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Purpose The purpose of this paper is to argue for a strengthening of the relational aspect of social work and for initiatives that involve local people and local communities.Design/methodology/approach A think piece based on observations of the current situation and supporting evidence.Findings Social work has become distanced from those whom it seeks to help. Case management and risk assessment need to be complemented by a more human approach based on positive relationships between professionals and service users.Originality/value An informed discussion on the future of social work. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the impact of the Health and Social Care Act, 2012 on London’s rough sleepers as seen from the perspective of one former homeless service user (currently working as a support worker in a day centre providing outreach and “drop in” facilities for people who are street homeless and other vulnerable adults including female sex workers). The discussion centres on some of the unintended impacts of changes to healthcare commissioning; the new arrangements for patient, public representation; and the enhanced role of local councils.Design/methodology/approach This paper is grounded in front line practitioner reflection/opinion and draws on practical experience and observation at Spires, as well as research and government papers published by other service providers. The aspirations of the Health and Social Care Act, 2012 are set out before its practical application are examined from the rough sleeper’s dimension.Findings Putting clinicians and GPs centre stage in the commissioning and purchasing of healthcare may have some benefits for individual patient choice, but it can also dilute patient public involvement in health and social care with negative effects for vulnerable and excluded groups, including rough sleepers. The terms of reference ascribed to Local Healthwatch Organisations, the official representatives of the people, are narrower than previously and limit their ability to influence official policy. The Act centralises control whilst devolving operational responsibility, especially for public health provision on which rough sleepers often rely. It is suggested that local voluntary organisations and specialist “inclusion” health groups are increasingly being expected to take over responsibility for delivering health and social care and that mainstream collaboration is much reduced rather than enhanced by this fragmentation.Research limitations/implications This review is based on the opinion of an “expert by experience” which may not be representative.Originality/value This is one of few papers which present a front line service user/practitioner perspective on the impact of clinical commissioning on services for marginalised groups. [ABSTRACT FROM AUTHOR]

Purpose Comment on the contribution that housing can make to delivering better health and wellbeing outcomes. More specifically, the purpose of this paper is threefold: summarise recent evidence that makes the case for housing in helping to address health and social care issues; comment on the challenges and opportunities of partnership working; and describe examples of interesting and innovative local joint provision.Design/methodology/approach Draws on the author's briefing papers on housing, health and social care for housing quality network, which is a national housing consultancy organisation as well as the author's role as Chairperson of East Midlands Housing Care and Support, which is a regional housing association.Findings Collaboration between housing, health and social care is making slow progress at the national level in England. This is despite an ever-increasing evidence base highlighting that good housing can help to address issues, such as delayed discharges. Nevertheless, there are an increasing number of interesting examples of successful local initiatives on housing, health and adult social care. The way forward is to facilitate joint working at a local level.Originality/value Focusses on the success of examples of local joint working between housing, health and social care to achieve better outcomes for vulnerable people. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to illustrate the hostility many young women who are also mothers experience within their everyday lives.Design/methodology/approach The paper will draw on qualitative research, incorporating a narrative approach, to illustrate the hostility many young mothers experience on a daily basis. The research design included a focus group, semi-structure interviews and participant observations.Findings The paper reports the findings of a study that explored the experiences of young women who are also mothers. The author presents the findings that indicate that many young women, who are also young mothers, experience hostile reactions and interactions as part of their everyday lives.Research limitations/implications The small sample size means that this study cannot be generalised, but it does contribute to the growing body of qualitative evidence in relation to young mothers.Practical implications The findings suggest that there needs to be more recognition and acknowledgement of the hostility young women experience. Such hostility could have deleterious consequences on the young women, their parenting ability and also on the children.Originality/value This paper documents the experiences of young women who are also mothers and how they experience hostility as a daily occurrence. The hostility ranged from verbal to non-verbal and how they felt they were being treated, inferences about their sexuality to stereotyping. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate whether the Stages of Change (SOC) model can be applied to working with offenders with learning disabilities (LD), and furthermore, to determine if it might be efficacious for this approach to be incorporated into a wider service model for this population.Design/methodology/approach This paper reports on the results of a consultation to a specialist forensic LD service in the South West of England. A two-pronged approach was taken to consult to the service in relation to the research questions. First, a comprehensive literature review was undertaken, and second, other forensic LD teams and experts in the field were consulted.Findings There is a dearth of research that has examined the application of the SOC model to working with offenders with LD, and as such, firm conclusions cannot be drawn as to its efficacy in this population. The evidence base for the SOC model in itself is lacking, and has been widely critiqued. However, there are currently no other evidence-based models for understanding motivation to change in offenders with LD.Research limitations/implications There is a clear clinical need for more robust theory and research around motivation to change, which can then be applied to clinical work with offenders with LD.Originality/value There has been a historical narrative in offender rehabilitation that “nothing works” (Burrowes and Needs, 2009). As such, it is more important than ever for the evidence base to enhance the understanding of motivation to change in offending populations. [ABSTRACT FROM AUTHOR]

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system.Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing.Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions.Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group.Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment.Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to expose and dispel some outdated dilemmas and straw men that have drawn attention away from debates of substance in social work. The paper presents what Frontline believes to be the substantive dilemmas facing the social work profession, as it looks into the future.Design/methodology/approach The paper draws on the insights and experiences of the past four years during which Frontline has been innovating in the field of social work education and leadership development.Findings Building a better social work system requires addressing several important questions, namely, whether social work; first, is a practical or intellectual task; second, is a generic or specialist profession; third, focuses on social or therapeutic change; fourth, requires bureaucrats or change agents; and fifth, involves measuring inspections or measuring outcomes.Originality/value The paper sets out the key dilemmas facing the social work profession, which must be debated and addressed in order to build a better social work system. [ABSTRACT FROM AUTHOR]

