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Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusions Impact Reporting Method Patient or Public Contribution to the Development of this Study To explore nursing students' lived experience of a clinical placement within healthcare in a prison, to gain an insight into the support provided prior to and during this unique clinical placement.An inductive phenomenological study.Participants included 14 nursing students from three undergraduate nursing programmes in England, Adult (n = 4), Learning Disability (n = 3) and Mental Health (n = 7). Following a clinical placement in a prison, each participant completed a semistructured audio‐recorded interview on MS Teams between October and December 2021. Audio recordings were transcribed verbatim and thematic analysis was completed.Two overarching themes were identified, ‘shock’ due to the (a) reality of prison; (b) overwhelming emotional impact and (c) frequency and severity of self‐harm and ‘surprise’ due to (a) the need to work with prison officers; (b) recognizing and addressing preconceptions of people in prison and (c) the development of clinical knowledge, skills and becoming a nurse.The need remains for a comprehensive strategy of preparation and orientation for nursing students before commencing a clinical placement in prison, which includes the development of knowledge and clinical skills to support the complex health and social care needs of people in prison.Our research identified the support provided to nursing students prior to clinical placement in prison varies considerably. The development of a preparation and orientation programme has the potential to reduce pre‐placement anxiety, emotional burden and support nursing students in addressing their preconceptions of people in prison. This approach is essential to support future nursing students to embrace the unique opportunity of a clinical placement within a prison, enhance their clinical knowledge and skills, and develop as a nurse.Our paper adheres to the consolidated criteria for reporting qualitative research (COREQ).None. [ABSTRACT FROM AUTHOR]

Aim: To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. Method: 27 in‐depth interviews were conducted to inform the development of the 42‐item PREM which was cognitively tested with 10 people. A refined 38‐item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. Results: The PREM had low drop‐out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. Conclusions: This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality. [ABSTRACT FROM AUTHOR]

Background: In recent years, a significant proportion of inpatient facilities for people with intellectual disabilities and/or autism has been de-commissioned in England, This has resulted in individuals with intellectual disabilities being sent to distant hospitals far away from their families and carers leading to challenges in follow-up, community care and interventions. The impact of de-institutionalisation, has often caused patient trauma, family distress and subsequent discharge difficulties. Not every individual with intellectual disabilities and/or autism requires inpatient care but inpatient care when needed has to be local, adequate and appropriate. Aims: To evaluate current evidence of utility of inpatient models for people with intellectual disabilities and outline best clinical practice. Method: PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with key search terms. The search was conducted by the information specialist and identified abstracts screened further for inclusion criteria, methodological issues, and other appropriate characteristics. Twenty-three papers were included in the rapid review. Papers shortlisted had the inclusion criteria applied against the full text version independently by two reviewers. Disagreements regarding eligibility of studies was resolved by discussion and consensus within the project team. Key data related to in-patient models of care was extracted from the included papers, which included year of study, design, study objectives, target population, method/s tested, outcomes reported, country of study/studies, and results. Data extraction was performed by two reviewers and reviewed by the project team. Results: From the review of services for people with intellectual disabilities, we came across four broad models/frameworks/approaches. Evidence on what worked for inpatient service provision tended to be based on models developed and implemented locally. Conclusions: We make recommendations for the best clinical practice and standards. Both clinical service providers and policymakers need to be aware of specific needs of individuals with intellectual disability and/or autism. [ABSTRACT FROM AUTHOR]

Safeguarding for healthcare involves working together to protect adults, children, and young people at risk of harm. Despite global research and national guidance outlining health professionals' roles in this regard, there is limited knowledge about the type of strategies used to mobilise safeguarding research to practitioners in England. Our critical interpretive synthesis (CIS) sought to explore how safeguarding knowledge is mobilised to enable practitioners to use research effectively. This synthesis aimed to bridge the theory-practice gap in mobilising safeguarding knowledge to practitioners. Knowledge mobilisation (KMb) is an emerging discipline concerned with moving knowledge across communities to catalyse change. This review aimed to build understanding about how safeguarding knowledge is mobilised for healthcare in England and to synthesise the type of approaches undertaken to protect adults and children from harms, including abuse. A critical interpretive synthesis was undertaken using KMb theory and computer-assisted modelling technologies for secondary thematic analysis of complex literature of relevance, including qualitative research, reviews, and reports. Few papers informed how safeguarding knowledge is mobilised for healthcare in England. Learning from experience dominated the literature in three ways: (i) crisis response, (ii) practice engagement, and (iii) influencing actions (for "best" practice). Embedding safeguarding knowledge and skills in healthcare settings usually followed a crisis response. Learning from experience showed movement between practice engagement and influencing actions for adult and/or child protection. KMb might be useful in supporting the implementation of evidence-based safeguarding for practice. CIS identified a gap in how safeguarding research is mobilised to practitioners for healthcare. KMb theory provided an analytical bridge to computer-assisted modelling of factors associated with moving learning from experience to learning in practice. Future research could build on hybrid synthesising of safeguarding functions and impacts for healthcare, to enable practitioners to protect adults and children from multiple harms, including violence and abuse. [ABSTRACT FROM AUTHOR]

