Michele Abendstern

• PhD
• Research Associate at The University of Manchester

Context: Care coordination is one important mechanism to provide effective care at home for frail older people in a world with ageing populations. In England this has usually been undertaken by state funded local authority social care services. The Care Act 2014 promoted greater involvement of the non-statutory sector in the provision of care and s...

National Evaluation of the Single Assessment Process

National Evaluation of Self Assessment Vol 3

There is a growing recognition of the importance of the social work contribution within community mental health services. However, although many texts describe what the mental health social work contribution should be, little empirical evidence exists about their role in practice and the difference it might make to service users. This qualitative s...

Despite being a profession dedicated to the empowerment of service users, empirical study of mental health social work appears dominated by the perspectives of social workers themselves. What service users value is less often reported. This study, authored by a mix of academics and service users/carers, reports a Best–Worst Scaling analysis of ten...

Background: Qualitative methods are increasingly included in larger studies to provide a richer understanding of people's experience. This paper explores the potential of using a novel approach to embedded qualitative design as part of an observational study examining the effectiveness of home support for people in later stage dementia in England....

Context: Support workers play an essential role in multidisciplinary community mental health teams for older people (CMHTsOP) in England. However, little is known about how they perceive their role or the impact this has on their levels of stress, wellbeing and job satisfaction. Objectives: To compare CMHTsOP support workers’ perceptions of the ps...

Gathering meaningful data from people with dementia presents challenges to researchers involved in both qualitative and quantitative studies. Careful planning and implementation are required, including skilful and sympathetic management by the researcher who must pay attention to the cognitive challenges experienced by the person with dementia. The...

The article addresses the continued lack of clarity about the role of the mental health social worker within community mental health teams for working age adults and particularly the limited evidence regarding this from the perspective of service users. It compares findings from the literature, found to originate from a predominantly professional v...

Policy and practice developments in adult social care in England and elsewhere recognise the increasing role of the non-statutory sector. Care coordination services are central to the delivery of tailored support. This qualitative study focuses on support for older people and reports an analysis of 13 non-statutory sector services providing care co...

This study explored practitioner preferences about the relative value of attributes of care coordination services for older people. A Discrete Choice Experiment (DCE) survey was used to identify the views of 120 practitioners from 17 services in England in 2015. The survey design was informed by an analysis of standards of care coordination, a post...

Aim: To explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research. Background: Most people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored. Design: Systematic review...

Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff's views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff's...

Objective: Integrated community mental health teams (CMHTs) are a key component of specialist old age psychiatry services internationally. However, in England, significant shifts in policy, including a focus on dementia and age inclusive services, have influenced provision. This study portrays teams in 2009 against which subsequent service provisi...

Aims: To explore the support worker functions in community mental health teams for older adults in relation to roles, boundaries, supervision and training. Background: Support workers in community mental health teams provide important help to older people with complex mental and physical health needs in their own homes. Their numbers have grown...

The third sector has played a significant role internationally in the delivery of adult social care services for many years. Its contribution to care co-ordination activities for older people, however, in England and elsewhere, is relatively unknown. A scoping review was therefore conducted to ascertain the character of the literature, the nature a...

The Personal Social Services Research Unit (PSSRU) at the University of Manchester has been funded to investigate the role of social workers in community mental health teams. It will include teams serving both younger adults and older people. Within the UK the issue of how to use the specific skills, knowledge and attributes of social workers effec...

Purpose The provision of information and advice for older people arranging their own care is a policy objective. The purpose of this paper is to explore the range and scope of web-based information about care coordination activities for older people in the non-statutory sector in England. Design/methodology/approach Non-statutory organisations w...

Purpose The purpose of this paper is to provide new insights into the contribution and experiences of non-statutory sector (voluntary) services delivering care coordination. Design/methodology/approach This qualitative study, based on face-to-face semi-structured interviews with 17 managers from a range of non-statutory sector services, used thema...