Purpose In the past 40 years, both health policy and educational policy in England have adopted commitments to reducing socially created inequalities. However, an inequalities perspective has only begun to emerge in relation to child protection, and child welfare services more widely. The purpose of this paper is to chart evidence of these green shoots of a new policy direction which focusses on two aspects: equalising service provision and outcomes for looked after children.Design/methodology/approach The paper provides an analysis of trends in policies as expressed in official documents, research studies and policy statements.Findings The paper outlines the argument for a more comprehensive approach to addressing inequalities in child protection and child welfare services, and concludes by suggesting some implications for policy and practice.Originality/value The paper develops the concept of an inequalities perspective in child protection and outlines key implications. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify the particular characteristics and strengths of mainstream undergraduate and postgraduate university education for social workers.Design/methodology/approach A brief summary of the establishment of the honours degree or M-level qualification as the requirement for registration as a social worker in England is followed by a summary of the main aspects of “mainstream” social work courses. The values underpinning a “student” rather than a “trainee” route into social work are explored and some limited comparisons made with recently introduced fast-track specialist programmes. Where relevant, the student experience is contrasted with that of fast-track specialist trainees.Findings The paper concludes with a discussion of the potential impact on the social work profession and on agencies providing social work services of the cuts over the past few years in the numbers of students on “generalist” mainstream social work programmes.Research limitations/implications This is a conceptual paper. It recognises that more information is available on long-established university programmes than on the more recently available fast-track routes into social work and cites relevant research.Practical implications The paper points to the changing balance between numbers entering social work in England via mainstream and fast-track specialist programmes and argues for a fuller debate amongst all stakeholders as to whether this change is in the interest of the profession and those who need social work services.Social implications The author argues that the unequal level of funding between the different entry routes into social work is distorting choice (for students and future employers) between fast-track specialist and mainstream social work education. It is hypothesised that differences between the curricula and learning experiences of the two routes may have an impact on the social work service available to vulnerable people across age and needs groups. It also points to a potentially negative impact on social work education and the knowledge base of the reduction in numbers of academics with both social work practice experiences and research qualifications.Originality/value This is an original paper that draws on the author’s experience and the published research and grey literature cited. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the impact of hospital discharge on the wider wellbeing of older people, drawing out implications this can have on mental health.Design/methodology/approach This paper is based on research from the Healthwatch England Special Inquiry into hospital discharge. The paper focuses on the experiences of 1,300 older people, with the majority of the research being undertaken by the local Healthwatch network. The 58 local Healthwatch who submitted evidence on the experiences of older people as part of the inquiry were autonomous in how they were able to carry out the research, with results being analysed through use of a qualitative framework.Findings Older people often felt they were not ready for discharge due to not feeling involved in planning of their discharge, being discharged without the information they need and having difficulties accessing aftercare support. This paper examines the impact these issues can have on the mental health and wellbeing of older people, their carers and specifically patients with dementia both during and after discharge from hospital. Through examination of these issues the discharge process can be viewed from the perspective of the individual, and start to conceptualise where the hospital discharge process could further support older people’s mental health and wellbeing.Research limitations/implications This paper examines these issues in detail through case studies collected regarding older people, and exposes the impact poor discharge can have on physical and mental wellbeing for older patients. The paper presents a number of issues which have implications for policy and practice in both health and social care, and the integration of the two services.Originality/value This is the first Special Inquiry conducted by Healthwatch England in conjunction with the local Healthwatch network and presents a large scale piece of research led by the experiences of older people. [ABSTRACT FROM AUTHOR]

Purpose Managerial quality improvement (QI) in terms of accountability management has become central to healthcare institutions. Yet, managerial QI is largely considered irrelevant by healthcare professionals. In consequence, the implementation of managerial QI implementation is hampered. Knowledge brokering is discussed as a means to foster the implementation of (QI) knowledge in healthcare. Yet, the benefit of knowledge brokering for managerial QI has so far been neglected. Therefore, this research asks how knowledge brokering can support the implementation of managerial QI.Design/methodology/approach This article builds on a single case study approach as a unit of analysis. Qualitative data collection comprises 21 semi-structured interviews at the managerial and clinical levels, 220 h of participant observation and document analysis.Findings This paper identifies three strategies of how brokers implement managerial QI into a hospital by means of knowledge brokering: prioritizing, obscuring and redefining. The strategies help to transform multiple external QI demands into one managerial QI strategy. Yet the strategies also reduce non-managerial perspectives on QI, which generates frustration among healthcare professionals.Practical implications The paper works out the benefits and costs of managerial knowledge brokering. This allows to spell out practical implications for managers, nurses and clinicians who have to deal with managerial QI in healthcare organizations.Originality/value This paper fulfils an identified need to study managerial knowledge brokering practices as a means to implement managerial QI into healthcare organizations. By doing that, the article adds to the body of research on knowledge translation in healthcare. [ABSTRACT FROM AUTHOR]

Purpose – Homelessness often results from the loss of social networks and individuals are tested in being able to sustain or develop new positive social networks necessary to rebuild lives. The purpose of this paper is to present findings from an exploratory study which investigated how different agencies and professionals support people experiencing multiple exclusion homelessness (MEH) to develop and maintain their social networks amid other competing priorities, such as reducing substance misuse and re-offending. Design/methodology/approach – The study was undertaken in England 2010-2011 in three case study sites. Data were collected in 76 interviews with practitioners and managers, from disciplines including housing support, social work, criminal justice, mental health and substance misuse services. Totally, 56 interviews and five focus groups were also undertaken with people with experiences of MEH. Data were analysed thematically. Data from one site in particular permitted a focus on personal relationships and social networks which were seen as beneficial but also potentially problematic. These data are drawn upon to reflect on the implications for housing providers and practitioners. Findings – While multiple factors had often led to the loss of social networks among homeless people, findings revealed that practitioners working with homeless people may be able to promote existing social networks, such as partnerships, help develop new ones, and support people withdrawing from less positive relationships. The authors conclude that practitioners should be alert to structural changes that threaten social networks and may need to enhance skills in creating opportunities to foster existing positive relationships in direct work with their clients and in collaboration with other professionals. The need to be careful of blurring professional boundaries is also observed. Practical implications – This paper suggests approaches that may encourage practitioner reflection and commissioning practice in achieving good outcomes for people with experiences of MEH by highlighting the importance of social networks and the potential for practitioners to foster supportive relationships. Originality/value – This paper considers the often under-researched area of day-to-day engagement with social networks and the implications of working to support these as part of the role of homelessness services. While drawing primarily on recent research in England the themes raised will have wider relevance to housing and care services generally. [ABSTRACT FROM AUTHOR]