Background: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. Aim: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. Methods: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. Results: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. Conclusion: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present findings from a mixed-methods study on the impact that COVID-19 has had on adult safeguarding. The research sought to explore the challenges and opportunities presented by COVID-19 to both frontline and non-frontline professionals working in adult safeguarding. Design/methodology/approach: A mixed-methods project was undertaken comprising a literature review, survey, semi-structured interviews and a small number of freedom of information requests. This paper presents the findings predominantly from the survey and interviews. Findings: Unsurprisingly, COVID-19 has presented a variety of challenges for professionals working in adult safeguarding. The themes that occurred most often were the day-to-day changes and challenges, relationships across sectors, information and navigating the ethical questions in safeguarding. Originality/value: To the best of the authors' knowledge, the findings represent the first focused qualitative mixed-method study aimed at understanding more about the impact the pandemic has had on adult safeguarding through the eyes of those professionals working in that field. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to underline the importance of using a collaborative approach when designing and adapting a post diagnostic psychosocial intervention of cognitive stimulation therapy (CST) for people with intellectual disability and dementia. Design/methodology/approach: As part of a service improvement, a manual of CST was adapted, for delivery in clinical practice. A qualitative co-production method allowed participants with a lived experience to provide regular feedback relating to the development of the adapted CST manual and intervention programme. This feedback was used to make continual development changes to the CST manual. Findings: The study demonstrated co-production with those who provide care is valuable in adapting psychosocial therapies for people with an intellectual disability and dementia. Additional findings identified the need for carer education in ageing, dementia care and the physical health needs for older people with intellectual disability. Originality/value: To the best of the authors' knowledge, this is the first study that has used a co-production approach with families and carers in adapting a group therapy programme for people with an intellectual disability. This paper underlines the need for post diagnostic clinical interventions for people with dementia and those who provide care. [ABSTRACT FROM AUTHOR]

Bourdieu argued that class-based inequalities influenced educational outcomes and this paper illustrates the relevance of Bourdieu's concepts in understanding one specific community. A wider study by the authors used the concept of habitus to identify factors which impacted on the participants—predominantly white working-class mothers'—perceptions of their engagement with schools. This paper provides two selected case study examples from the wider study which describes the ways these mothers interpret different habitus in relation to education and discusses how habitus can inform understandings of different parental perceptions towards education and how this affects engagement. Schools can use this insight to ensure that parents from such backgrounds feel better able to engage with their children's education. Schools use this insight to inform to ensure that parents from such backgrounds feel able to engage with their children's education, both at home and in school. [ABSTRACT FROM AUTHOR]

Social enterprises, which are businesses with social objectives, have been championed by the UK government as an opportunity to deliver more innovative, socially oriented, and commercially sustainable public services. However, very little is known about them, especially in a social care context. This paper therefore aims to answer the following three questions: (1) What are care social enterprises?, (2) What are their distinctive qualities?, and (3) How can they contribute to the adult social care sector? It presents evidence from a "mapping" of care social enterprises in three English local authorities, and from interviews with 35 stakeholders from across the social care and social enterprise sectors. Drawing on an institutional logics framework, we explore the influence of different norms, goals, and practices on care social enterprises and the extent to which they are aligned with those of the public, private, and not-for-profit sectors. We found that their unique combination of business and social logics, along with an entrepreneurial mindset, may make them more flexible, innovative, and able to diversify their income than public and not-for-profit care organisations. They were also considered more trustworthy than private care services. However, their competing social and business logics can create internal tensions and bring uncertainty about what organisational model they are. These tensions can make it challenging for us to define what a care social enterprise is and in turn for social enterprises to promote themselves and attract funding. [ABSTRACT FROM AUTHOR]

Given the intense politicisation of education, many teacher educators are caught in the cross-hairs of government's reform agendas, university expectations and student teacher needs. This paper reports on a study of 28 literacy teacher educators in four countries (Canada, US, Australia and England). This paper reports on the broad question: How is politics affecting literacy teacher educators? Three specific aspects are considered: their pedagogies, identity and well-being. It describes how their pedagogy (goals and teaching strategies) has narrowed because of mandated curriculum and exit exams. It shows how their identity as academics is being complicated because they often do not have time for their research. And their well-being is compromised because of excessive external inspections and as their community in the university splinters. [ABSTRACT FROM AUTHOR]

BACKGROUND: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. AIM: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. METHODS: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. RESULTS: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. CONCLUSION: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified. [ABSTRACT FROM AUTHOR]

This paper reports findings from a national, qualitative study in England that investigated if young adult carers services are facilitating young people's transitions to adulthood, including considering a future beyond caring. Semi-structured, online interviews were conducted in 2022 with a purposive sample of managers or lead workers of eleven young adult carers services in England. We discuss the consideration given in assessments to young people's caring preferences and the availability of support to facilitate them to relinquish their role, if they so wished. The majority of young adult carers services gave young people the opportunity to express their views on this issue. Although the Care Act 2014 aimed to provide choice over caring in adulthood to young adult carers, this was not matched by the necessary service provision to facilitate their preferences. A new national carers strategy is urgently required to ensure that young people, particularly women, have a credible choice over their future lives. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Pain is increasingly affecting young people, their quality of life and wellbeing including education, social life and mental health. Current Western approaches to psychological support for Chronic Pain often focus on 'pain management' and learning skills and strategies from professionals, making use of Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and psychoeducation approaches in individual and group interventions. As a Paediatric Psychology service, we have trialled groups running over multiple weeks informed by these approaches and experienced low attendance rates. Method: This paper describes a feasibility study of an alternative group intervention; the 'Living with Pain group', which combines the 'Journey of Life' (Denborough, 2014) with collective narrative and liberation psychology approaches. Results: Thirty three young people and eight parents / carers attended the intervention. Attendance rates, quantitative and qualitative feedback from one face-to-face group for young people and parents and two online groups for young people showed increased access and acceptability of the group. Conclusion: The findings from this study have shown that a 1-day collective narrative group intervention is feasible, suitable and acceptable and has increased access to our group intervention. Future directions include co-creation with young people and families, community engagement to increase accessibility of our groups and developing partnerships to respond to young people's hopes to raise awareness. [ABSTRACT FROM AUTHOR]

