Provision Of Social Care Services Research Articles

The use of technology to address loneliness and social isolation among older adults: the role of social care providers

BackgroundAddressing loneliness and social isolation among older adults remains a public health priority. The restrictions enforced during the COVID-19 pandemic simultaneously heightened the need for services to overcome social isolation and reduce loneliness among older adults, while also limiting social care providers’ ability to deliver these. The aim of this study was to explore the experiences of social care providers in using technology to address loneliness and social isolation among older adults during the pandemic.MethodsThis was a mixed methods study involving an online survey and interviews with providers of older adult social care in Wales, UK. Invitations to participate were sent to commissioners and providers of adult social care services, including those working in the voluntary and community sectors, across all local authorities in Wales. Data was collected between September 2021 and January 2022.ResultsSixty-one service providers completed the survey, 19 of whom also took part in an interview. Addressing loneliness and isolation among older adults was reported as a key concern by nearly all survey respondents. While telephone calls were the most common means of facilitating social interaction, many service providers also tried to support older adults to make more use of devices that they already had (e.g., smartphones to hold video calls). Where funding was available, organisations purchased devices, such as tablets and smart speakers, for older adults. Analysis of interviews resulted in three themes: (1) The potential and limitations of technology; (2) Individuals’ capabilities, confidence, motivations and values; and (3) The wider system.ConclusionsTechnology was employed in a variety of ways during the pandemic to address loneliness and social isolation among older adults; many service providers continue to use technology in a hybrid system of care now that pandemic-related social restrictions have been lifted. Our findings emphasise a need for technology-assisted interventions to be designed and deployed in alignment with service users’ values, motivations and capabilities. Further, there is a need to better support service providers to assess loneliness and social isolation among older adults, and to acknowledge the important role providers play in helping older adults to adopt technology-assisted interventions.

The Association of Organizational, Environmental, and Staffing Characteristics of Residential Care Facilities and the Risk Rating of Statutory Notifications: A Cross-Sectional Study in Ireland.

Safety incidents (SIs) are an indicator of quality in health and social care services. Safety incident research has largely focused on acute health care settings. We aimed to examine the association of organizational, environmental, and staffing characteristics of residential care facilities (RCFs) and severity of regulatory SI notifications. This was a retrospective analysis of SI notifications to the regulator for social care in Ireland received in 2018 and 2019. The mean risk rating of SI notifications for each RCF was used as the outcome. Regression analysis was conducted for the association of RCF characteristics (beds, staff to bed ratio, staff full-time equivalent (FTE), nurse to bed ratio, nurse FTE, number of RCF operated by the service provider, non-statutory or statutory provider) and the outcome, separately for nursing homes and residential disability services. A total of 53,268 SI notifications were received. One thousand nine hundred RCFs were operational during the period: 594 (31.3%) for RCF-Nursing home and 1304 (68.7%) for RCF-Disability. For nursing homes, in the most adjusted model, the number of RCF operated by a provider ( β coefficient [95% confidence interval] = 0.508 [0.223-0.793]) was positively associated with mean risk rating of SI. For disability services, the following characteristics were positively associated in the most adjusted model: beds (0.081; 0.060-0.101), staff to bed ratio (0.068; 0.017-0.120), nurse to bed ratio (0.356; 0.044-0.667), staff FTE (0.029; 0.015-0.042), and number of RCF operated by a provider (0.067; 0.050-0.084). Various modifiable organizational, environmental, and staffing characteristics and severity of SI notifications were associated in this study, most of which were related to RCF-Disability. Policymakers and providers of social care services should be cognizant of the relationship of these characteristics and severity of SI, when designing and planning residential care.

