise in public health, social care, and place services in local authorities facilitates tackling the wider determinants of health using transdisciplinary approaches. Local authority research systems are needed to enable local authorities to become research active, co-produce research, evaluate their impact, and produce and use evidence to shape practice and policy at pace. We aimed to explore and recommend what is necessary for a South Gloucestershire Council (SGC) research system to sustainably produce impactful research activity. MethodsWe did qualitative interviews with elected members and senior leadership of SGC and key stakeholders from local National Institute for Health Research (NIHR) infrastructure and organisations identified by expert sampling. Interviews were semi-structured with tailored topic guides exploring several topics, including relationships between SGC and local partners, resource and support, co-production, social care research, and the impact of COVID-19. Data from interviews were electronically transcribed verbatim using Otter.ai and coded using NVivo qualitative data analysis software. Data were analysed using the framework method and recommendations were proposed based on the findings. Ethical approval was granted by the University of Bristol's Faculty of Health Science Research Ethics Committee. FindingsWe interviewed 27 participants (five from SGC, 22 from local research organisations). Participants identified a need for a SGC research lead to facilitate collaboration and relationship building, and more joint posts across the local authority and external organisations. There was a need for collaborative cross-boundary working, as SGC works with other local authorities in their Sustainability and Transformation Partnership and Clinical Commissioning Group. Challenges included difficulties identifying SGC's priorities and population needs, data, staff training, and collaboration with academic researchers. They also reported resource issues exacerbated by COVID-19. Participants did not express conflicting views on these findings. InterpretationWe recommended the creation of a local authority research lead post working across Council directorates, local authority research networks, support for joint posts, increased accessibility and use of local authority data, cross-boundary research systems, and infrastructure to support research to respond to local authority needs. We also suggested increased funding and incentivisation for academics to engage with local authority research. Potential barriers to these recommendations include local authority funding and staff capacity challenges. This study was limited by its recruitment method, sample size, and data collection and analyses completed by a single researcher. Future research should explore what types of evidence local authorities consider most relevant and useful. FundingNIHR Public Health Research (grant number NIHR131952).

Co-production in local government: process, codification and capacity building of new knowledge in collective reflection spaces. Workshops findings from a UK mixed methods study

BackgroundCo-production of research evidence is valued by local government to improve effective decision-making about public services in times of austerity. However, underlying structural issues of power (so-called ‘dark shadows of co-production’) challenge this ambition with limited evidence on how to embed research use sustainably. In this paper we reflect on mechanisms for increasing co-production in local government.MethodsThis paper presents findings from a Health Foundation funded research project that explored how a culture of evidence use to improve population health could be embedded in UK local government. Five linked work packages were undertaken using mixed methods. In this paper, we report the views of UK local authority staff who participated in four workshops (n = 54), informed by a rapid literature review and an online scoping survey.ResultsWe identified five themes that facilitate public health evidence use in local government: (1) new governance arrangements to integrate national and local policies, (2) codifying research evidence through local system-wide approaches and (3) ongoing evaluation of programmes, and (4) overcoming political and cultural barriers by increasing absorptive capacity of Local Authorities to embed co-produced knowledge in their cognitive structures. This requires adaptive governance through relationship building between academic researchers and Local Authority staff and shared understanding of fragmented local policy making, which are supported by (5) collective spaces for reflection within local government.ConclusionsCreating collective spaces for reflection in between government departments allows for iterative, interactive processes of co-production with external partners that support emergence of new governance structures to socially action the co-produced knowledge in context and build capacity for sustained evidence use.

Building Heath Research Capacity: The Impact of a United Kingdom Collaborative Programme

Purpose: Strengthening research capacity (RC) amongst health professionals has both organisational and individual benefits. It can increase the quality of research and support the transfer of evidence into practice and policy. However there is little evidence on what works to develop and strengthen RC. This paper contributes to the evidence base by reporting findings from an evaluation of a programme that aimed to build capacity to use and do research amongst NHS and local authority organisations and their staff in a large english research partnership organisation. Methods: The evaluation used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n=131 respondents including public advisers, university, NHS, and local government partners). Results: The RC building programme provided a range of development opportunities for NHS and local authority staff resulting in increased confidence and skills to undertake, participate in, and use research. Additionally, positive influences on organisational practice and collaborative working were reported. Conversely, challenges to developing research capacity were also identified as were the importance of resources, senior level buy-in, and the relevance of research topic to practice in facilitating participation in the programme. Conclusion: Collaboration for Leadership in Applied Health Research and Care North West Coast’s (CLAHRC-NWC) RC building programme differed from convential approaches giving less emphasis to formal teaching and more to experiental learning and focusing on both individual capacities and supporting organisations to integrate RC building into staff development programmes. The findings demonstrate that providing opportunities for staff in NHS and local authority organisations to develop research knowledge and skills alongside an infrastructure that supports and encourages their participation in research can have positive impacts on research capacity and organisational research culture. The potential for generalising this approach to other organisational contexts is discussed