This paper explores the current approach to the interaction between policing and sex work in England and Wales. It reviews the legal and policy context and outlines current policing guidance and priorities, introducing the Harm Reduction Compass as a mechanism to advance policing policy and optimise operational decision-making. Through critical discussion of occupational culture and reforms in policing, it also assesses how continuity, reliability, and transferability can be achieved across police forces within the existing hostile and outdated statutory framework. The Harm Reduction Compass (HRC) aims to focus policing resources on adult sexual exploitation and crimes experienced by sex workers by decoding the complexities of different individuals' personal circumstances. This paper proposes a new framework as a model to aid operational policing by triaging different scenarios to reach the most appropriate response. This new model, which identifies autonomy and harm as the most significant indicators, addresses harm and vulnerability holistically and combines policing with public health and community-based approaches; this ensures the pathway to assistance and intervention is an integrated multi-partnership. The HRC is a step forward in progressing police culture around the use of language and in dealing with crimes against sex workers in the most appropriate way. [ABSTRACT FROM AUTHOR]

About a quarter of the adults living in England have been diagnosed with a mental health condition (for example, anxiety and depression). The purpose of this paper is to discuss the difficulties faced by these people when they travel, and ways in which policy interventions could be used to encourage them to travel more. The main evidence in the paper comes from a weighted sample of 363 people with mental health conditions who completed an on-line survey. The paper concentrates on anxiety issues. The anxieties are considered under five headings: interacting with fellow travellers, interacting with staff and purchasing tickets, wayfinding, needing support, and needing to take urgent action. Policy interventions to improve access to infrastructure and services to help address the anxieties are discussed under these headings. The number of respondents who say that they would travel more if some of the interventions were introduced is then considered. The paper concludes that there are ways in which some of the anxieties that people have when travelling can be addressed and that introducing these types of intervention would increase travel by people with mental health conditions. • Psychological barriers to travel are revealed in an on-line survey. • 99% of the respondents identified aspects of travel that caused them anxiety. • The largest cause of anxiety was interacting with other people when travelling. • Other causes of anxiety included wayfinding and needing to find public toilets. • Policy interventions would encourage the respondents to travel more. [ABSTRACT FROM AUTHOR]

This paper uses the 1908 Oxford Report, a founding document for the Workers' Educational Association, as a window onto the internal contradictions of the university adult education movement, an issue that has been neglected by historians of education. Examining the early history of the WEA shows that while the movement was inspired by Oxford Idealism and set itself the aim of democratising higher education, it also drew support from people who intended to professionalise the university by introducing the principles of trained expertise and selection by merit. The confluence of Idealism and professionalism resulted in a ground-breaking but inconsistent educational programme outlined in the Oxford Report. This paper suggests that the attempt to simultaneously democratise and professionalise higher education was untenable and foreshadowed later tensions within the WEA movement. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus and associated mitigation efforts have produced barriers to accessing services for adults with intellectual disabilities. This paper aims to evaluate the impact of Covid-19 on access to psychological services. The paper evaluates monthly referral rates and psychological distress scores for service users awaiting therapy. Design/methodology/approach: A quantitative service evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. A single case experimental design was used to examine the impact of events in March 2020 on referral rates. Descriptive statistics and effect size calculations were used to examine the impact of prolonged waiting times on psychological distress scores. Findings: Referral rates were examined comparing a 5-year rolling average monthly referral rate for the 12 months prior to March 2020 with the 12 months following. Findings demonstrate that events starting in March 2020 have had a considerable impact on referral rates and rates have not recovered. Eight service users were contacted to determine the impact of prolonged waiting times with results demonstrating increases in psychological distress of large effect size. Originality/value: This is the only paper the authors are aware of examining the impact of the coronavirus on access to services and psychological distress for adults with intellectual disabilities. It is hoped that these findings will be able to inform both policy and practice as services continue to navigate the pandemic. [ABSTRACT FROM AUTHOR]

Purpose: The Adult Social Care Outcomes Toolkit for informal carers (ASCOT-Carer) can be used to assess long-term care-related quality of life (LTC-QoL) of adult informal carers of persons using LTC services. The ASCOT-Carer instrument has been translated into several languages, but preference weights reflecting the relative importance of different outcome states are only available for England so far. In this paper, we estimated preference weights for the German version of the ASCOT-Carer for Austria and investigated the value people place on different QoL-outcome states. Methods: We used data from a best–worst scaling (BWS) experiment and estimated a scale-adjusted multinomial logit (S-MNL) model to elicit preference weights for the ASCOT-Carer domain-levels. Data were collected using an online survey of the Austrian general population (n = 1001). Results: Top levels in the domains of 'Space and time to be yourself', 'Occupation' and 'Control over daily life' were perceived as providing the highest utility, and states with high needs in the same domains seen as particularly undesirable. 'Personal safety' was the only domain where levels were roughly equidistant. In all other domains, the difference between the top two levels ('ideal state' and 'no needs') was very small. Conclusion: The paper provides preference weights for the German version of ASCOT-Carer to be used in Austrian populations. Furthermore, the results give insight into which LTC-QoL-outcomes are seen as particularly (un)desirable, and may therefore help to better tailor services directed at informal carers and the persons they care for. [ABSTRACT FROM AUTHOR]

Ofsted, the inspection authority in England, has told schools to ensure that all students have access to cultural capital, taken as a canon of music, literature and art. In this paper, we trouble this guidance by analysing conversations with 1447 senior secondary students. The students reported that the arts offered considerable personal benefits, as well as creative self-expression (visual art) and vocational and networking skills (performing arts). By bringing Bourdieu to the dataset we offer a field analysis that shows how arts cultural capitals might follow the logics of the education field. We speculate that, despite the likelihood that these elite cultural capitals were not of equal value to all students, arts capitals and dispositions might support wider resistances to logics of practice in other fields. [ABSTRACT FROM AUTHOR]