Wellbeing and healthcare access for sexuality and gender minority secondary school students with long-term health conditions

ObjectiveTo explore the prevalence of long-term health conditions (which includes disorders such as asthma and diabetes, lasting six months or more) among sexuality and gender minority youth (SGMY) within Aotearoa New Zealand, and report on SGMY access to health care services. MethodWe used data from a population-based survey (Youth’19) of 7,059 secondary school students in Aotearoa New Zealand. Multivariable logistic regression models were used to investigate the associations of five sex, gender and sexuality groups: heterosexual cisgender females (n = 3,127, 44.30%); heterosexual cisgender males (n = 2,934, 41.64%); sexuality minority cisgender females (n = 659, 9.34%); sexuality minority cisgender males (n = 216, 3.06%); and gender minority adolescents (n = 123, 1.74%), and the selected outcome variables (i.e., general health, long-term health conditions, difficulties accessing healthcare and talked to a health provider privately). ResultsGender minority adolescents reported the highest odds of having a long-term health condition (adjusted Odds Ratio/aOR = 6.69, 95% Confidence Intervals/CI 3.89–11.42) compared to heterosexual cisgender males. Sexuality minority cisgender females and males also had significantly higher odds of having a long-term health condition compared to heterosexual cisgender males. Gender minority youth reported the highest odds of experiencing difficulties accessing health care (aOR = 3.99, 95% CI 2.50–6.36) compared to heterosexual cisgender males. Sexuality minority cisgender females and males were also significantly more likely to experience difficulties accessing healthcare than heterosexual cisgender males. ConclusionSGMY are more likely to report a long-term health condition compared to their peers and access to health care for SGMY is constrained. Health and social care service providers need to ensure their provisions are safe, accessible, inclusive, and appropriate for SGMY.

Older adults’ experiences of ehealth in health and social care

Using the Unified Theory of Technology Acceptance (UTAUT) model as a framework for this study, the aim was to describe how older adults assess digital services in terms of ease of use and quality in health and social care and how often those services are offered. Further, the aim was to describe how older adults receive support for service use, focusing on people aged 65 and over. A structured web-based questionnaire was used for data collection. The data (N=978) was analysed by quantitative statistical analysis. Most of the respondents found the digital services of health and social care easy to use. The function of the services was considered understandable. Respondents also felt that they could find the necessary information about the services. For the most part, they received service use help from their children or grandchildren. However, the role of health and social services professionals was less important. According to our findings, older adults received minimal support from health and social care professionals or employees in third sector organizations. Although, most respondents (70 %) needed support when using digital services. In the future, health and social care service providers should invest in increased digital services. In conclusion, we found that older citizens know how to use digital services in the health and social care context and they receive adequate help from their relatives in using them.

Mapping blended learning in social work practice education to national standards - a Hybrid Placement Model Teaching and Learning Resource

In Ireland as elsewhere, the Covid-19 pandemic and ensuing public health restrictions, gave rise to an unprecedented crisis in health and social care service provision, leading to cessation of student social work placements in March 2020. The Hybrid Placement Model Teaching and Learning Resource was developed to ensure that quality practice-based placements could resume and continue to be viable during subsequent phases of the Covid-19 pandemic. Combining four elements of onsite practice, off-site practice, online practice, and reflective practice the model provided a ‘road map’ that supported both practice teachers and students as they navigated placements within this context. Through provision of a user-friendly diagram and detailed practical examples of blended learning opportunities mapped to each of the eighty-three national standards of proficiency, the resource enabled practice teachers and students to visualise a range of practice learning opportunities that could be undertaken as part of a blended placement and provided assurance that blended learning met regulatory requirements.
 In this article the authors discuss the context and rationale for the model and describe its four integrated components. The usefulness of the model in supporting optimal learning on hybrid placements is addressed and its potential post Covid-19 restrictions is considered.

Formation of a mechanism for regulating the long-term care system for senior citizens in Stavropol Krai of the Russian Federation

The article is devoted to the issue of developing the interaction of participants in the system of long-term care for senior citizens. The solution of this problem will improve the quality and level of provision of social care services and will help to meet the existing interests and individual needs of the recipients of social services. The purpose of the article is to develop a mechanism for regulating the system of longterm care for older people using financial, personnel, organizational, managerial, information and technological components in the Stavropol Krai of the Russian Federation. The authors used such research methods as a systematic approach, analysis and systematization of information, methods of processing and displaying the information received. The article analyzes the existing definitions of the “mechanism”, “regulatory mechanism” concepts. Based on the analysis of definitions, considering industry specifics, the authors’ definition of the mechanism for regulating the longterm care system is formulated. Based on the results of the article, the authors concluded that the formed mechanism is able to ensure coordinated and interdepartmental interaction between all participants in the long-term care system at the regional and municipal levels, as well as attracting additional financial, human, organizational resources to provide social care services of proper quality, which will fully satisfy the need for them among the recipients of services.

