scholarly journals The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

2017 ◽  
Vol 5 (31) ◽  
pp. 1-186 ◽  
Author(s):  
Katrina Forsyth ◽  
Laura Archer-Power ◽  
Jane Senior ◽  
Rachel Meacock ◽  
Roger Webb ◽  
...  
Keyword(s):  
Social Care ◽  
Unit Cost ◽  
Well Being ◽  
Functional Health ◽  
Care Needs ◽  
Care Plans ◽  
Older Prisoners ◽  
Care Assessment ◽  
Health And Social Care

Background Older people are the fastest-growing group in prisons in England and Wales and have complex health and social care needs that often remain unmet. Objectives (1) Evaluate the efficacy of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) in improving (i) the ability to meet older male prisoners’ health and social care needs, (ii) health-related quality of life (HRQoL), (iii) depressive symptoms and (iv) functional health and well-being and activities of daily living; (2) assess the quality of care plans produced; (3) explore the experiences of older prisoners receiving, and staff conducting, the OHSCAP; and (4) evaluate the cost-effectiveness of the OHSCAP compared with treatment as usual (TAU). Design Multicentre, parallel-group randomised controlled trial (RCT) with follow-up at 3 months, with a nested qualitative study and quality audit of care plans (n = 150, 68%). Setting Ten English prisons. Participants Four hundred and ninety-seven newly arrived male prisoners aged ≥ 50 years with a discharge date at least 3 months from recruitment. A total of 14 prisoners and 11 staff participated in qualitative interviews. Intervention Randomisation to OHSCAP or TAU. The OHSCAP group had health and social needs assessed by a trained health-care worker or prison officer. Care plans were devised and subsequent actions included professional support and appropriate referrals. Main outcome measures Primary outcome measure – mean number of unmet health and social care needs as measured by the Camberwell Assessment of Need – Short Forensic Version. Secondary outcome measures – measures of functional health and well-being, depressive symptoms and HRQoL. A health economic evaluation was undertaken using service contact between baseline and follow-up and appropriate unit cost information. Results A total of 497 prisoners were recruited (248 to OHSCAP and 249 to TAU). The 404 completed follow-ups were split evenly between the trial arms. No significant differences were observed between the intervention and TAU groups in relation to the primary outcome measure. The OHSCAP did not demonstrate convincing benefits in HRQoL over TAU, and there were no significant differences in relation to costs. Audit and qualitative data suggest that the intervention was not implemented as planned. Limitations As a result of the limited follow-up period, potential long-term gains of the intervention were not measured. Some of the standardised tools had limited applicability in prison settings. Cost-effectiveness data were limited by unavailability of relevant unit cost data. Conclusions The OHSCAP failed in its primary objective but, fundamentally, was not implemented as planned. This appears to have been attributable, in some part, to wider difficulties currently affecting the prison landscape, including reduced levels of staffing, the loss of specialist support roles for such initiatives and increased prevalence of regime disruption. Future work Partnership working and information sharing across disciplines within prison settings require improvement. Research should explore the potential involvement of other prisoners and third-sector organisations in identifying and addressing older prisoners’ health and social care needs to better match community provision. Further examination should be undertaken of how the prison regime and system affects the well-being of older prisoners. Future prison-based RCTs should carefully balance the fidelity of initiatives being evaluated and testing in a ‘real-life’ setting. Trial registration Current Controlled Trials ISRCTN11841493. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 5, No. 31. See the NIHR Journals Library website for further project information.

scholarly journals Health and social care services for older male adults in prison: the identification of current service provision and piloting of an assessment and care planning model

2013 ◽  
Vol 1 (5) ◽  
pp. 1-138 ◽  
Author(s):  
J Senior ◽  
K Forsyth ◽  
E Walsh ◽  
K O'Hara ◽  
C Stevenson ◽  
...  
Keyword(s):  
Social Care ◽  
Qualitative Interviews ◽  
Research Programme ◽  
Older Men ◽  
Care Needs ◽  
Care Services ◽  
Older Prisoners ◽  
Care Assessment ◽  
Health And Social Care ◽  
The Impact