Facilitators and challenges in delivering a peer-support physical activity intervention for older adults: a qualitative study with multiple stakeholders

BackgroundInvolving peer volunteers in intervention delivery can provide social support and improve adherence. Whilst such interventions have the potential to reduce physical activity (PA) intervention costs, little is known about the process of delivering them in practice. This qualitative study explored the facilitators and challenges of delivering a peer-support PA intervention for older adults, with a view to making recommendations for the delivery of future interventions.MethodsData were collected via (7) semi-structured interviews and a focus group with stakeholders involved in a peer-support PA intervention for older adults in a large city in the North-West of England. Participants included local authority staff (n = 3), peer volunteers (n = 2) and service users (n = 7). Audio data were transcribed verbatim and thematically coded to identify perceived facilitators and challenges.ResultsFacilitators to delivery included social interaction, community referral pathways, suitable facilities, peer volunteers and high-quality instructors. Challenges surrounded inconsistent practice, staff capacity, safety and accountability, and awareness raising.ConclusionsPeer volunteers can provide an additional support mechanism alongside qualified instructors for increasing social interaction within PA interventions. For optimal intervention delivery, consideration needs to be given to equipment and space, safety and accountability and consistency of practice.

Vulnerability assessment of building material against river flood water: case study in Malaysia

Flood risk is increasing in Malaysia specifically around river which influencing of climate change. The aim of this study is assessing the vulnerability of building materials by revealing the degree of loss for each structure. There are most five common materials has been assessing namely: brick, concrete block, steel wall panels, wooden wall and precast concrete framing. This research was conducted on 110 buildings, to record detailed attributes of each building in the city of Kuantan. Afterwards, the interviews were conducted with residents of 85 households along with a local authority staff expert. The lowest flood depth that effected on wall building was 25 cm and the highest depth of flood was recorded 150 cm. In general, the interview revealed that the flood lasted for 48 hours. The vulnerability of the structural type of building is determined from the percentages of damage to the wall material resulting from occurrence of the flood. Vulnerability curves were made for these five structural types, by plotting the relationships between flood depth and damage for each structural type. The result shows that by increasing the flood depth wood wall encounter by more damage, which needs more cost to repair. In other hand, Concrete block wall, which consider as one of the industrial building systems has less damage against floodwater. Although, until the depth of 75 cm both Concrete block wall and precast concrete has a same stability. The result of this research can help housemaker to choose the best material for building in flood zone area, which needs less cost in repair stage after flood hit the building.

The physical education and sport premium: Social justice, autonomy and school sport policy in England

ABSTRACTSince the global economic recession, public services in the UK have been badly affected by austerity measures. However, whilst public services, including health, defence and the police faced significant cuts to their budgets, Primary Physical Education in England has actually received additional ring-fenced funding through the Physical Education and Sport Premium since 2013. This funding is provided directly to schools, and though the Department for Education provides guidance on how the Premium might be spent, schools effectively have autonomy to spend it in ways that they believe will best meet the needs of their learners and wider stakeholders. Utilising a mixed method approach involving analysing published material on school websites and semi-structured interviews with primary school and local authority staff, the aim of this article is to critically analyse how primary schools across a borough in the North West of England are spending the Premium. Our analysis is underpinned by principles of social justice, which we interpret as a marker for concerns to do with fairness, equality, exclusion, discrimination, power differentials and privilege. We argue that, in large part due to the autonomy of implementation, the Physical Education and Sport Premium has failed to realise its inherent social justice agenda in that investment in PE and school sport is unjust and too heavily dependent on the value placed upon it by individual schools. It is our contention therefore, that equal opportunities will remain unobtainable if the central tenets of the reproduction of privilege are allowed to remain uncontested.

Implementing minimum nutritional guidelines for school meals in secondary schools in Wales: What are the challenges?