Provision of Social Care Services by US Hospitals.

Despite growing interest in identifying patients' social needs, little is known about hospitals' provision of services to address them. We identify social care services offered by US hospitals and determine whether hospital spending or state policies toward community benefits are associated with the provision of these services by tax-exempt hospitals. National secondary data about hospitals were collected from the American Hospital Association Annual Survey, with additional Internal Revenue Service (IRS) Form 990 data on community benefits spending from CommunityBenefitInsight.org and state-level community benefits policies from HilltopInstitute.org. Descriptive statistics for types of social care services and hospital characteristics were calculated, with bivariate chi-square and t-tests comparing for-profit and tax-exempt hospitals. Multivariable Poisson regression was used to estimate associations between hospital characteristics and types of services offered and among tax-exempt hospitals to estimate associations between social care services and community benefits spending and policies. Multivariable logistic regressions modeled associations between community benefits spending/policies and each type of social care services. Private US hospitals offered an average of 5.7 types of social care services in 2018. Tax-exempt hospitals offered about 36% more social care services than for-profit hospitals. Larger number of beds, health system affiliation, and having community partnerships are associated with more social care services, whereas rural hospitals and those managed under contract offered fewer social care services. Among tax-exempt hospitals, greater community benefits spending is associated with offering more total (incidence rate ratio [IRR] = 1.10, p < 0.01) and patient-focused social care services (IRR = 1.16, p < 0.01). Hospitals in states with minimum community benefits spending requirements offered significantly fewer social care services. Although tax-exempt status and increased community benefits spending were associated with increased social care services provision, the observation that certain hospital characteristics and state minimum community benefits spending requirements were associated with fewer social care services suggests opportunities for policy reform to increase social care services implementation.

What are lay UK public perceptions of frailty: a scoping review.

Perceptions of frailty can influence how families cope, quality of life and access to support services. Yet little is known of how lay members of the UK general public perceive frailty. This scoping review aimed to explore how frailty is perceived among the lay public in the United Kingdom. The established scoping review methodology by Arksey and O'Malley was followed and searches were conducted across eight electronic databases and grey literature websites for articles published between 1990 and August 2022. In total, 6,705 articles were identified, of which six were included in the review. Data were analysed using Braun and Clarke's thematic analysis framework. Three key themes were identified; frailty as a normal part of ageing, perceived consequences of frailty and coping with frailty. Overall, frailty has negative connotations and is perceived as linked to a natural part of the ageing process, increased dependency, loss of identity and social exclusion and stigma. However, it is unclear whether these perceptions have a direct bearing on access to support services for communities. This review identifies that it is imperative for health and social care service providers to consider the individual meaning of frailty for older people and families, to understand and integrate their particular needs and preferences when planning and delivering person centred frailty care and support. There is also a need for development of interventions that focus on increasing education and reducing stigma around frailty in order to change frailty perceptions in the UK.

Using a hospital passport from the perspective of adults with intellectual disabilities, family carers and health professionals: A qualitative study.

This article explores the experiences of the use of the Regional Health and Social Care Hospital Passport (Regional Hospital Passport) in Northern Ireland from the perspectives of adults with intellectual disabilities, family carers and health professionals. From semi-structured interviews three themes emerged: usefulness; facilitators; and barriers to the use of the Regional Hospital Passport. There were clear benefits of the Hospital Passport when used across hospital services and clinical practice settings such as dental and General Practices. There was participant agreement that communication and the person-centred care experiences were enhanced. Findings suggest that providers of health and social care services need to take greater responsibility and accountability for ensuring Regional Hospital Passports are promoted and used across all settings. There is a requirement to develop the wider use and uptake of hospital passports to support adults with intellectual disabilities, with potential for use with other patient groups.

A realist approach to understanding alliancing within Local Government public health and social care service provision.