Purpose Recovery Colleges are education-based mental health resources, utilising practitioner and lived experience expertise, promoting skills to enhance student independence. The purpose of this paper is to evaluate the impact of engagement with a Recovery College in Northern England on student wellbeing.Design/methodology/approach Feedback questionnaires were analysed from 89 students attending the Recovery College. Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBS) and “Empower Flower” (a measure of personal resources) data for 56 students were compared pre- and post-attendance at courses.Findings The SWEMBS and Empower Flower indicated improvements in wellbeing and personal resources pre- to post-attendance at Recovery College courses. Satisfaction with the service was high. Students saw the service as unique, accepting and enabling. Students noted they developed a sense of hope, confidence and aspirations. They related this to practical changes, e.g. increasing work-related activity and decreasing service use.Research limitations/implications This research suggests that there is a need for further evaluation of the unique contribution that Recovery Colleges can make to mental wellbeing, and the mechanisms involved in promoting the process of recovery.Practical implications The Recovery College may be a cost-effective way to provide a supportive recovery-orientated environment which promotes students’ ability to build self-confidence and skills, enabling them to connect with others and progress towards independence and valued goals. This complements more traditional mental health services.Originality/value This paper reports on an area of mental health development where there is very limited research, adding valuable data to the literature. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support.Design/methodology/approach Semi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines.Findings Three dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted.Originality/value This paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms. [ABSTRACT FROM AUTHOR]

Purpose How might the profession of child protection social work be “future proofed”, i.e. remain intact and of value beyond its present existence? The paper aims to discuss this issue.Design/methodology/approach This is a discussion/“think piece” paper, in which the author argues that foregrounding the art and science of helping relationships is a way forward. Recognising and promoting the centrality of helping relationships is the direction in which the author believes (or is it hopes?) social work should head, because “more of the same” is not, in the author’s view, possible to sustain for much longer. Treading the well-worn but pot-holed path of box-ticking, endless risk assessment and perfunctory statutory visiting is likely to lead to continuing problems retaining social workers and, for those who do stay, increased burnout, compassion fatigue and secondary trauma, each of which interrupts or delays the development of working alliances with family members.Findings Growing reliance on thresholds and checklists to assess risk has served to increase referrals. As a result, social workers spend much of their time on triaging and filtering rather than working with the children and families that most need help and protection. Further, it is not what is in the practitioner’s toolkit that matters: rather, it is a defined set of personal skills and qualities that tips the balance to achieve lasting change. Thus, in order to “future proof” social work, we would do well to deepen our understanding of how helping relationships can lead to lasting change. Supporting social workers in this work is not just the responsibility of individual practitioners and their professional bodies, action also needs to be taken at governmental and managerial levels.Originality/value This is a discussion/“think piece”. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide an analysis of the changes in child protection policy and practice in England over the last 30 years, in particular to critically analyse the nature and impact of the “refocusing” initiative of the mid-1990s.Design/methodology/approach Policy analysis.Findings While the period from the mid-1990s until 2008 can be seen to show how policy and practice attempted to build on a number of the central principles of the “refocusing” initiative, the period since 2008 has been very different. Following the huge social reaction to the death of Peter Connelly, policy and practice moved in directions quite contra to the “refocusing” initiative’s aims and aspirations such that we can identify a refocusing of “refocusing”. Such developments were given a major impetus with the election of the Coalition government in 2010 and have been reinforced further following the election of the Conservative government in May 2015.Originality/value The paper places the changes in child protection policy and practice in England in their political and economic contexts and makes explicit how the changes impact on the role and responsibilities of professionals, particularly social workers. [ABSTRACT FROM AUTHOR]

Purpose Notwithstanding heightened awareness of the issues faced by homeless people, the notion that homelessness is the result of individual failings and weaknesses persists. The purpose of this paper is to challenge that perception by giving voice to this marginalised group and exploring the mechanisms through which they made and remade as homeless and may be protected.Design/methodology/approach Semi-structured interviews (n=23) were carried out with a sample of homeless people who had accessed a range of homelessness services in the study area.Findings It is argued that largely deprived of the private sphere, which arguably renders them in most need of public space, homeless people find themselves most subject to scrutiny, surveillance, social disapprobation and exclusion.Research limitations/implications The authors reiterate that rather than simply being associated with rooflessness, homelessness is as a function of ongoing geographical marginalisation and social alienation.Practical implications The authors suggest that dedicated spaces for homeless people to occupy during the day continue to be in need of development because, whilst not unproblematic, they can disrupt processes associated with homelessness.Social implications Further resources should be directed towards homelessness and the issues that arise during daytime for homeless people.Originality/value The paper supports the literature which highlights the spatial practices by which stigmatised groups come to be separated from mainstream society. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore whether relatives of care home residents are best placed to act as “champions” or advocates for their family members, as is often the expectation.Design/methodology/approach Focus groups and interviews were conducted with 25 relatives of residents in four care homes for older people in the South East of England. Two rounds of focus groups were held in each participating care home: the first was to discuss any issues arising from the care received, or concerns about the home itself; the second was to enable a deeper exploration of the key themes that arose from the first round and explore why relatives, in this case, failed to complain.Findings Thematic analysis revealed a complex range of emotions experienced by relatives that contributed to a conflict between what they believed to be the correct response and how they behaved in reality, which led to a culture of acceptance. Analysis revealed some relatives were reluctant to “interfere” for fear of possible negative repercussions, thus they downplayed issues in an attempt not to “rock the boat”.Originality/value This paper discusses the flaws in the policy emphasis on personalisation and the reliance on family members as advocates, and concludes with suggestions on how care homes may foster an environment where relatives, and indeed residents, feel comfortable to raise issues and concerns. [ABSTRACT FROM AUTHOR]

Purpose The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.Design/methodology/approach Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.Findings Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.Research limitations/implications The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.Practical implications The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.Social implications The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.Originality/value This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia. [ABSTRACT FROM AUTHOR]