The research explored the impact of an employability programme, delivered by a Community Interest Company and other third sector partners in England. The programme was designed to increase the employability of people aged between 16–72 years-old who were unemployed or economically inactive. To measure the impact of the programme on participants, 1,098 people engaging in the project completed questionnaires designed to capture demographic data and measure general self-efficacy (GSE) upon joining the programme (Time 1); whilst 163 of the same participants completed the questionnaire upon completing the programme (Time 2). Interviews were conducted with 26 participants engaged with the programme. Results of the questionnaire data analysis revealed a statistically significant relationship between levels of disadvantage experienced by the participants and GSE at Time 1; statistically significant increases in GSE levels between Time 1 and Time 2 for participants who completed the programme; and a statistically significant relationship between GSE at Time 2 and employment/training outcomes. Triangulation of the quantitative and qualitative results revealed the positive impact of the programme on participant's self-efficacy and employability. This paper is the first of its kind in the UK to explore the impact of employability programmes on adults experiencing multiple disadvantage. [ABSTRACT FROM AUTHOR]

Objectives: Ascertaining whether mental health service users have children is a clinical requirement in UK health services, and acknowledgement of a patient's parenting role is necessary to enable engagement with their parenting experience and to facilitate support, both of which are associated with improved outcomes for the parent–child dyad. The current study sought to investigate the practice of mental health practitioners working in UK adult mental health services with regard to the following: Ascertaining whether patients have children; engagement with the parenting role of patients; engagement with the construct of 'think patient as parent'. Methods: Self‐report online/paper survey of 1105 multi‐disciplinary adult mental health practitioners working in 15 mental health trusts in England. Results: A quarter of adult mental health practitioners did not routinely ascertain whether patients had dependent children. Less than half of practitioners engaged with the parenting experience or the potential impact of parental mental health on children. Conclusions: The parenting role of patients is not routinely captured by large numbers of practitioners working in adult mental health settings. This is despite it being a mandatory requirement and an integral component of the systematic care of the adult, and preventative care for the offspring. Failure to engage with patients who are parents is a missed opportunity with profound downstream public health implications. The practice deficits identified in this study should be viewed in terms of broader structural failures to address the intergenerational transmission of poor mental health. Practitioner points: Some parents who have mental health difficulties may struggle to provide appropriate and effective care to their children. The parenting role can also exacerbate mental health difficulties.Identification of dependent children is a mandatory component of adult mental health clinical practice and is necessary to understand a parent's support needs.A quarter of adult mental health practitioners are failing to do so. A missed opportunity to engage with the support needs of the parent–child dyad. [ABSTRACT FROM AUTHOR]

This paper reports on key findings from a mixed method study analysing how teachers in secondary schools (students aged 11–19) in London and South East England view and experience pastoral care provided to students with social, emotional and mental health (SEMH) needs. In England there is statistical evidence which shows schools are increasingly spending funding on support staff rather than teaching staff. The role of Pastoral Support Staff (PSS) who work with students with SEMH in some secondary schools is one such group of support staff. To date there has been limited research into how teachers perceive these changes and the effects on their role and responsibilities. The views of fifty-one respondents were gathered using an online semi-structured survey, followed by semi-structured interviews with six qualified teachers. Using a figured worlds conceptual framework, teachers' perceptions of the use of pastoral support staff and the delivery of pastoral care in their schools, and therefore their worlds, were analysed. The findings were analysed using Hoy's and Tschannen-Moran's work on trust in schools exploring the trust dynamic between PSS and teachers. Results show that the teachers who participated in this research felt there was a lack of information sharing between different PSS and teachers and have seen the separation of pastoral care from the role of teacher leading to confusion around their responsibilities. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents the results of a thematic analysis of safeguarding adults reviews (SARs) where homelessness was a factor to illuminate and improve safeguarding practice and the support of adults who are homeless in England. Design/methodology/approach: SARs were identified from a variety of sources and a thematic analysis was undertaken using data extraction tables. Findings: In addition to identifying shortcomings in inter-agency co-operation, SARs highlighted a failure to recognize care needs and self-neglect among people with experience of homelessness and evidenced difficulties in engagement between professionals and people with experience of homelessness. Research limitations/implications: The authors may have failed to find some SARs in this category (there is no central registry). SARs vary in quality and in detail; some were not full reports. The approach to people's experience of homelessness was broad and covered more than the circumstances of people who were rough sleeping or living on the streets. Originality/value: This paper contributes to the current practice debates and policy initiatives in respect of homelessness and safeguarding in England. It may have wider relevance in the rest of the UK and internationally. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the recent National Appropriate Adult Network (NAAN) report on the role of the appropriate adult. Design/methodology/approach: This paper is based on the NAAN report and a review of relevant policy and research literature. Findings: There to Help 2 highlights that there are still significant gaps in the provision of appropriate adult schemes across England and Wales. These gaps potentially place vulnerable adults at increased risk. Originality/value: This paper is a review of recent research. [ABSTRACT FROM AUTHOR]

This paper examines two contrasting creative methods; a drawing task and a LEGO building task used in a study exploring the gap between policy and practice in widening participation to higher education across two different types of university in England. These creative methods were used within 16 semi-structured interviews in seven universities to attempt to explore deeper understandings of everyday policy and what they mean in practice and to make comparisons across types of institutions. This paper examines the role that creative confidence played in the effectiveness of both methods through exploring the successes and failures of each arguing that understanding these barriers can improve the successful use of these methods, especially with adults. When these barriers are overcome, the paper also demonstrates how creative methods encouraged more reflective discussion of everyday issues, increased levels of rapport, and shared engagement in the interview process. [ABSTRACT FROM AUTHOR]