Within the current context of continued austerity and post-pandemic recovery, it remains important that Local Government services address the increasing needs of residents as cost-effectively as possible. Alliancing, whereby services work collaboratively focusing on the 'whole-system', has gained popularity as a tool with the potential to support collaborative whole systems approaches. This synthesis aims to identify how alliancing can be successfully operationalised in the commissioning of public health, wider National Health Service (NHS) and social care-related services. A realist literature synthesis was undertaken in order to identify underlying generative mechanisms associated with alliancing, the contextual conditions surrounding the implementation and operationalisation of the alliancing approach mechanisms, and the outcomes produced as a result. An iterative approach was taken, using a recent systematic review of the effectiveness of Alliancing, online database searches, and grey literature searches. Three mechanistic components were identified within the data as being core to the successful implementation of alliances in public health and social care-related services within Local Government: (i) Achieving a system-level approach; (ii) placing local populations at the heart of the system; and (iii) creating a cultural shift. Programme theories were postulated within these components. The alliancing approach offers an opportunity to achieve system-level change with the potential to benefit local populations. The realist synthesis approach taken within this study has provided insights into the necessary contextual and mechanistic factors of the Alliancing approach, above and beyond effectiveness outcomes typically collected through more conventional evaluation methodologies.

Smart Home Sensing and Monitoring in Households With Dementia: User-Centered Design Approach.

BackgroundAs life expectancy grows, so do the challenges of caring for an aging population. Older adults, including people with dementia, want to live independently and feel in control of their lives for as long as possible. Assistive technologies powered by artificial intelligence and internet of things devices are being proposed to provide living environments that support the users’ safety, psychological, and medical needs through remote monitoring and interventions.ObjectiveThis study investigates the functional, psychosocial, and environmental needs of people living with dementia, their caregivers, clinicians, and health and social care service providers toward the design and implementation of smart home systems.MethodsWe used an iterative user-centered design approach comprising 9 substudies. First, semistructured interviews (9 people with dementia, 9 caregivers, and 10 academic and clinical staff) and workshops (35 pairs of people with dementia and caregivers, and 12 health and social care clinicians) were conducted to define the needs of people with dementia, home caregivers, and professional stakeholders in both daily activities and technology-specific interactions. Then, the spectrum of needs identified was represented via patient–caregiver personas and discussed with stakeholders in a workshop (14 occupational therapists; 4 National Health Service pathway directors; and 6 researchers in occupational therapy, neuropsychiatry, and engineering) and 2 focus groups with managers of health care services (n=8), eliciting opportunities for innovative care technologies and public health strategies. Finally, these design opportunities were discussed in semistructured interviews with participants of a smart home trial involving environmental sensors, physiological measurement devices, smartwatches, and tablet-based chatbots and cognitive assessment puzzles (10 caregivers and 2 people with dementia). A thematic analysis revealed factors that motivate household members to use these technologies.ResultsOutcomes of these activities include a qualitative and quantitative analysis of patient, caregiver, and clinician needs and the identification of challenges and opportunities for the design and implementation of remote monitoring systems in public health pathways.ConclusionsParticipatory design methods supported the triangulation of stakeholder perspectives to aid the development of more patient-centered interventions and their translation to clinical practice and public health strategy. We discuss the implications and limitations of our findings, the value and the applicability of our methodology, and directions for future research.

Patterns and costs of hospital-based cancer care in the last year of life: A national data linkage study in England.