Purpose A one-hour intergenerational event held at an infant school in Norfolk, England, aimed to increase the citizenship experience of young children and their awareness of what it means to live with stroke, and to address social isolation or self-confidence in communicating among stroke survivors with aphasia. It was also intended to gauge whether this activity might provide a basis for future research. The paper aims to discuss these issues.Design/methodology/approach Four community-dwelling stroke survivors with aphasia were recruited. In total, 12 pupils aged six and seven were selected by their Year 2 teacher and head-teacher. At the event, participants sat in groups of one adult and three pupils and engaged in writing, hand-tracing and talking about pictures. The author circulated among the groups to facilitate engagement.Findings All participants enjoyed interacting together in the activities. The pupils gained insights into the stroke survivors’ lived experience and wanted them to return to “see us again soon”; the adults valued being in the “real world” and practising their conversation in activities different from their usual routines. Feedback indicated the value of the engagement and that participants welcomed similar intergenerational opportunities. The author will develop a research application exploring enablers, barriers and benefits of this type of engagement.Originality/value The event gave a rare opportunity for stroke survivors with aphasia to participate in intergenerational activities and for children to engage with vulnerable older adults. It demonstrated the value of interactions in which learning and insights are obtained on both sides. It also provided evidence that pursuing research in this field is feasible. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to answer the question as to why until 2004 there had been no systematic, effective implementation of HACCP in the hospitality industry anywhere in the world. It is the third article in the second Worldwide Hospitality and Tourism Themes issue of the International Journal of Contemporary Hospitality Management presenting a new method of HACCP for the hospitality industry and proof of its utility. Design/methodology/approach - In-depth narrative interviews, supported by documentary analysis, were carried out in 22 hospitality businesses in Greater Manchester. Findings - The research techniques find 21 practical and psychological barriers to success at knowledge, attitude and behavioural levels. These are investigated in depth in order to develop a model for overcoming the problems and achieving tangible improvements in food safety and HACCP in the hospitality industry. Originality/value - The research techniques chosen for the project documented in this paper overcome the methodological limitations of most previous research in the area. Using an in-depth psychological perspective they have uncovered important barriers not previously considered. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to answer the question as to why until 2004 there had been no systematic, effective implementation of HACCP in the hospitality industry anywhere in the world. It is the third article in the second Worldwide Hospitality and Tourism Themes issue of the International! Journal of Contemporay Hospitality Management presenting a new method of HACCP for the hospitality industry and proof of its utility. Design/methodology/approach - In-depth narrative interviews, supported by documentary analysis, were carried out in 22 hospitality businesses in Greater Manchester. Findings - The research techniques find 21 practical and psychological barriers to success at knowledge, attitude and behavioural levels. These are investigated in depth in order to develop a model for overcoming the problems and achieving tangible improvements in food safety and HACCP in the hospitality industry. Originality/value - The research techniques chosen for the project documented in this paper overcome the methodological limitations of most previous research in the area. Using an in-depth psychological perspective they have uncovered important barriers not previously considered. [ABSTRACT FROM AUTHOR]

Purpose: Applications for clinical psychology training far outstrip places and relevant work experience is key. Paid opportunities are limited and therefore many choose volunteering, with well-connected graduates faring best. To promote equal opportunities a coordinated psychology graduate voluntary internship programme was established in a National Health Service Trust in the South of England. The purpose of this paper is to evaluate intern and supervisor outcomes, equality of access and adherence to governance standards. Design/methodology/approach: Three cohorts of interns, unappointed applicants and supervisors were surveyed. Between 2013 and 2016, 270 psychology graduates applied, 119 were recruited and 151 either refused a place or were unsuccessful. In total, 91 supervisors provided service-level feedback. Findings: Interns and applicants were predominantly young, able-bodied white British heterosexual females. Demographic profiles were similar and broadly representative of psychology graduates nationally. While fewer were from Black and Ethnic Minority backgrounds, proportions were greater than the local population. Participants were more socioeconomically privileged than undergraduates nationally. The scheme was popular and well governed according to interns and supervisors. Post-internship employment prospects were improved, with most interns gaining paid mental health roles like assistant psychologist. Most supervisors commented on the positive contribution made by interns to service outcomes. Originality/value: This study makes a significant contribution to the literature on voluntary psychology graduate posts, an area under-researched until now. Our results suggest that a coordinated, transparent approach can benefit both interns and services by minimising exploitation and maximising developmental opportunities for the new graduate. The programme makes an important contribution to addressing inequalities experienced by psychology graduates attempting to enter mental health careers. [ABSTRACT FROM AUTHOR]

This paper describes the secondment of a health professional to the care management team to assess the efficacy and cost-effectiveness of out-of-borough placements for individuals who present challenging behaviour. Lambeth Partnership agreed that dedicated psychology/challenging needs time of a practitioner with more than 10 years' experience in the borough would be available to the care management team, creating collaborative working and enhancing the existing service. To assess the quality of services, a questionnaire was developed that covered demographics, types of service provision and intervention package employed (including monitoring and outcome measures), implementation of person centred-planning (PCP) and the views of the key stakeholders. This paper summarises the findings of five months of assessing the quality of service provision for people with challenging needs placed out of the London Borough of Lambeth. [ABSTRACT FROM AUTHOR]

Purpose Asylum seekers and refugees experience substantial barriers to successful transition to a new society. The purpose of this paper is to explore the value and meaning of a community drop-in service offering social support for refugees and asylum seekers in the northeast of England and to identify the occupational preferences of the service users.Design/methodology/approach A qualitative approach using semi-structured interviews was conducted with refugees and asylum seekers using a community drop-in service. In total, 18 people participated from ten countries. Data were analysed using interpretive phenomenological analysis.Findings The value and meaning of the service was expressed through four key areas: the need to experience a sense of community; being able to make an altruistic contribution within the community; the need for societal integration; and having the opportunity to engage in meaningful and productive occupations.Practical implications Community and altruism have profound cultural meaning for asylum seekers and refugees and the need to integrate, belong and contribute is paramount to successful resettlement. Community-based drop-in services can aid this at deep, culturally relevant levels. This study may inform policy and practice development, future service development and highlight potential opportunities for health and social care services provision amongst this growing population.Originality/value To date there are no studies that provide empirical evidence on how community-based drop-in services for refugees and asylum seekers are received. This study provides a cultural insight into the deeper value and meaning of such services, and is particularly relevant for professionals in all sectors who are working with asylum seekers and refugees. [ABSTRACT FROM AUTHOR]