Autistic adults are at increased risk of mental health difficulties; however Adult Mental Health Services (AMHS) often struggle to offer appropriate support to this group. Within England, Government initiatives, such as the 'Transforming Care' programme which included 'Building the Right Support' (NHS England, 2015) have promoted the need for AMHS to consider how they can better provide autism-informed support to autistic adults. Here, we describe the first two years of work of the Transforming Care in Autism (TCA) Team; a specialist service that supports autistic adults, without a moderate or severe intellectual disability or presenting significant risk to others, experiencing a mental health crisis. The service model is described, and descriptive data is presented over the two years of the service operation. Results: Between February 2019 and February 2021, 110 referrals were received; 52 (47%) were accepted. Support offered to autistic adults included psychoeducation, psychological interventions, family-focused interventions, and consultation with professionals about specific individuals. Seventy autism training sessions were delivered to professionals working in medical health settings, AMHS, social care and residential services. Developing more autism-informed community and inpatient AMHS is vital for improving care. Further research about the experiences and needs of autistic adults using AMHS is needed, along with improved awareness of autism and provision of tailored intervention within these settings. Autistic people have mental health problems more often than people who are not autistic. When autistic people need help from mental health services, often these services do not know how to help autistic people. The Government says mental health services must do more to help autistic people. In this paper we write about a new team, called the Transforming Care in Autism team. In its first two years the team was asked to help 110 people and worked with 52 of them. Help included talking to autistic people about how autism affects them and offering therapy. We also worked with families and professionals supporting autistic adults and offered 70 training sessions. More work is needed to make sure mental health services work well with autistic people. We also need to ask autistic people about their experiences of getting help from mental health services. • A bespoke service to support autistic adults, experiencing a mental health crisis. • Primary remit to support autistic adults at risk of admission or already inpatient. • Secondary remit to improve knowledge and skills within local non-specialist autism. • Specialist autism support was welcomed by mainstream services. [ABSTRACT FROM AUTHOR]

This paper presents findings of a pedagogical strategy for enhancing social work students' knowledge and practice of 'personal reflexivity'. Twenty-five MA students in England were presented ideas about 'reflective practice', 'critical reflection' and 'reflexivity' and encouraged to examine different interpretations including Archer's theory of reflexivity as 'internal conversation'. Archer's Internal Conversation Indicator (ICONI) was used to determine students' dominant reflexive 'mode'. On programme entry, two students (8%) practised a communicative-reflexive mode, nine (36%) were autonomous-reflexives, six (24%) meta-reflexives and four (16%) fractured-reflexives. Four (16%) were unclassified. Sixteen students (64%) completed ICONI on two further administrations. Seven (44%) registered unchanged reflexive modes, whereas nine (56%) changed. Three (33%) unclassified changed to meta-reflexive, one (11%) from autonomous-reflexive to meta-reflexive and one (11%) from fractured-reflexive to meta-reflexive. Two (22%) meta-reflexives changed to autonomous-reflexives. One (11%) communicative-reflexive and one (11%) meta-reflexive became unclassified. Integrating Archer's theorising into a pedagogical strategy for enhancing understanding of personal reflexivity encouraged students to identify their dominant mode. Resultantly, students were able to consider relevance of reflexive modes for reasoning, making decisions and being able to act within their value-commitments, beliefs and concerns within the constraints of social work contexts. Implications for social work education and practice are discussed. [ABSTRACT FROM AUTHOR]

Posttraumatic Stress Disorder (PTSD) may be a common issue in primary care in the UK, but there have been no studies of all-cause PTSD in general samples of attenders in this country. The current paper thus explores the extent and distribution of probable PTSD among patients attending general practices in England. Cross-sectional survey data from adult patients (n = 1058) attending 11 general practices in southwest England were analysed. Patients were recruited from waiting rooms and completed anonymous questionnaires, including measures of depression, anxiety and risky alcohol use. Current probable PTSD was measured using the 4-item Primary Care PTSD Scale (PC-PTSD). Results indicated 15.1% of patients that exhibited probable PTSD (PC-PTSD ≥ 3), with higher levels observed in practices from deprived areas. There were 53.8% of patients with probable PTSD that expressed the desire for help with these issues. The analyses suggested that rates were lowest among older adults, and highest among patients who were not in cohabitating relationships or were unemployed. Measures of anxiety and depression were associated with 10-fold and 16-fold increases in risk of probable PTSD, respectively, although there were no discernible associations with risky drinking. Such preliminary findings highlight the need for vigilance for PTSD in routine general practice in the UK, and signal a strong need for additional research and attention in this context. [ABSTRACT FROM AUTHOR]

Research on the promotion of 'fundamental British values' (FBV) in English schools has tended to focus on its nationalistic and securitising elements. Its role within a broader, politically conservative shift in values education, both in England and beyond, has received less attention. This paper addresses the latter, reporting on research into FBV with secondary school teachers who already see themselves as values educators. Using life history methods, the research investigated how the teachers' subject backgrounds and existing commitments to values education influenced their enactment of the policy. Findings suggest that the teachers' existing enthusiasm for values education per se acted as an important factor in their willingness to engage seriously with the policy. Personal and professional commitments, as well as subject-specific pedagogies, were important in the ways teachers responded creatively to FBV, indicating the significant role of teacher agency in responding to the shifting policy landscape in values education. [ABSTRACT FROM AUTHOR]