Background: Minimum nutritional guidelines for school meals were introduced across the UK to address concerns about poor provision and rising childhood obesity but little evidence relates to the challenges associated with implementing guidelines within the school context. Aims: Using an implementation model, this paper reports a qualitative study of the views, experiences and challenges identified in respect of the implementation of minimum nutritional guidance (Appetite for Life) in secondary schools in Wales. Methods: Semi-structured interviews (n=13) were undertaken with policy, local authority and school staff members in four schools within one local authority in Wales. Interviews were recorded and transcribed and analysis was underpinned by a framework approach. Findings: Members of staff welcomed the guidelines, noting the contribution to the health and wellbeing of pupils, however, they reported that meals were less popular and that take-up of school meals had reduced as pupils endeavoured to access banned foods elsewhere. Conclusions: The guidelines have implications for school meal uptake and contextual factors such as the built environment will influence the success of such policies.

Influenza and vaccination: beliefs and practices of local authority staff.

Influenza causes large outbreaks every year. Professionals outside healthcare, including social care staff and non-care giving roles, have a key role in protecting their clients and sustaining operational productivity through influenza vaccination. There has been little research on non-healthcare staff working with vulnerable people and those working in non-caregiving settings regarding influenza and influenza vaccination. To understand the practices, experiences, perceptions and motivations of local authority staff regarding influenza and influenza vaccination. Semi-structured focus groups were carried out with local authority staff in Gloucestershire. Transcripts were thematically analysed. Participants tended to perceive influenza as a serious illness, where a person had a specific risk factor or during pandemics. They did not feel vulnerable unless they had previous experience of infection or had an underlying health condition. Motivation to vaccinate was based on previous experience of influenza, where they had a close family member at risk or when working directly with vulnerable clients. Beliefs about negative side effects of the vaccine were the strongest reason for vaccine refusal. Ease of access to vaccination through on-site clinics is key to uptake. Management are perceived as key motivators or blockers to vaccine uptake. Workers outside healthcare settings do not feel vulnerable to influenza and have low motivation to vaccinate, unless they have previous experience of infection or an underlying health condition. Vaccination programmes must proactively address workers' beliefs and motivations to ensure their participation in flu vaccination programmes.

Red Bag scheme evaluation—hospital transfer pathways and their relevance to HCAs

This article provides an insight into the evaluation of a hospital care transfer pathway, which was operationalised with the intention of improving information for healthcare professionals and local authority staff working in home and secondary care settings, such as hospitals. The evaluation of the Red Bag scheme provides timely reminders of the need for effective communication in any context of patient-centred care, the need for the capacity to keep learning and perhaps most importantly to remain reflective on practice every day. The article ends with 10 specific recommendations for all staff working in the context of hospital transfer, to ensure that optimal experience for patients can be assured as far as possible.

Are the early benefits of the Adoption Support Fund (therapeutic support for adoptive families) sustainable?

PurposeThe purpose of this paper is to explore the wider context in which the national evaluation of the Adoption Support Fund (ASF) was delivered and raise concerns about the sustainability of the early outcomes.Design/methodology/approachThe paper briefly summarises the outcomes of a two-year mixed-methods evaluation. This included a two-wave postal survey (n=792) and follow-up (n=481), an online survey of adopters (n=586) and professionals (providers n=50, local authority staff n=124) and in-depth family interviews. The focus of the discussion on sustainability is drawn from the qualitative research of 10 local authority case studies based on 86 interviews with adoption teams and 33 providers and the perspectives of parents.FindingsWhilst the ASF showed modest early outcomes for families in terms of improved mental health and wellbeing without the scaffolding of wider support of services able to understand the complex lifelong needs of adoptive children and their families, the sustainability of the benefits of therapeutic support is questioned. Adoption teams struggled with the increased burden of administration of the fund, their knowledge of therapeutic interventions, an evidence base and quality of provision from a market that is difficult to regulate. In a society that is failing to meet the mental health and wellbeing needs of children generally, how can a single intervention meet the needs of a very vulnerable group?Research limitations/implicationsResearch and evaluation on interventions in children’s social care could be more systems aware and instead of narrowly focusing on outcomes pay attention to the complex network of services that interlink to support vulnerable children and their families and the restraints on resources that they are working with.Social implicationsTo prevent adoption breakdown and increase recruitment of adopters, support for adoptive families needs to be improved beyond the current scope of the ASF. A wide range of services are required to support adopted children particularly as they grow into adolescence. While families have the right to live independently of social services, the awareness of their needs throughout public organisations should be raised particularly in schools.Originality/valueThis paper represents the views of the evaluators at TIHR of the ASF beyond the scope of the original evaluation. It reflects on the wider context of the role out of the Fund and raises important questions about the failure to support the mental health and wellbeing needs of the most vulnerable children in society. It is an organisation reflection drawing on early research in children’s social care from its archive.