Purpose – The critical potential of hospital discharge policies and practices to ameliorate the health and social care needs of homeless people has become the focus of considerable interest in England. Central to this rise in policy formation and practice development is an acute understanding of the multiple exclusions homeless people face in navigating public health and social care systems. In ways small and large this nascent landscape is serving to redefine and reshape hospital arrangements for homeless people, and opening-up new ways to deliver care across clinical, social and therapeutic boundaries. The purpose of this paper is to seek to add empirical vigour and theoretical rigour to this unfolding policy and practice terrain. Design/methodology/approach – This paper draws on findings from a case study concerned with exploring and explaining how statutory and voluntary sector organisations use specialist hospital discharge policies and practices to coordinate pathways of care for homeless people. Findings – This paper illustrates how people affected by homelessness and ill-health are routinely denied access to statutory housing support, social work assessments and district nursing provision through acts of institutional gatekeeping and professional abrogation. Originality/value – This paper makes an important contribution to understandings of the connections between hospital discharge arrangements for homeless people and statutory housing, social work and district nursing provision. [ABSTRACT FROM AUTHOR]

Purpose Pre- and post-immigration trauma and stress make refugees a particularly vulnerable group in terms of mental health and well-being. The purpose of this paper is to describe a listening project undertaken in Plymouth, UK, which sought the views of 17 service users (n=12) and staff (n=5) from four local support organisations, for people with refugee and asylum seeker status and those with diverse cultural backgrounds. Aims of the project were to expand Western-centric understandings regarding beneficial support and the promotion of good mental health and well-being in this population.Design/methodology/approach Responses were subjected to thematic analysis, co-conducted with a service user. Participants were asked about their personal understandings of mental health and well-being and what supports or hinders well-being.Findings The findings enabled the development of a model incorporating 10 threads which support and 9 holes that can hinder well-being.Research limitations/implications The relatively small numbers of participants compared with the numbers of asylum seekers and refugees in Plymouth may not be fully representative of the general population in Plymouth and the UK.Originality/value Despite increasing cultural diversity within the UK population, available mental health services exist mainly as developed from a Western psychological model of mental distress and treatment. This research provides services with a more informed understanding of mental health for asylum seekers and refugees. As such it is of value towards future service design in Plymouth and the UK. Findings also contributed to a successful funding bid to set up a peer-led support project in the city. [ABSTRACT FROM AUTHOR]