This paper explores practice examples relating to young people's transitions from care to adulthood. It discusses examples drawn from young people's pathways to adulthood, leaving care law and policy and participation. The paper concludes with a discussion of the research evidence on promoting the resilience of young people from care to adulthood, by proposing a framework for evaluating the impact of practice. It is suggested that practice should be interrogated in respect of the contribution made to stability and continuity, educational achievement, involving young people, preparation and support into adulthood, and health and well‐being. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England. Design/methodology/approach: Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities. Findings: In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing. Social implications: While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care. Originality/value: This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England. [ABSTRACT FROM AUTHOR]

Drawing on a 2010 analysis of the reform and costs of adult social care commissioned by Downing Street and the UK Department of Health, this paper sets out projected future costs under different reform scenarios, reviews what happened in practice from 2010-19, explores the impact of the growing gap between need and funding, and explores the relationship between future spending and economic growth. In the process, it identifies a 'lost decade' in which policy makers failed to act on the warnings which they received in 2010, draws attention to the disproportionate impact of cuts on older people (compared to services for people of working age) and calls for urgent action before the current system becomes unsustainable. [ABSTRACT FROM AUTHOR]

This paper explores the housing pathways of young adults following the breakdown of a first intimate relationship based on co-residence. In particular it explores the frequent recourse to shared housing and returns to the parental home, and how these options may be seen as steps backward, yet also offer opportunities for support. Findings are discussed in the context of the de-standardisation of transitions to adulthood characterised by uncertainties related to early years of employment and the shortage of affordable housing. Although often not as consequential as mid-life relationship breakdowns for future housing prospects, intimate relationship breakdowns linked to initial co-residence are nonetheless critical life events for young adults, leading to a re-evaluation of their existing relationships and of their plans in relation to housing and family formation. Our findings also indicate that the backwards and forwards movements associated with intermediary housing arrangements and in-between phases are deserving of greater attention. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis, and to address the challenge of change, exploring the necessary components beyond an action plan to ensure that findings and recommendations are embedded in policy and practice.Design/methodology/approach Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. The repetitive nature of the findings prompts questions about how to embed policy and practice change, to ensure impactful use of learning from SARs. A framework for taking forward an action plan derived from an SAR findings and recommendations is presented.Findings Familiar, even repetitive findings emerge once again from the thematic analysis. This level of analysis enables an understanding of both local geography and the national legal, policy and financial climate within which it sits. Such learning is valuable in itself, contributing to the evidence base of what good practice with adults who self-neglect looks like. However, to avoid the accusation that lessons are not learned, something more than a straightforward action plan to implement the recommendations is necessary. A framework is conceptualised for a strategic and longer-term approach to embedding policy and practice change.Research limitations/implications There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here enables conclusions to be reached about issues to address locally and nationally to transform adult safeguarding policy and practice.Practical implications Answering the question “how to create sustainable change” is a significant challenge for SARs. A framework is presented here, drawn from research on change management and learning from the review process itself. The critique of serious case reviews challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice.Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of following up SARs by using the findings and recommendations systematically within a framework designed to embed change in policy and practice. [ABSTRACT FROM AUTHOR]

Trauma‐informed practice has been developing for decades, though much remains unknown regarding how it is understood and practised. Drawing upon focus group data from an evaluation of a trauma‐informed approach (TIA) implemented by an organisation in Southeast England, this paper provides a unique perspective of 31 staff members and 18 young people. Results indicate how choice and control, key elements of a TIA, align with the Capability Approach (CA). The CA is then used as a novel analytic framework to examine the data. A 'Trauma‐Informed Capabilities Approach' is introduced as a holistic, person‐centred way of conceptualising young trauma survivors' well‐being. [ABSTRACT FROM AUTHOR]

At a time of heightened international debate about youth precarity, how do we understand and support transitions to adulthood for people who have been in care? This paper reports on a qualitative longitudinal study of 75 young adults (aged 16–32 years) from Norway, Denmark, and England. All had been in care during childhood and at the time of their recruitment to the study all were in education, employment or training. Against the context of a literature largely focused on transitions specific to 'leaving care', our analysis addresses aspects of early adulthood which are not specific to being care experienced; some (such as romantic break-ups, or moving home) might be considered normative, whilst others (such as changing course or dropping out of university) are less common. Cross-national analysis shows how care and wider welfare systems intersect with informal networks in everyday lives, functioning to scaffold young people, or to exacerbate precarity, as they navigate biographical transitions in early adulthood. The research shows the importance of developing socially and culturally located biographical accounts of 'transition' that recognise the complexities, uncertainties and essential interdependence of everyday lives and emerging adulthoods. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.Design/methodology/approach The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.Findings The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.Originality/value Addressing the implementation of OBC in adult social care in England in the context of extra care housing. [ABSTRACT FROM AUTHOR]

Aim: To compare mortality rates for cardiovascular disease, cancer, and respiratory disease between adults with cerebral palsy (CP) and the general population.Method: A cohort study was conducted using data from adults with CP in England, identified through a primary care data set (the Clinical Practice Research Datalink), with linked data on death registrations from the Office for National Statistics. Cause of death was categorized according to International Classification of Diseases codes. Standardized mortality ratios (SMRs) were calculated to compare mortality rates between adults with CP and the general population, adjusted for age, sex, and calendar year.Results: Nine hundred and fifty-eight adults with CP were identified (52.5% males, 47.5% females; median age at start of follow-up 31y [interquartile range 22-43y]) and followed for a total of 7693 person-years. One hundred and forty-two patients (15%) died during follow-up. Adults with CP had an increased risk of death due to cardiovascular disease (SMR: 3.19, 95% confidence interval [CI] 2.20-4.62) and respiratory disease (SMR: 13.59, 95% CI 9.89-18.67), but not from malignant neoplasms (SMR: 1.42, 95% CI 0.83-2.45).Interpretation: We found that adults with CP in England have increased risk of death due to diseases of the circulatory and respiratory systems, supporting findings from two studies that compared cause-specific mortality rates between adults with CP in the USA and the general population. Further research is required into primary and secondary prevention of cardiovascular and respiratory disease in people with CP worldwide.What This Paper Adds: Adults with cerebral palsy (CP) in England have 14-fold increased risk of mortality due to diseases of the respiratory system. They have a 3-fold increased risk of mortality due to diseases of the circulatory system. Adults with CP had an increased risk of death due to cerebrovascular disease and ischaemic heart disease. The elevated risk of ischaemic heart disease, however, did not reach statistical significance at the 5% per cent level. [ABSTRACT FROM AUTHOR]