Introduction Standards for care coordination in adult social care can support the delivery of high-quality services. Methods A content analysis of 20 guidance documents produced over the last 30 years was undertaken to consider their utility for current practice. a mix of convenience and purposive sampling was used. Data were extracted on document...

Introduction This English study is the first to focus on the contribution of occupational therapists to the work of community mental health teams for older people. Method A mixed methods study comprising: a national survey of community mental health team managers; caseload audit; qualitative interviews; and a practitioner survey provided informati...

As a result of national policy in respect of social care of adults in England, the non-statutory sector is increasingly more evident in the provision of care services previously undertaken by local government, including the delivery of care coordination for older people. However, little is currently known about the scope, content, or quality of ser...

Objectives: To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the costs of service provision; (ii) rates of mental health inpatient and care home admission. Methods: An observational study of service use and admissions to institutional care was undertaken for a prospectively-sampled c...

Background Mental health problems in older people are common and costly, posing multiple challenges for commissioners. Against this backdrop, a series of initiatives have sought to shift resources from institutional to community care in the belief that this will save money and concurs with user preferences. However, most of this work has focused on...

The study comprised: • A scoping review of the literature relating to care coordination arrangements for older people in the non-statutory sector comprising 29 documents produced between 1985 and 2013 • An international review of care coordination agency and practice standards comprising 20 documents produced between 1989 and 2013 • A Discrete Choi...

Mental health problems in older people are common and costly, posing multiple challenges for commissioners. Against this backdrop, a series of initiatives have sought to shift resources from institutional to community care in the belief that this will save money and concurs with user preferences. However, most of this work has focused on the use of...

The focus of this booklet is upon Dover Street and its heritage, a small side street which joins Oxford Road to Upper Brook Street on the University of Manchester’s Oxford Road Campus. If you are familiar with the area, it is difficult to imagine that Dover Street was once on the edge of Manchester close to open space and fields, a quiet and afflue...

Journal of Integrated Care: ISSN: 1476-9018 Purpose – The purpose of this paper is to identify features of community mental health teams (CMHTs) for older people valued by their managers, and those they would most like to change. Design/methodology/approach – Content analysis was used to analyse “free text” responses to open questions from a nati...

Social workers have worked with older people with mental ill health in multidisciplinary teams for many years. Research regarding their contribution is nevertheless sparse. This article addresses this gap. Qualitative data from semi-structured staff interviews were drawn from a multiple case study of community mental health teams (CMHTs) for older...

Introduction This article examines the introduction of self-assessment in occupational therapy services, focusing on the impact of new tools and approaches on professional culture and practice. Method Qualitative data were collected via interviews with managers of five pilot projects and analysed using a mixture of predetermined and emergent theme...

Objectives To determine the extent to which services provided to older people via community mental health teams (CMHTs) vary in duration, composition and intensity. In particular, to identify the degree to which differences between teams are due to casemix.Methods Data were collected about the services provided to a random sample of patients from 1...

Objectives The study sought to identify the characteristics of community-dwelling older people supported by community mental health teams (CMHTs) in England and, in particular, to determine whether there is a common threshold for CMHT entry and/or a core client group. Methods Data were collected about a random sample of 15 CMHTs' caseloads, includ...

Background The rising number of older people with mental health problems makes the effective use of mental health resources imperative. Little is known about the clinical effectiveness and/or cost-effectiveness of different service models. Aims The programme aimed to (1) refine and apply an existing planning tool [‘balance of care’ (BoC)] to thi...

With anticipated greater demand for formal care services globally, this article examines the sociodemographic and health characteristics of frail older people in receipt of community support. Data were collected from audits of case files of older people receiving care management at two time points during which two government policy initiatives were...

The objective of this study is to identify the extent of outreach activity community mental health teams (CMHTs) for older people provide to mainstream services in light of the recommendations of the National Dementia Strategy. In particular, to determine the range of settings in receipt of support; to specify the form of this activity; to identify...