Purpose – Relative deprivation is associated with poor mental health but the mechanisms responsible have rarely been studied. The purpose of this paper is to hypothesize that childhood perceived relative deprivation (PRD) would be linked to sub-syndromal psychotic symptoms and poor wellbeing via beliefs about justice, trust and social rank. Design/methodology/approach – In total, 683 undergraduate students were administered measures of childhood PRD, hallucination-proneness, paranoia and wellbeing and measures of trust, social rank and beliefs about justice. A subsample supplied childhood address data. Multiple mediation analysis was used to assess pathways from childhood experiences to outcomes. Findings – Childhood PRD was associated with all three outcomes. The relationship between PRD and paranoia was fully mediated by perceptions that the world is unjust for the self and low social rank. The same variables mediated the relationship between PRD and poor wellbeing. There were no significant mediators of the relationship between PRD and hallucination-proneness. Research limitations/implications – Although our outcome measures have been validated with student samples, it may not be representative. The study is cross-sectional with a retrospective measure of PRD, although similar results were found using childhood addresses to infer objective deprivation. Further studies are required using prospective measures and patient samples. Social implications – Social circumstances that promote feelings of low social worth and injustice may confer risk of poor psychological outcome. Ameliorating these circumstances may improve population mental health. Originality/value – Improvements in public mental health will require an understanding of the mechanisms linking adversity to poor outcomes. This paper explores some probable mechanisms which have hitherto been neglected. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe service users’ perspectives on the difference between high secure long-stay forensic psychiatric services in the Netherlands and high secure forensic psychiatric care in England. These perspectives are relevant in considering the benefits of a similar long-stay service in England.Design/methodology/approach A current in-patient detained in a high secure hospital in England and other mental health service users and carers with experience in forensic-psychiatric settings were asked to watch a documentary on a Dutch high secure long-stay service. Then they were invited to make comparisons between this service and high secure care in England. These perspectives were gained in the context of their membership of the Service User Reference Group of an externally funded study on long-stay in forensic-psychiatric settings in England.Findings The small group of participants highlighted the importance of relational security, meaningful occupation, autonomy, positive therapeutic relationships with staff and a homely environment for those with lengthy admissions and perceived these to be better met in the Dutch service. These factors might contribute to improved quality of life that services should strive to achieve, especially for those with prolonged admissions.Practical implications Perspectives of service users with lived experience of long-stay in forensic settings are important in informing service developments. Lessons can be learnt from initiatives to improve the quality of life in long-stay services in other countries and consideration be given on how to best manage this unique group.Originality/value To the authors’ knowledge this is the first study asking service users about their view on forensic services in other countries. The findings suggest that service users have valuable contributions to make to aid service developments and should be involved in similar such exercises in the future. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report an evaluation of a leading-with-compassion recognition scheme and to present a new framework for compassion derived from the data. Design/methodology/approach Qualitative semi-structured interviews, a focus group and thematic data analysis. Content analysis of 1,500 nominations of compassionate acts. Findings The scheme highlighted that compassion towards staff and patients was important. Links to the wider well-being strategies of some of the ten organisations involved were unclear. Awareness of the scheme varied and it was introduced in different ways. Tensions included the extent to which compassion should be expected as part of normal practice and whether recognition was required, association of the scheme with the term leadership, and the risk of portraying compassion as something separate, rather than an integral part of the culture. A novel model of compassion was developed from the analysis of 1,500 nominations. Research limitations/implications The number of respondents in the evaluation phase was relatively low. The model of compassion contributes to the developing knowledge base in this area. Practical implications The model of compassion can be used to demonstrate what compassion "looks like", and what is expected of staff to work compassionately. Originality/value A unique model of compassion derived directly from descriptions of compassionate acts which identifies the impact of compassion on staff. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age. Design/methodology/approach: The author uses data from housing and health, combined with the author's experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition. Findings: As well as its massive economic impact, housing greatly affects people's health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be "on the radar" of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person's tenure, requires vision and innovation and is an essential element in the integration of health, social care - and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back "On the Radar" of national government policy. Social implications: There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing. Originality/value: The author draws on over 30 years' experience of innovation, development and evaluation of older people's housing, services and policy development to provide a vision for greater integration across health, care and housing. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe an intervention with a group of homeless men from the Horn of Africa, service users of the Horn of Africa Health and Wellbeing Project in London. The group was conceived by the second author who noted the presence of significant psychosocial issues for her clients, but equally their reluctance to access mainstream mental health or social care services.Design/methodology/approach Designing the group and introducing it to the men involved threw up some challenges which are explored, and the impact of the group on participants is evaluated.Findings Overall both the participants and the facilitators evaluated the group positively and it appeared to have led to lasting change for some of the group members, and this is described. The authors argue that this sort of group may be a more acceptable way to work on psychosocial issues than something more directly focused on mental health intervention. The group protocol is outlined along with suggestions for future work in this area.Originality/value This intervention represents a creative alternative to more mainstream psychological interventions for homeless or exiled men. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explain how the CAPITAL Project Trust established an inpatient peer support project in West Sussex. Design/methodology/approach – The paper sets the project within local and historical contexts, seeking to explain some of the reasons for the growing interest in formal peer support, before explaining the methodology used to set up the project and the learning along the way. The author draws on evidence from evaluations to demonstrate the added value offered by inpatient peer support and argues for a peer defined set of values to underpin all peer support projects. Findings – Models of inpatient peer support need to be flexible to both the individual talents of peer support workers and the cultures of the different wards in which they work. Originality/value – The paper shows that the project demonstrates the value that can be added by independent peer support workers being placed on acute inpatient wards and the importance for service users of peer support being peer led. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to provide an overview of recent reforms to the social care system in England.Design/methodology/approach - The reforms are described and contextualised within a broader account of the history of social care that includes an analysis of the factors that have encouraged reform.Findings - The current reforms of social care will bring about some benefits but their long-term impact is still very uncertain. The changing political and economic environment and the inherent difficulties that reform suggests indicate that these changes will be subject to significant differences in interpretation for some time.Research limitations/implications - This analysis is framed by a set of ethical assumptions about the rights of disabled people and the injustice of arrangements that limit those rights.Practical implications - The paper encourages practitioners to treat new ideas such as individual budgets and self-directed support as positive opportunities for improving practice, while being mindful of tensions and unresolved issues that may harm good practice.Social implications - This research should help policy-makers and the general public to avoid misunderstanding the role of these innovations and to better understand when and how these reforms can be used positively.Originality/value - This paper offers a new and historical perspective on the social care reforms from someone who is closely associated with inventing and implementing those ideas. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to prove the effectiveness of a new method of HACCP for the hospitality industry that was developed, piloted and validated by the UK Food Standards Agency (FSA) and the University of Salford between 2002 and 2005. It is the fifth article in the second Worldwide Hospitality and Tourism Themes issue of the International Journal of Contemporary Hospitality Management presenting a new method of HACCP for the hospitality industry and proof of its utility. Design/methodology/approach - In 2003, in-depth narrative interviews, supported by documentary analysis, were carried out in 22 hospitality businesses in Greater Manchester. The new method was implemented in these businesses, and the research method was replicated at six month and three year periods to assess change. Findings - The findings show notable improvements in food safety knowledge, attitude and behaviour, and a reduction or elimination of all 21 previously identified barriers, as a result of implementing the new method. They also show these are maintained over time with no external pressure or involvement. Originality/value - Based on the evidence of success provided through this research, the paper shows that the new method has been extended and published as Menu-Safe, a system for hospitality businesses of all types and sizes. It has also been shortened and developed by the UK FSA into a ready-to-use package called Safer Food Better Business (SFBB) for very small hospitality businesses, and implemented nationwide. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to share findings from the evaluation of dementia adventure (DA) holidays provided in 2016 and drawing on these data, to share reflections on positive risk-taking, which are inherent in outdoor activities, and consider the implications for research and practice with people with dementia.Design/methodology/approach Data are drawn from the 2016 internal evaluation report, using mixed methods design, of DA holidays independently reviewed by Dr Ruth Bartlett at the University of Southampton.Findings DA holidays are leading to a range of social, emotional and physical well-being outcomes, as well as wider benefits for the community of people with dementia, their family and carers.Practical implications Drawing on what positive risk-taking means for individuals, families and organisations, top ten considerations for positive risk taking outdoor activities are presented.Originality/value The number of organisations providing adventure experiences and holidays for people with dementia in the UK remains very low with just a handful of organisations. The impact and evaluation of these holidays is just emerging and whilst compelling needs replication, with larger sample sizes supported by clinical and scientific expertise to deepen our understanding of the impact of positive risk-taking outdoor activities. Additionally, there is a need for thinking and acting differently summarised by the phrase “THINK OUTSIDE” in developing a wide range of nature based positive risk-taking activities with people with dementia. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline the development of a resource designed to support practitioners, who are not sexual health specialists, but who work with young people who may be at risk of teenage pregnancy or parenthood. Its aim was to enable practitioners to carry out an assessment using a screening tool, and to use educational interventions designed to reduce risk-taking behaviour or refer to a sexual health specialist. A research project to examine the perceptions of practitioners who had used the resource is reported.Design/methodology/approach The resource was based on a local needs assessment and developed by a multi-agency working group. The research utilised an online questionnaire and telephone interviews with practitioners.Findings Practitioners reported using the screening tool with young people with an average age of 13.1 years. They thought the educational interventions provided knowledge and helped with communication, self-awareness, reflection, confidence, attitudes and values clarification.Research limitations/implications The project was based in one county in England. A sample of 17 per cent of the practitioners responded to the questionnaire, and they might be biased towards those who had engaged most, or most positively, with the resource. Three practitioners undertook interviews. The views and behaviours of young people are yet to be evaluated.Originality/value Within a climate of limited resources, the findings suggest that the project is providing an acceptable proportionate universalist, early sexual health intervention for young people. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore evidence about the role played by micro-cultures in long-term care (LTC) settings in shaping residents’ mental health and wellbeing.Design/methodology/approach A scoping review on micro-cultures in LTC, including database search of academic and grey literature using pre-determined combinations of key terms and specific inclusion/exclusion criteria. The review followed the methodological framework of Arksey and O’Malley (2005).Findings Micro-cultures (localised, distinctive cultures of a small group of people) in LTC are complex, multi-faceted and multi-directional; they include social dynamics as well as structural and environmental factors. Although much work has been done on the nature of micro-cultures, limited work has focused on LTC for older people. Initiatives to promote the mental health and wellbeing of residents rarely consider micro-cultures in any holistic way; they tend to be taken into account either as part of a contextual backdrop, or as a uni-directional process often equated with the concept of “care culture” or “organisational culture”.Originality/value The role played by micro-cultures in influencing the mental health and wellbeing of older people living in LTC settings is significantly under researched. The findings of this review suggest that their complexity and multidimensionality challenges researchers. However if the authors are to develop interventions that promote the mental health and wellbeing of residents it is important to invest in work to explore their nature and systemic influence. [ABSTRACT FROM AUTHOR]