AbstractBackgroundOlder prisoners are the fastest growing subgroup in the English and Welsh prison estate. Existing research highlights that older prisoners have high health and social care needs and that, currently, these needs routinely remain unmet.Objectives(1) To explore the needs of men entering and leaving prison; (2) to describe current provision of services, including integration between health and social care services; and (3) to develop and pilot an intervention for identifying health and social care needs on reception into prison, ensuring that these are systematically addressed during custody.MethodsThe research programme was a mixed-methods study comprising four parts: (1) a study of all prisons in England and Wales housing older adult men, establishing current availability and degree of integration between health and social care services through a national survey and qualitative interviews; (2) establishing the health and social care needs of older men entering prison, including experiences of reception into custody, through structured (n = 100) and semistructured (n = 27) interviews; (3) the development and implementation of an intervention to identify and manage the health, social care and custodial needs of older men entering prison; and (4) exploration of the health and social care needs of older men released from prison into the community through qualitative interviews with older prisoners prior to and following discharge from prison. Descriptive statistics were produced for all quantitative data, and qualitative data were analysed using the constant comparison method.ResultsThe number of older prisoner leads has increased in recent years but they do not all appear always to be active in their roles, nor in receipt of specialist training. Nearly half (44%) of establishments do not have an older prisoner policy. There is a lack of integration between health and social care services because of ambiguity regarding responsibility for older prisoners' social care. The responsible social service may be located a considerable distance from where the prisoner is held; in such instances, local social services do not co-ordinate their care. The most frequent unmet need on prison entry was the provision of information about care and treatment. Release planning for older prisoners was frequently non-existent.LimitationsThe study used a cut-off age of 60 years as the lower limit for the definition of an older prisoner; evidence has emerged that supports a redefinition of that cut-off to 50 years. Our study examined the care provided for men and this should be considered if contemplating using the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) with older women in prison.ConclusionThe OHSCAP, developed as part of this study, provided a feasible and acceptable means of identifying and systematically addressing older prisoners' health and social care needs. Future work will include the conduct of a randomised controlled trial to examine the impact of the OHSCAP in terms of improving a range of outcomes, including economic impact.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a protocol for a scoping review

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018247 ◽  
Author(s):  
Elana Commisso ◽  
Katherine S McGilton ◽  
Ana Patricia Ayala ◽  
Melissa, K Andrew ◽  
Howard Bergman ◽  
...  
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Social Care ◽  
Grey Literature ◽  
Well Being ◽  
Multiple Chronic Conditions ◽  
Care Needs ◽  
Health And Social Care

IntroductionPeople are living longer; however, they are not necessarily experiencing good health and well-being as they age. Many older adults live with multiple chronic conditions (MCC), and complex health issues, which adversely affect their day-to-day functioning and overall quality of life. As a result, they frequently rely on the support of friend and/or family caregivers. Caregivers of older adults with MCC often face challenges to their own well-being and also require support. Currently, not enough is known about the health and social care needs of older adults with MCC and the needs of their caregivers or how best to identify and meet these needs. This study will examine and synthesise the literature on the needs of older adults with MCC and those of their caregivers, and identify gaps in evidence and directions for further research.Methods and analysisWe will conduct a scoping review of the peer-reviewed and grey literature using the updated Arksey and O’Malley framework. The literature will be identified using a multidatabase and grey literature search strategy developed by a health sciences librarian. Papers, reports and other materials addressing the health and social care needs of older adults and their friend/family caregivers will be included. Search results will be screened, independently, by two reviewers, and data will be abstracted from included literature and charted in duplicate.Ethics and disseminationThis scoping review does not require ethics approval. We anticipate that study findings will inform novel strategies for identifying and ascertaining the health and social care needs of older adults living with MCC and those of their caregivers. Working with knowledge-user members of our team, we will prepare materials and presentations to disseminate findings to relevant stakeholder and end-user groups at local, national and international levels. We will also publish our findings in a peer-reviewed journal.