Objective Self-assessment has been advocated in community care but little is known of its cost effectiveness in practice. We evaluated cost effectiveness of pilot self-assessment approaches. Methods Data were collected from 13 pilot projects in England, selected by central government, between October 2006 and November 2007. These were located with...

Background: Community mental health services are regarded as the preferred first tier of specialist psychogeriatric support, with integrated multidisciplinary teams believed to offer improved decision-making and greater continuity of care than separate single-profession services. In England over 400 community mental health teams (CMHTs) form the c...

Dementia continues to be under-recognized, an important issue in many countries. Policy addressing this has focused on the role of general practice-based staff, but dementia represents an area in which closer collaboration between community health and social services can reap benefits. This study examined the impact of a national policy in England,...

Abstract Prevention, comprising services that seek to delay deterioration of existing conditions and circumstances or prevent their occurrence by early access to support, is recognised as having an important role in adult social care. The gateway to social care services has traditionally been via needs-led assessments undertaken with professionals....

In the UK and elsewhere, specialist community mental health teams (CMHTs) are central to the provision of comprehensive services for older people with mental ill health. Recent guidance documents suggest a core set of attributes that such teams should encompass. This article reports on a systematic literature review undertaken to collate existing e...

Whilst community equipment and adaptations promote the independence of millions of people, ongoing problems have been identified with the delivery of such services by local authorities. Self-assessment has been identified as one possible means of improving service effectiveness, giving service users more choice and control and providing faster, eas...

Purpose – The purpose of this paper is to raise issues around the involvement of clinicians relevant to current policies for integrated care by reviewing a previous policy to integrate assessments. Design/methodology/approach – This paper is a review of data from a survey of specialist clinicians' involvement in the single assessment process for ol...

Depression continues to be under-recognized in older people. Most policies addressing this issue focus on the primary health care team. However, recognition may be improved by use of assessment tools and collaboration between secondary health and social care, particularly at the assessment stage. This study aimed to evaluate whether the Single Asse...

• Summary: Self-assessment is one of a range of new practices within adult social care, aimed at increasing the choices available to service users in relation to both the assessment process and the way services are delivered. By analysing the results of both project documentation and interviews with managers of pilot projects set up to test out thi...

The provision of timely and effective services for older people with health and social care needs is dependent on the collection of accurate assessment information being shared with relevant agencies and accepted by them. This requires an integrated assessment approach capable of spanning the longstanding institutional separation between health and...

Introduction: The Government plans to transform adult social care in England. Future services will place more emphasis on prevention and enablement, and promoting personalisation and choice. Self-assessment is one possible facilitator of this agenda. However, little is known about its utility in social care. This evaluation examined how eight local...

Introduction The Government plans to transform adult social care in England. Future services will place more emphasis on prevention and enablement, and promoting personalisation and choice. Self-assessment is one possible facilitator of this agenda. However, little is known about its utility in social care. This evaluation examined how eight local...

To investigate progress in joint working within community mental health teams for older people (CMHTsOP) against a range of national standards, and to consider team characteristics that may hinder or facilitate integrated practice. A postal questionnaire was sent to the managers of all CMHTsOP in England. A total of 376 teams responded representing...

Aims The article seeks to provide evidence of developments in relation to the extent and type of information sharing between primary care trusts (PCTs) and other settings involved in the assessment and provision of services for older people with health and social care needs following the introduction of the Single Assessment Process (SAP) in Englan...

The quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care pla...

Expert Briefing Paper 2. Manchester, University of Manchester, PSSRU.

The single assessment process (SAP) for older people, introduced in England across health and social care agencies from April 2004, aimed at improving assessment processes. We examined the impact of this policy in terms of the reliability of needs identification within statutory social services assessments. An observational study compared the accur...