e18769 Background: Delivery of high quality cancer care is associated with rising costs, both in earlier stages of the illness trajectory and at the end of life. A significant portion of the costs and health care utilisation occurs in the last year of life. Most publications to date have focused on costs in hospital. Little is known about the costs of care for cancer patients across the entire health service. The aim was to examine primary, secondary and acute health care utilisation and cost in the last 12 months of life and how these differ by cancer diagnosis and other patient characteristics among decedent patients aged 60 and over. Methods: We conducted a retrospective cohort study of people aged 60 years and over (N=26,077) who died in England between 2010 and 2017. We used routinely collected and linked data from primary care (Clinical Practice Research Datalink (CPRD) secondary and acute care, (Hospital Episode Statistics (HES), and death data (Office for National Statistics (ONS)). This provided a nationally representative sample of the English population. We analysed of healthcare utilisation and resource use amongst decedents by gender, primary cause of death, age, geography, socio-economic status and comorbidities. Results: Overall, 90.2 % of the cancer decedents were admitted in the hospital at least once in the last 12 months of life. About 50% of patients we admitted to hospital in the last month of life with 37.6 being admitted to the hospital more than once in the last month of life. The health care utilisation and costs increased sharply in the last month of life. life. The mean number of hospital admissions in the last year of life was 3.7 (SD, 5.8). Those dying of haematological cancers (N=2093) had highest number of hospital admissions (mean:7.2, SD:10.8) and longer average hospital stay (mean:36.7, SD:33.0) (mean:12.0, SD:14.4). Use of outpatient services was highest in the group dying of haematological cancers (mean:12.0, SD:14.4) whereas those dying of prostate cancer (N= 2197) had higher number of emergency (mean:2.0, SD: 1.9) and GP visits (mean:30.8, SD: 20.7). Healthcare costs were highest among haematological cancers and lowest among those dying of breast cancer. Proximity to death and comorbidities were the main contributors of end-of-life care health care utilisation and costs. Conclusions: This study uses large linked datasets (linked to the whole spectrum of hospital episode statistics) providing a comprehensive picture of healthcare services accessed by cancer patients at end of life in England. There is significant variation in use and cost of care for cancer patients in the last year and month of life. Further analysis of variation according to hospice, palliative, and social care service provision may identify strategies to address this variation.

ФУНКЦИИ ГОСУДАРСТВЕННЫХ РЕЕСТРОВ НКО В РАЗВИТИИ ТРЕТЬЕГО СЕКТОРА: РОССИЙСКИЙ ОПЫТ

Development of the third sector in Russia is accompanied with its maintenance of open-access state registries of non-profit organizations. Compared to the NPO registries in other countries, those in Russia appeared 10-15 years later and became new tools for the development of the non-profit sector. The purpose of this article is to categorize the functions of NPO registries in other countries, as well as suggest those attributed to Russian NPO registries. The following hypothesis is put forward in the article: Russian NPO registries have similar functions as registries in other countries, but they are currently not being fully implemented. There are four registries in the focus of the research: the registry of NPOs by the Ministry of Justice of Russia and three types of registries of socially oriented NPOs – recipients of state support, providers of social services, and providers of social care services. The research was carried out by analyzing legal acts which set up the registries, as well as analyzing the registries located on the Internet. The following functions have been suggested: collecting, systematizing and disclosing the information on the third sector; aggregating the data on supply and demand for NPO services; promoting cooperation of NPOs with the state and intersectoral partnerships; promoting government support to NPOs; as well as ensuring accountability of NPOs to the state and society. The hypothesis was confirmed: the functions are not fully implemented due to the lack of clearly defined goals when setting up registries, weaknesses of their structure and formats. Several recommendations were formulated to enhance the system of existing registries and their structure.

Factors Associated with Unplanned Admission to Hospital: A National Time-To-Event Analysis of Over 65s In Scotland

IntroductionMany high-income countries are reorganising and integrating health and social care (long-term care) services. However, little evidence exists showing how these services interact. Demographic changes and austerity measures have led to increased demand for social care services at the same time as the availability of formal and informal services has declined. The aim of this study was to identify risks for unplanned hospital admission taking account of social care receipt, multimorbidity and sociodemographic status.&#x0D; Objectives and ApproachThis retrospective, observational study included all individuals over the age of 65 in Scotland in financial year (Apr-March) 2015/16 (n = 879,027). The main outcome was time to first unplanned hospital admission. Kaplan-Meier curves were plotted to compare survival rates. Cox proportional hazards regression models were used to determine risk factors for unplanned admission. Explanatory variables included: receipt of social care, multimorbidity, socioeconomicposition, age, and sex.&#x0D; ResultsMultivariate analysis showed that, after adjusting for: age, sex, multimorbidity, socioeconomic position, and any past unplanned admissions, receipt of social care was associated with a two-fold increased risk of having an unplanned admission compared to those without care (HR 1.98 95%CI 1.95-2.00). Increasing age, severity of multimorbidity, and lower socioeconomic position were also all associated with increasing risks of unplanned admission.&#x0D; Conclusion / ImplicationsOur results show those in current receipt of social care are also more likely to use unplanned hospital care compared with those that do not receive care. Current provision of social care services is unlikely to lead to reductions in unplanned hospital admission.