scholarly journals Links between depressive symptoms and unmet health and social care needs among older prisoners

2016 ◽  
Vol 45 (1) ◽  
pp. 158-163 ◽  
Author(s):  
Kate O'Hara ◽  
Katrina Forsyth ◽  
Roger Webb ◽  
Jane Senior ◽  
Adrian Jonathan Hayes ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Social Care ◽  
Care Needs ◽  
Older Prisoners ◽  
Health And Social Care

‘They just throw you out’: release planning for older prisoners

2014 ◽  
Vol 35 (9) ◽  
pp. 2011-2025 ◽  
Author(s):  
KATRINA FORSYTH ◽  
JANE SENIOR ◽  
CAROLINE STEVENSON ◽  
KATE O'HARA ◽  
ADRIAN HAYES ◽  
...  
Keyword(s):  
Social Care ◽  
Qualitative Interviews ◽  
Comparison Method ◽  
Physical And Mental Health ◽  
Care Needs ◽  
Release Planning ◽  
The North ◽  
Older Prisoners ◽  
Health And Social Care ◽  
Formal Communication

ABSTRACTOlder prisoners are the fastest growing incarcerated sub-group. They have more complex health and social care needs than both younger prisoners and their age-matched peers living in the community. Prisoners who have been recently released are at enhanced risk in terms of their physical and mental health. Consequently, there is a need for timely, multi-disciplinary release planning. The aim of this study was to explore the health and social care needs of older male adults discharged from prison into the community. Qualitative interviews were carried out with prisoners with four weeks left to serve (N=62), with follow-up interviews conducted four weeks after release (N=45). Participants were selected from nine prisons in the North of England. The constant comparison method was used to analyse the data. Older prisoners perceived release planning to be non-existent. There was a reported lack of formal communication and continuity of care, causing high levels of anxiety. Older prisoners experienced high levels of anxiety about the prospect of living in probation-approved premises; however, those who did go on to live in probation-approved premises had their immediate health and social care needs better met than those who did not move into such accommodation. Release planning for older prisoners is generally inadequate and there is currently a missed opportunity to address the needs of this vulnerable group.

scholarly journals The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katrina Forsyth ◽  
Roger T. Webb ◽  
Laura Archer Power ◽  
Richard Emsley ◽  
Jane Senior ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Unmet Needs ◽  
Social Care ◽  
Controlled Trial ◽  
Care Needs ◽  
Treatment As Usual ◽  
Prisoner Health ◽  
Care Assessment ◽  
Health And Social Care ◽  
Randomised Controlled

Abstract Background Older people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison. We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs 3 months after prison entry, compared to treatment as usual (TAU). Methods The study was a parallel randomised controlled trial (RCT) recruiting male prisoners aged 50 and over from 10 prisons in northern England. Participants received the OHSCAP or TAU. A clinical trials unit used minimisation with a random element as the allocation procedure. Data analysis was conducted blind to allocation status. The intervention group had their needs assessed using the OHSCAP tool and care plans were devised; processes that lasted approximately 30 min in total per prisoner. TAU included the standard prison health assessment and care. The intention to treat principle was followed. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30 November 2016. Results Data were collected between 28 January 2014 and 06 April 2016. Two hundred and forty nine older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. Two hundred and fifty three 3 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD = 2.07) and 2.06 (SD = 2.11) for the TAU group (mean difference = 0.088; 95% CI − 0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving the OHSCAP did not experience improved outcomes compared to those who received TAU. Trial registration Current Controlled Trials: ISRCTN11841493, 25/10/2012.

scholarly journals The Older Prisoner Health and Social Care Assessment and Plan (OHSCAP) versus Treatment as Usual: A Randomised Controlled Trial

2020 ◽  
Author(s):  
Katrina Forsyth ◽  
Roger T Webb ◽  
Laura Archer Power ◽  
Richard Emsley ◽  
Jane Senior ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Unmet Needs ◽  
Social Care ◽  
Controlled Trial ◽  
Care Needs ◽  
Treatment As Usual ◽  
Prisoner Health ◽  
Care Assessment ◽  
Health And Social Care ◽  
Randomised Controlled