This paper provides an initial evaluation of the impact of the Single Assessment Process (SAP) in England upon practice regarding multidisciplinary assessment. To investigate changes in recorded health needs of older people and in the number of multidisciplinary assessments undertaken using social care agencies' case files. To examine differences i...

National Evaluation of Self Assessment: Vol 1

National Evaluation of Self Assessment: Vol 2

National Evaluation of Self Assessment: Vol III

National Evaluation of the Single Assessment Process: Stage II Vol 5

Trade union attitudes towards European immigrants have rarely been studied in a post-war context. As a response to this, this article focuses on trade union reactions to European workers in the Lancashire cotton industry between 1946 and 1951. Highlighting the merits of local case studies of labour relations, the focus is predominantly on the Amalg...

European volunteer workers have received comparatively little attention in the history of British post-war immigration, with greater coverage given to, for example, demobilised members of the Polish Resettlement Corps. This paper is based upon oral history interviews with a group of European immigrants, predominantly European volunteer workers, and...

National Evaluation of the Single Assessment Process: Stage II Vol 3

National Evaluation of the Single Assessment Process: Stage II Vol 4

There has been debate for some years as to whether the best model of care for people with dementia emphasises specialist facilities or integrated service provision. Although the United Kingdom National Service Framework for Older People recommended that local authority social services departments encourage the development of specialist residential...

National Evaluation of the Single Assessment Process: Stage II Vol 1

Current policy in England emphasises the importance of caring for highly dependent older people for as long as possible at home. It is therefore crucial that day care services are effective and widely available. To compare the type and standard of care provided for older people with dementia in day centre and day hospital settings. A cross-sectiona...

Current policy in England emphasises both the importance of caring for highly dependent older people for as long as possible in their own homes, and the development of specialist care services for people with dementia. However, the differences between specialist and generic home care services for people with dementia are poorly understood. This cro...

Delivering integrated and specialist mental health services for the growing population of older people with dementia in Britain is a key concern of the present government. To consider the nature of current practice among multi-disciplinary and single discipline health and social care teams providing a service to people with dementia and compare the...

This paper reports one aspect of a larger study. The aim of this aspect was to explore the role of the "welfare officer" in promoting the health of cotton mill workers during this period. The paper considers one element of a broad exploratory study of the health of women cotton mill workers in the North West of England. The original purpose of the...

National Evaluation of the Single Assessment Process: Stage I Vol 1 Literature Review

If the price of liberty had always been constant vigilance, it seemed that the price of survival in the late 1980s was constant surveillance and the price of efficiency constant competition and the publication of results. In return for their employment, academics must now submit to scrutiny, designed in part to establish whether or not they were gi...

In the late 1980s the students at Manchester had come to distrust the gesture politics and rituals of left-wing protest, partly, perhaps, because they offered no solution to the practical and material problems of student life. Student officers in 1989–90 came close to agreeing with the views adopted by the Vice-Chancellor in 1981—to the effect that...

The student activists of the 1980s were not the revolutionaries of the decade, the bearers or prophets of a new order; instead they seemed fated to be rebels, protesting against changes imposed from on high. The initiative had passed to a neoliberal, sink-or-swim, roll-back-the-state government which nevertheless contrived to interfere with univers...

In 1973 came one of the great turning points in British university history, a transition into a bleaker world governed by the principles of uncertainty, economy and improvisation. The finances of most British universities lay at the mercy of politicians and were subject to capricious cuts in public spending. Their precarious situation was a consequ...

During the 1970s little appeared to have come of the 1960s dream of transforming the University into a workplace democracy, rather than a specialised institution dedicated to extending and communicating knowledge and know-how. However, the institution was well-equipped with committees and consultative bodies, with departmental boards to advise prof...

Stern critics accused the radical students of the 1970s of trying to carry on the 1960s by the same means. Raucous pickets, disrupted meetings and occupations of administrators' offices still characterised the ritual of protest; squabbles between left-wing factions threatened to drive disillusioned students to vote for Conservative candidates who w...