Challenges in Data Linkage – Experiences from An Upper Gastrointestinal Cancer Data Linkage Study

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector.&#x0D; Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with &gt;60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement.&#x0D; ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed.&#x0D; Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.

Development and Initial Validation of a Harmonised Multi-Jurisdiction Work Injury Compensation Database

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector.&#x0D; Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with &gt;60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement.&#x0D; ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed.&#x0D; Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.

Street-level bureaucracy in the pandemic: the perception of frontline social workers on policy implementation

Abstract The COVID-19 pandemic highlighted the strategic role of social care policy to minimize the effects of this health crisis and its consequences on the poorest and most vulnerable population. This article analyzes the perception of street-level bureaucrats in the Brazilian social care network on how the pandemic has affected their performance and professional routine. The research was based on a survey, consultations with representatives of municipal social care services, and analysis of government regulations. The results show that social workers feel unprotected and unable to provide adequate responses to the pandemic’s increasing and urgent demands, revealing a lack of institutional support to act appropriately. The professionals also reported substantial changes in their working dynamics, particularly in their relationship with the attended population, one of the main pillars of the Brazilian social care network. These elements directly affect the provision of social care services and their potential to combat the adverse effects of the crisis.

INTEGRATED SOCIAL SERVICES BASED ON PRESERVATION AND PROMOTION OF COMMUNITY HEALTH: AN ANALYSIS OF THE STATE AND PROSPECTS OF DEVELOPMENT

Introduction: At the final stage of administrative-territorial reform in Ukraine, it is important to realistically assess the social needs and social problems that exist in newly created territorial communities. Territorial communities should be based on healthy families and healthy individuals, whose initiative will help ensure the continued social development of the community. In its turn, the community should be built on the principles of friendly to its own citizens, meeting their needs, first of all, the needs of the least protected categories - children, people with disabilities and chronic diseases, elderly people. Therefore, integrated social services based on the principles of preserving and promoting health are a tool for solving social problems in the community (Klos, Khudoba, Shkoliar, 2019, p. 26).&#x0D; Purpose. The purpose of the study is to show the importance of using integrated social services in the community based on the principles of preservation and promotion of health as an important means of promoting territorial community development and social development of the country.Methods. The study used theoretical methods of research, in particular, the search and collection of statistical information on the formation, normalization and approval of the composition of territorial communities; collection and analysis of sources on the problem of social services and social protection of the population of territorial communities; systematization of sources and their analysis by blocks of tasks; analysis, comparison, synthesis and implementation of the results of the study of social services based on the principles of promoting and preserving community health.Results. Within the framework of the U-LEAD Program with Europe and the ICO Partnership Every Child, the project “Community for Human: Enhancing Communities' Competence for the Development of Social Services” and understanding the peculiarities of organizing social support for vulnerable segments of the UTC population through the implementation of the social services model. Among the objectives of the project were, inter alia, to study the status of providing local communities with social workers, the range of social services provided in the community, taking into account the real needs of the population in social assistance (ICO Partnership for Every Child, 2019, p. 5-6).The study covered 245 projected territorial communities in Ukraine. Because most communities did not have the information to make appropriate decisions about the services they needed, a special methodology was used to assess the needs of the population in social services. An appropriate tool for monitoring the needs of the population in social services was developed and tested at the Oxford Policy Management Consortium with the participation of the Every Child Partnership, in collaboration with UNICEF, and with financial support from the European Union. The aggregate index of providing the population with social services of the population of the UTC is determined by the set of indicators: the index of provision of social services for children and families with children; index of provision of social care services for orphans and children deprived of family care; the index of provision of social services for the elderly; index of provision of social services for persons with disabilities; index of provision of social services to persons in need of adaptation and integration (reintegration); index of provision of social services to persons in need of emergency or crisis intervention (ICO Partnership for Every Child, 2019, p. 28).Mostly communities use the resource of available social services already at their disposal, their range is limited and needs improvement and review, taking into account real social problems and needs of consumers. An important tool for addressing the issues that are relevant to UTC members is those based on the principles of preserving and promoting health. In particular, social prevention, community representation services, crisis and emergency intervention, social support / patronage, asylum, home care, day care, supported living.Conclusion: The study of the results of the mentioned project and the current state of providing territorial communities with social services lead to the conclusion that there is a high level of community needs for social work professionals who are able and able to provide integrated social services in the community on the grounds of preservation and promotion of health. To do this, professional training of skilled social workers for the provision of integrated social services in the community should be stepped up