Abstract Background Older adults are the fastest-growing subgroup among prisoners in England and Wales and have more health and social care needs than their younger counterparts and those the same age living in the community . We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs three months after prison entry, compared to treatment as usual (TAU).MethodsA parallel randomised controlled trial (RCT) was conducted at ten prisons in the North of England. Males aged 50 and over received the OHSCAP or TAU. The allocation procedure was minimisation with a random element. The OHSCAP process involved individuals having their needs assessed, care plans being created and reviewed. TAU encompassed the standard prison health assessment. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30th November 2016.ResultsData were collected between 28th January 2014 and 06th April 2016. 249 older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. 253 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD=2.07) and 2.06 (SD= 2.11) for the TAU group (RR = 0.088; 95% CI -0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion Those received the OHSCAP did not experience an improvement to the meeting of the needs in comparison to the TAU g. This was largely due to the OHSCAP not being implemented as planed due to a national prison crisis.The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving OHSCAP did not experience improved outcomes compared to those who received TAU. Trial RegistrationISRCTN11841493 25/10/2013Protocol available at: http://www.isrctn.com/ISRCTN11841493

scholarly journals Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Personal Growth ◽  
Social Care ◽  
Well Being ◽  
Work Conditions ◽  
Individual Interviews ◽  
Work Related ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Communication Challenges ◽  
The Uk

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.

scholarly journals Maudsley International: improving mental health and well-being around the world

2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Care ◽  
Well Being ◽  
Building Capacity ◽  
The Past ◽  
Health And Social Care ◽  
The World ◽  
Set Up ◽  
Health And Well Being ◽  
And Training

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.

scholarly journals The burden of triumph: meeting health and social care needs

The Lancet ◽  
2017 ◽  
Vol 390 (10103) ◽  
pp. 1630-1631 ◽  
Author(s):  
Andrew Dilnot
Keyword(s):  
Social Care ◽  
Care Needs ◽  
Health And Social Care

scholarly journals Creating an Age-Friendly Community in Affordable Housing Using a Resident Health Risk Assessment Focused on the 4Ms

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Jennifer DeGennaro ◽  
Sherry Pomerantz ◽  
Margaret Avallone ◽  
Melonie Handberry ◽  
Elyse Perweiler
Keyword(s):  
Risk Assessment ◽  
Health Risk ◽  
Health Risk Assessment ◽  
Affordable Housing ◽  
Risk Function ◽  
Well Being ◽  
Screening Tools ◽  
Care Plan ◽  
Care Plans

Abstract The NJGWEP team in partnership with Fair Share Housing/Northgate II (NGII), an affordable housing complex in Camden, NJ, employed an iterative quality improvement process to collaboratively develop a Resident Health Risk Assessment (RHRA) to meet the needs of the housing facility and incorporate the essential elements of the 4Ms framework (Mentation, Medication, Mobility, and What Matters). Using the RHRA, NG II social services staff and Rutgers School of Nursing (RSoN) students were trained to collect health information and administer several evidence-based screening tools (i.e., MiniCog, TUG, PHQ-2). A final element of the RHRA still in development is the documentation process of referral and follow-up based on personalized care plans. Since July 2019, 43 RHRAs have been completed (60% female, mean age 66, age range=43 to 88). Almost all residents (94%) have at least 1 chronic condition (HTN, DM, COPD, CHF), although only 26% have an advance care plan. Most (81%) were screened for future fall risk; function (ADLs/IADLs) was assessed for all (100%). Every resident who was able or did not refuse (88%) was screened for cognitive impairment. Just 7% were taking a high-risk medication (i.e., an opioid or benzodiazepine). The NJGWEP team has initiated an age-friendly community at NGII by providing education on geriatric-focused topics and implementing the 4Ms-focused RHRA to detect issues impacting the resident’s well-being. Establishing a follow-up process to track referrals to available resources will enable NGII to allow residents to age in place with appropriate supports.

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