Purpose There is extensive empirical literature that has sought to establish the prevalence of, and risk factors for, loneliness and social isolation in later life. Traditional empirical gerontological approaches have characterised loneliness as a linear experience that is both pathological and easily relieved with external intervention. The purpose of this paper is to explore the potential of qualitative interview data to reveal the possible complexities in understanding loneliness, including conceptual considerations for the dynamic and multi-dimensional aspects of loneliness.Design/methodology/approach The authors draw on two different studies where the purpose was to qualitatively examine the meaning of loneliness in the lives of older people and how they understood loneliness in the context of their daily life (n=37).Findings Interviews with “lonely” older people revealed that loneliness is a complex and dynamic experience. The authors also identified a range of internal and external factors that contribute to vulnerability for loneliness as well as resources to alleviate it.Originality/value The dynamic and multi-dimensional characteristics of loneliness in older people may help explain why community-based interventions to diminish it may be so challenging. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore supposed inevitable personal decline for long-term prisoners, particularly those serving a sentence of life without parole. Design/methodology/approach - Using the prison records of a life without parole sentenced prisoner. Findings - Findings suggest that prisoner deterioration is not inevitable in a whole life prison sentence. Research limitations/implications - Findings are based on one account, of a female prisoner. Practical implications - Distinct services and support are required for those with a natural life prison sentence. Originality/value - To date, there is limited research of prisoners serving life without parole, particularly the mental health implications of denying a prisoner future parole. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to consolidate policy, research, evidence and good practice around strategies tackling fuel poverty and affordable warmth for older people aged over 60 to support the development of more effective services for this life course stage and to tackle physical and mental health inequalities. Design/methodology/approach – The authors consolidate current policy, research, evidence and examples of good practice in exploring effective interprofessional approaches that contribute to affordable warmth for older people through “desktop analysis”. The authors support this with qualitative data from Health and Wellbeing Boards (HWBs), health inequalities and environmental health from research comprising four longitudinal case studies in the Midlands and North of England over 18 months and semi-structured interviews with members and support officers. A total of 50 interviews were undertaken and 55 hours of HWB meetings observed. Findings – There are numerous older people living in fuel poverty. The depth of fuel poverty increases with age particularly the over 75s and physical and mental ill health are affected. There are an increasing number of tools to help estimate health care costs around the cost effectiveness of interventions and there is a real need for more local evidence about what is working well, how and why. However, there is no mandatory requirement for fuel poverty strategies and more creative local strategies are required taking organisational and interprofessional relationships into account. The emphasis in integrated care provides new impetus and scope to encourage preventative services but these new partnerships need to be effective in what is a complex policy environment. There is still a long way to go in places. The challenges of ageing are numerous, complex and not fully understood and sit across multiple policy areas. Originality/value – Fuel poverty strategies tend to be delivered on a geographical or income bases rather than by life course approach and a focus on older people. We need to focus more specifically on older people, a rapidly growing population and to better understand thermal properties of our ageing housing stock and how best to intervene to protect and improve health and safety. Emerging approaches need to overcome artificial statutory and non statutory divides and move towards sustainable, evidence based affordable warmth strategies for older people to protect and improve health. [ABSTRACT FROM AUTHOR]

Purpose – Homeless populations are a politically contentious problem and researchers struggle to achieve a balanced approach. They place emphasis on sharply contrasting factors, such as; institutional structures, ideologies or individual dispositions and differences. Central questions remain unanswered, i.e., is homelessness an outcome of society’s failings related to housing shortages, or a personal choice, as in the status of “intentional homelessness?” The purpose of this paper is to set aside assumptions, to explore experiences of homelessness and psychosis. Design/methodology/approach – An existentially informed hermeneutic phenomenological analysis; exploring transcribed narratives from semi-structured interviews with three men. Findings – These participants started to wander as a spontaneous response to distressing life experiences. Without any plan they travelled to new locations living on the street. Being contained and treated against their will in the psychiatric system was another source of distress. They did not choose homelessness through a rational calculation of their best interests. They felt at odds with society, which did not protect them and failed to meet their needs. Research limitations/implications – In qualitative research, findings are not generalisable to other settings. Practical implications – Homeless services should be enhanced by psychological expertise along with more person-centred emphatic approaches; the authors of social policies should consider their philosophical assumptions. Social implications – Systemised mental healthcare does not solve complex problems; fails to meet needs. Originality/value – The analysis informs the design of further research, prompts practitioners to review their understandings and provides grounds for the rewriting of policies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on a small telehealth pilot in local authority sheltered housing in NE England. This explored the training and capacity building needed to develop a workforce/older person, telehealth partnership and service that is integrated within existing health, social care and housing services. Design/methodology/approach – A qualitative case study approach on the implementation and deployment of a pilot telehealth service, supporting sheltered housing tenants with Chronic obstructive pulmonary disease (n=4). Findings – Telehealth training and capacity building, needs to develop from within the workforce/older person partnership, if a usable and acceptable telehealth service is to be developed and integrated within existing health, care and housing services. To be adaptable to changing circumstances and individual need, flexible monitoring is also required. Practical implications – Service users and workforces, need to work together to provide flexible telehealth monitoring, that in the longer term, may improve service user, quality of life. Originality/value – The pilot explored a workforce/older person partnership to consider how to add and implement telehealth services, into existing health and housing services. [ABSTRACT FROM AUTHOR]