Autistic Spectrum Disorder (ASD) affects approximately 1% of the general population. The prevalence of ASD, or symptom complexes compatible with ASD, amongst young people residing within Secure Children's Homes (SCH's) remains ill understood. There are critical implications for the resourcing and understanding of the management of young people with social/communication difficulties. This paper describes a preliminary investigation of the prevalence of ASD within SCH's in the UK. The Social Communication Questionnaire (SCQ) was completed with support workers for 113 adolescents admitted to two SCH's in England as a screen for ASD. The SCQ identified 15 (13.3%) young people with symptoms compatible with an ASD presentation; differences in gender, legal status and a history of Child Sexual Exploitation (CSE) are discussed. [ABSTRACT FROM AUTHOR]

This paper starts by exploring the relevance of Bernstein’s work on vertical and horizontal discourses and the constitution of professional knowledge for conceptualisation of the knowledge needed for teaching practice. Building on arguments for the differentiated nature of knowledge, and drawing on the work of Winch, Young and Muller on expertise, and the sociology of the professions, this paper advances a conception of teaching as a ‘specialised professional practice’ that requires the support of particular socio-epistemic arrangements and conditions embedded in professional communities. Prevalent notions of teaching and teacher education that find favour in some European countries are examined in the light of these arguments, with particular reference to recent reforms in England. [ABSTRACT FROM PUBLISHER]

The collection of a subset of CFS/ME patient data as part of the.national CFS/ME collaborative was confirmed to be service evaluation by the North Somerset & Bristol Research Ethics Committee under REC reference 07/Q2006/48, and in a letter dated 29 January 2007 the Chair of the Research Ethics Committee had previously confirmed (a) that it would not be necessary to apply for ethical permission to use the data being collected as part of service evaluation for the national CFS/ME collaborative and (b) that if in future this data were to be used as part of a research project, this would be agreeable. The "Ethical Approval" section of this paper has been updated to read The data used in this study was originally collected and collated in the National Outcomes Database for the purposes of evaluation of CFS/ME services. [Extracted from the article]

Purpose – The purpose of this paper was to establish the extent to which safeguarding procedures in North Somerset identified and reviewed outcomes for the alleged adult at risk. The project aimed to address whether outcomes could be achieved and what steps need to be taken to make the experience of safeguarding personal. Design/methodology/approach – Three social care teams with a responsibility for following up safeguarding referrals were asked to participate in the work and provide feedback on cases completed within the project timeframe. Data were gathered centrally on specific forms and through focus group discussions with social workers. Findings – The findings confirmed the need for a change in practice to ensure safeguarding procedures are personal. Research limitations/implications – The number of completed cases in the timeframe of the project was small and this limits the conclusions. Practical implications – The paper identifies change needed to training and recording systems and recognises that further work is needed to embed the learning from this work and explore the implementation of alternative approaches. Originality/value – The paper establishes the extent to which existing safeguarding practice is outcome focused. [ABSTRACT FROM AUTHOR]

Purpose -- Winterbourne and Mid-Staffordshire scandals have had a significant impact on how Care Quality Commission inspects and regulates intellectual disability services (IDS). The purpose of this paper is to describe the changes and development of regulation of these services and future work. Design/methodology/approach -- The paper is a descriptive paper. Findings -- A new regulatory model is currently implemented for IDS. It has been developed in consultation with patients, carers, providers and other stakeholders. There will be ongoing development and refinement of the inspection methodology. Originality/value -- This is an original descriptive paper which will provide useful information to readers on how the regulatory process works in IDS. [ABSTRACT FROM AUTHOR]

A lack of esteem for teachers and the teaching profession is a central tenet underpinning policy reforms put forward by the 2010 UK Government White Paper ‘The Importance of Teaching’. This article argues that the policy problem and solutions presented in the White Paper lack awareness of the historical and social positioning of teaching. Drawing on in-depth interviews with 32 London-based secondary teacher training students from various social class and ethnic backgrounds, this paper asks how the profession is perceived and what sort of choice it is for the trainees. It employs a Bourdieusian lens and concepts of social and cultural capital to examine the interplay of gendered, classed and ‘raced’ biographies in relation to individuals’ decisions to become teachers. Understanding the social world as ‘accumulated history’, as Bourdieu does, stresses that experiences and outcomes are rooted and collected in a series of historical structures and functionings. The paper argues that the ambiguous status of the profession is both a function and an effect of its conceptualisation as feminised. It also asks whether the weak professional standing of teaching has further destabilising consequences in the present political moment where a string of neoliberal and neoconservative policy reforms reshape the profession. [ABSTRACT FROM PUBLISHER]

Drawing on data from in-depth interviews with refused asylum seekers from Zimbabwe and Kurds from Turkey, who have stayed in Britain as irregular migrants, this paper examines everyday lives, strategies and fears. The paper focuses on four main areas: individual experiences of the asylum system leading to irregularity; living as an irregular migrant with the constraints on economic participation and limited housing options; social lives, relationships and community activities alongside the ways in which decisions about social interactions intersect with irregularity and subsistence support; the fears and everyday struggles faced by irregular migrant's living in England, and the ways in which this translates into relationships with place and space. The paper draws out both the commonalities and the diversity of experiences among refused asylum seekers living in England. [ABSTRACT FROM AUTHOR]