Services for refugees subject to sexual and gender-based violence in Turkey and Sweden

Abstract Background Sexual and gender-based violence affects an unknown proportion of Syrians seeking refuge from the ongoing conflict. Exile implies a vulnerability to gendered harms with consequent health effects over the short- and long-term. Services for refugees tend to presume physical gendered harms accruing to women prior to exile, with little attention paid to the effects on refugees’ settlement in the new society. Methods Interviews with health and social care providers of services to refugees in Sweden (n = 20) and Turkey (n = 20), including international organisations, non-government agencies, municipal and other statutory agents. Results Definitions of sexual and gender-based violence that inform service delivery vary greatly between health and social care service providers, with these definitions proving critical for how services are configured and provided. Service providers may consider longer-term health problems arising from refugees’ experience of sexual and gender-based violence, but refugees’ prospects of integration are rarely explicitly addressed. Refugees’ own views on their health and social care needs do not inform the design or development of service provision. Conclusions The experience of sexual and gender-based violence by refugees from Syria is widely recognised among health and social care providers in Turkey and Sweden. However, the experience of such violence is rarely addressed as a public health problem, that is, as a social determinant of ill health and, furthermore, an impediment to successful integration. The long-term, ill effects of sexual and gender-based violence, as seen over the lifecourse, are over-looked when considering refugees. Key messages Services for refugees who have been subject to sexual and gender-based violence vary in terms of how that violence is understood and which of its outcomes are addressed. Sexual and gender-based violence when experienced by refugees is rarely seen as a public health problem.

The Experiences of Relatives of People with Acquired Brain Injury (ABI) of the Condition and Associated Social and Health Care Services

Context: ABI can arise from many causes and is a significant issue for long-term care. Developments in health care have meant that many more people with ABI are living longer, some with complex needs arising from their brain injury. The consequences of injury are generally long-term, even lifelong. Family members of people with ABI are significant to their rehabilitation, support and care, and research has identified many of the challenges they face. Objective: This paper reports work to survey the views of family members of people with ABI to ascertain their experience of the condition and their views and experience of related health and social care services. Method: An online survey was distributed via ABI networks to family members of individuals affected by ABI. One hundred ten respondents ranked the difficulties met by their relative living with an ABI and rated the services they had encountered. A series of open questions enabled respondents to provide greater detail regarding their experience and knowledge. Findings: The key findings are that relationships between the injured and non-injured parties change, alterations to roles and responsibilities are difficult and mediated via unending and complex grief. Relatives reported poor levels of involvement in decisions regarding the provision of social and health care services, a failure to be given good, accurate information in a timely fashion and the need to ‘fight’ for virtually any service provided. Service provision, particularly post-hospital discharge, was very regularly criticized for being either entirely absent, unaware of the impact of brain injury, failing to take account of actual functioning and/or structured in ways that are not concomitant with the needs of the injured person or the relative. Lack of knowledge of the impact of ABI by non-specialist staff and services is particularly highlighted as a barrier to progress and an added burden for relatives to contend with. Social work in particular was commented upon most negatively, most often for a failure to understand the condition and needs. Valued services and professionals are noted to be humane, knowledgeable about ABI, aware of the impact ABI has on the non-injured relative and able to act as a single ‘one-stop’ focal point for service provision. Limitations: As a self-selecting cohort of respondents to an online survey the work is not necessarily generalisable to the population as a whole. The findings, however, provide important considerations for improving social and health care services for people with ABI and the key relatives involved in supporting them. Implications: Commissioners and providers of social and health care services ought to work more closely with family members of people living with ABI. Services and individual practitioners need to be more knowledgeable about the likely functional outcomes of ABI, in particular the impact of invisible impairments to cognition and executive functioning. Relatives identify the benefit of good quality, accurate information and of a knowledgeable single point of contact across time and setting. Knowledge of ABI, of neurorehabilitation and of the impact of ABI upon family members by social workers is noted to be poor and attention to this may help with people’s rehabilitation and to prevent unnecessary additional carer burden.