Purpose – Previous research has established that there is a relationship between housing and mental health, however, understanding about how and why housing affects mental health is still limited. The purpose of this paper is to address this deficit by focusing on the experiences of residents of houses in multiple occupation (HMOs). Design/methodology/approach – Semi-structured interviews were carried out with 20 HMO residents who were asked about their housing career and experience of living in a HMO. Participants were recruited with assistance from community organisations and landlords. Findings – The physical properties and social environment of the property, as well as personal circumstances experienced prior to the move into the property, all influenced how mental health was affected. The authors identify and discuss in detail three key meditating factors: safety, control and identity which may affect how living in the property impacts the mental health of tenants. Practical implications – Good property management can lessen the potential harmful effects of living in a HMO. However, poorly run properties which house numerous vulnerable people may increase the risk of poor mental health due to attendant high levels of stress and possible risk of abuse. Originality/value – Based on the reports of HMO residents, the authors outline the key mediating processes through which living in HMOs may affect mental wellbeing, as well as illuminating the potential risks and benefits of HMOs, an overlooked tenure in housing research. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to detail the Wellbeing Project that was developed by Manchester Mental Health and Social Care Trust, in partnership with Manchester City Council.Design/methodology/approach - A group-based cognitive behavioural therapy intervention ("Be Well, Age Well") was written specifically to help improve the mood and wellbeing of older adults.Findings - A preliminary evaluation showed promising results and in response to a significant increase in demand for continued delivery of the intervention, there are now plans to examine the feasibility of non mental health qualified staff facilitating the course. Funding is currently being sought for a more definitive study.Originality/value - The Wellbeing Project believes that if older adults are educated via the approach as adopted by the "Be Well, Age Well" course, the level of resilience will improve for those individuals who would otherwise have experienced compromised wellbeing. [ABSTRACT FROM AUTHOR]

The closure of long-stay National Health Service (NHS) hospitals has seen the placement of people with learning disabilities who offend or have offending-type behaviours placed 'out of area' many miles from local services. This move of people out of area has made it difficult in many localities to develop local services and to monitor the quality of care for this group. This paper describes the start of an exercise to examine potential local care pathways for those who present with offending behaviours and to look at differences between the out of area group, and another receiving treatment locally. Within the two groups we found no significant differences regarding rates of psychiatric disorder, quality of life or levels of unmet need. The main difference was that the out of area group was largely characterised by a range of aggressive and challenging behaviour, necessitating the additional structure and securities provided by out of area placements. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned "one-size-fits-all" approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach: The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine (n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment (NHS Leadership Academy, 2012). The data were analysed using descriptive statistics and simple inferential methods. Findings: OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor's confidence in leadership is their experience in a management role. In multivariate regression, management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied "leadership learning" as opposed to theory-driven programmes. Drawing on SDT (Deci and Ryan, 1985; 2000; Ryan and Deci, 2000), this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes are likely to result in more relevant leadership learning that builds on doctors' previous experience in this area. Research limitations/implications: While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology to combine quantitative data with one-to-one interviews or a focus group. Practical implications: This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality/value: This is the first large-scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research, as the first author is an OHP with knowledge of how to engage OHPs in this work. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this article is to share the process and outcomes of an intergenerational community theatre project run by London Bubble in 2011. Design/methodology/approach – The article is a narrative describing the process of the project written by the project director followed by an observational evaluation from the Centre for Urban Community Research at Goldsmiths College. Findings – The process of making community drama from gathered oral histories has positive outcomes for elders, children and adults as individuals, and the theatre that results has a wider positive impact on audiences drawn from the immediate community. Originality/value – This process is unusual, if not unique. The article points the reader towards a fuller evaluation study, and a follow up project. [ABSTRACT FROM AUTHOR]

Purpose - This study aims to explore the experiences of residents and staff with new restaurant-style meal provision in four residential care homes in Norfolk, England. Design/methodology/approach - Meal and drink provision were observed over a full day in each home and unstructured individual interviews with 16 residents and 32 staff recorded and transcribed. Content analysis was used to discover and explore main themes. Findings - Although older care home residents enjoyed the restaurant experience, they valued stable table companions more highly than flexibility. Residents appreciated attractive surroundings, good food and their ability to make choices, but in some circumstances and for frailer residents, choice was more limited with care staff making some decisions. While the central restaurant was valued for the main meal some residents indicated they preferred smaller "family-type" dining for other meals. Care staff sometimes found the negotiation of their waitressing and caring roles difficult. Available space and the dining-room's location also contributed to the comparative success of the restaurant-style provision. Research limitations/implications - Residents valued the restaurant experience with attractive food, surroundings and the ethos of being served at lunch time, but other residents or the same residents at other meals, valued cosier stable family-type dining more highly. Staff were also tom between service roles implied by restaurant settings and supporting residents to remain independent in the domestic model Practical implications - When planning new eating facilities thought needs to be given to ensuring both restaurant and family-type food provision are available, and staff roles in these settings discussed and negotiated. Originality/value - The research provides insights into the experiences of residents and staff of new dining facilities. [ABSTRACT FROM AUTHOR]