At a time when the contemporary landscape of teaching is populated with successive and persisting government policy reforms that have increased teachers’ external accountabilities, work complexity, and emotional workload, understanding why and how many teachers are able to sustain their capacity to be resilient and continue to work for improvement is an important quality retention issue. The purpose of this paper is to build upon but take further current understanding of resilience in teachers by exploring in greater depth the nature of resilience in teachers as a relational concept and the ways in which it may be related to the learning and achievement of their pupils. The empirical basis of the paper draws upon analyses of twice yearly semi-structured face-to-face interview data from 300 teachers in different phases of their careers in 100 primary and secondary schools in England over a consecutive three-year period. Through these analyses, the paper contributes additional empirical evidence to the emerging but still limited literature on the factors which influence teachers’ capacity to be resilient. The paper concludes with a consideration of the implication of the findings for the quality retention of teachers. [ABSTRACT FROM PUBLISHER]

Botanic gardens, as well as being widely acknowledged as beautiful places, are often scientific organisations that aim to engage visitors, including families, in science learning. Yet, the extent to which families view them as settings for science learning is largely unexplored. Drawing upon social constructivist perspectives, this paper investigates families’ views of science learning at Kew Gardens. Kew is one of the largest botanic gardens worldwide and an internationally renowned scientific organisation located in London, UK. Twenty-four families took part in the study, which involved interviews and accompanied visits. Findings indicate that all families referred primarily to the aesthetic beauty of Kew, while its function as a site for science learning was less well acknowledged. However, interpretation helped families establish what constitutes science at Kew, and linked science to the beautiful plants, which offered avenues for families to appreciate science learning. The findings provide implications for developing interpretive provision in botanic gardens. [ABSTRACT FROM AUTHOR]

A small-scale consultation of care leavers in South London was undertaken in 2013–2014, in order to inform a pilot mentoring scheme to reduce depression in young women through supporting their transition from care to independence. Research on the social factors implicated in the onset and course of depression indicates that social support during stressful events can be protective. Youth mentoring is now widely offered to disadvantaged young people. This paper examines what some young people told us about if and how our proposed mentoring intervention might help in maintaining their well-being through the stress of leaving care. Eleven participants of focus group discussions told us they could see clear benefits in receiving mentoring at this time, and discussed the kind of mentor and activities they might like. However, most did not want a mentor now. Thematic analysis of the discussions arising identified unpaid, open-ended ‘natural mentoring’ relationships as particularly important to them in maintaining their well-being. We consider the fit with related research, and emerging new policy, and the implications for our proposed study, and conclude that supporting the establishment and continuation of natural mentoring is a particularly promising way forward. [ABSTRACT FROM PUBLISHER]

Purpose Serious Case Reviews (SCRs, now Safeguarding Adults Reviews (SARs)) may be held at local level in England when a vulnerable adult dies or is harmed, and abuse or neglect is suspected, and there is cause for concern about multi-agency safeguarding practice. There has been no analysis of SCRs focussing on pressure ulcers. The purpose of this paper is to present findings from a documentary analysis of SCRs/SARs to investigate what recommendations are made about pressure ulcer prevention and treatment in a care home setting in the context of safeguarding. This analysis is presented in cognisance of the prevalence and risks of pressure ulcers among care home residents; and debates about the interface of care quality and safeguarding systems.Design/methodology/approach Identification of SCRs and SARs from England where the person who died or who was harmed had a pressure ulcer or its synonym. Narrative and textual analysis of documents summarising the reports was used to explore the Reviews’ observations and recommendations. The main themes were identified.Findings The authors located 18 relevant SCRs and 1 SAR covering pressure ulcer care in a care home setting. Most of these inquiries into practice, service communications and the events leading up to the death or harm of care home residents with pressure ulcers observed that there were failings in the care home, but also in the wider health and care systems. Overall, the reports reveal specific failings in multi-agency communication and in quality of care. Pressure ulcers featured in several SCRs, but it is problems and inadequacies with care and treatment that moved them to the safeguarding arena. The value of examining pressure ulcers as a key line of inquiry is that they are “visible” in the system, with consensus about what they are, how to measure them and what constitutes optimal care and treatment. In the new Care Act 2014 context they may continue to feature in safeguarding enquiries and investigations as they may be possible symptoms of system failures.Research limitations/implications Reviews vary in content, structure and accessibility making it hard to compare their approach, findings and recommendations. There are risks in drawing too many conclusions from the corpus of Reviews since these are not published in full and contexts have subsequently changed. However, this is the first analysis of these documents to take pressure ulcers as the focus and it offers valuable insights into care home practices amid other systems and professional activity.Practical implications This analysis highlights that it is not inevitably poor quality care in a care home that gives rise to pressure ulcers among residents. Several SCRs note problems in wider communications with healthcare providers and their engagement. Nonetheless, poor care quality and negligence were reported in some cases. Various policies have commented on the potential overlap between the raising of concerns about poor quality care and about safeguarding. These were highlighted prior to the Care Act 2014 although current policy views problems with pressure ulcers more as care quality and clinical concerns.Social implications The value of this documentary analysis is that it rests on real case examples and scrutiny at local level. Future research could consider the findings of SARs, similar documents from the rest of the UK, and international perspectives.Originality/value The value of having a set of documents about adult safeguarding is that they lend themselves to analysis and comparison. This first analysis to focus on pressure ulcers addresses wider considerations related to safeguarding policy and practice. [ABSTRACT FROM AUTHOR]