Michelle Cornes

University of Salford · Health and Society

Purpose People experiencing homelessness often have multiple health and other support needs, requiring complex, coordinated support. Admission to hospital is potentially an opportunity to address these needs and begin integrating care, but so often it is a missed one. Our purpose in this research was to evaluate an ongoing, roll-out programme that...

Successful implementation of evidence-based services in health and social care depends largely on the fit of the services with the values and priorities of users who are shaping and participating in their delivery and use. When looking at the implementation of innovative specialist hospital discharge schemes for people who are homeless, there is a...

In 2021, we published research funded by the UK National Institute for Health Research that demonstrated the effectiveness and cost effectiveness of specialist hospital discharge schemes for people who are homeless. A key finding of the research was that areas that had a specialist homeless hospital discharge scheme had fewer delayed discharges and...

Objective To evaluate the cost-effectiveness of specialist hospital discharge and intermediate care (support after discharge) services for people who are homeless in England. Methods We estimated the comparative cost and consequences of different types of specialist care provided by 17 homeless hospital discharge and intermediate care services. We...

There are long‐standing concerns that people experiencing homelessness may not recover well if left unsupported after a hospital stay. This study reports on a study investigating the cost‐effectiveness of three different ‘in patient care coordination and discharge planning’ configurations for adults experiencing homelessness who are discharged from...

This article reports social workers’ attitudes and approaches to working with people experiencing multiple exclusion homelessness (MEH) who self-neglect, and whether these people receive services, including safeguarding, differently from other populations. It draws on telephone interviews in 2020 with twenty-two social workers working with adults i...

Hospital discharge for people experiencing homelessness is a perennial challenge. The Homeless Reduction Act 2017 (HRA) places new responsibilities on hospitals, but it remains unknown whether this has affected discharge practices. This qualitative study explores stakeholders' views on the challenges around hospital discharge for people experiencin...

High rates of COVID-19 infections and deaths amongst people who are homeless in London, UK were feared. Rates however stayed much lower than expected throughout 2020; an experience that compares to other settings globally. This study sought a community level perspective to explore this rate of infections, and through this explore relationships betw...

Background In 2013, 70% of people who were homeless on admission to hospital were discharged back to the street without having their care and support needs addressed. In response, the UK government provided funding for 52 new specialist homeless hospital discharge schemes. This study employed RAMESES II (Realist And Meta-narrative Evidence Synthese...

Background Symptom recognition and timely referral in primary care are crucial for the early diagnosis of cancer. Physician assistants or associates (PAs) have been introduced in 18 healthcare systems across the world, with numbers increasing in some cases to address primary care physician shortages. Little is known about their impact on suspected...

Purpose People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wick...

Aim Clinical research nurses work at the fulcrum of clinical trials with clearly defined roles and responsibilities. In England, the National Institute for Health Research (the main funder of health research) has broadened its scope to encompass social care research. The expectation is that clinical research nurses will expand their skill set to su...

The impacts on adult social work in England of the Covid-19 pandemic were sudden and are proving long-standing. In England, many social workers moved to home working and virtual contact with colleagues, managers, staff from other agencies and service users. A first national lockdown was followed by a lessening of restrictions, but a second wave sta...

Report about how to improve hospital discharge arrangements for people who are homeless.

Background: Symptom recognition and timely referral in primary care are crucial for the early diagnosis of cancer. Physician assistants or associates (PAs) have been introduced in 15 healthcare systems across the world, with numbers increasing to address primary care physician shortages. Little is known about their impact on suspected cancer recogn...

Background Inpatients experiencing homelessness are often discharged to unstable accommodation or the street, which may increase the risk of readmission. Methods We conducted a cohort study of 2772 homeless patients discharged after an emergency admission at 78 hospitals across England between November 2013 and November 2016. For each individual,...

Context: People with prior health conditions are susceptible to severe and sometimes fatal outcomes of the novel coronavirus SARS-CoV-2, that causes the disease COVID-19. The protection of the capacity of systems for social care was thus an important consideration for governments in the early stages of the global pandemic. Objectives: This paper re...

The article reports research aimed at identifying factors relating to retention in English intellectual disability services, drawing on a study of the social care workforce. The research involved two rounds of interviews with social care managers and staff between 2009 and 2014. The study uses social exchange theory, particularly the idea of ‘recip...

Background : Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless...

Purpose: The purpose of this paper is to explore the impact of personalisation policy on the providers of social care services in England, mainly to older people, within the context of austerity and different conceptions of personalisation. Design/methodology/approach: The paper draws on part of a longitudinal study of the care workforce, which inv...

Introduction In England, details on hospital admissions and mortality are recorded nationally, but housing status and patients’ hospital discharge arrangements are only recorded locally within discharge services. These data are required to evaluate specialist homeless hospital discharge (HHD) services in England, and can be obtained through linkage...

Purpose This paper presents a case study describing the progress that is being made in one city in England to increase access to Care Act 2014 assessments and personal budgets among people with experiences of homelessness and multiple exclusion. Design/methodology/approach A case study employing a 'study group' to describe and reflect on local d...

Abstract Purpose: The purpose of this paper is to present a case study describing the progress that is being made in one city in England to increase access to Care Act 2014 assessments and personal budgets among people with experiences of homelessness and multiple exclusion. Design/methodology/approach: A case study employing a "study group" to de...

This paper describes the early progress that is being made to implement the Care Act 2014 in England with regard to the care and support needs of people who are homeless. It outlines exploratory discussions that were generated through a series of interprofessional 'community of practice' meetings. These meetings highlighted practice challenges and...

Introduction People who are homeless often experience poor hospital discharge arrangements, reflecting ongoing care and housing needs. Specialist integrated homeless health and care provision (SIHHC) schemes have been developed and implemented to facilitate the safe and timely discharge of homeless patients from hospital. Our study aims to investig...

This review presents a realist synthesis of “what works and why” in intermediate care for people who are homeless. The overall aim was to update an earlier synthesis of intermediate care by capturing new evidence from a recent UK government funding initiative (the “Homeless Hospital Discharge Fund”). The initiative made resources available to the c...

This paper describes the early progress that is being made to implement the Care Act 2014 in England with regard to the care and support needs of people who are homeless. It outlines exploratory discussions that were generated through a series of interprofessional ‘community of practice’ meetings. These meetings highlighted practice challenges and...

Purpose Purpose To report and discuss the findings of an evaluation of the drama performance and reception of ‘Let’s Talk’ in the context of interprofessional practice. Design/methodology/approach This first stage evaluation addresses the initial development stage of the Let’s Talk drama initiative from the perspectives of health and social care p...

As government funding for housing related support (formerly Supporting People) services continues to shrink, it is timely to revisit the question as to whether ‘homeless people’ are eligible for publically funded care and support, including personal budgets, organised through the local authority. The Care Act 2014 which was implemented in England o...

Purpose – The purpose of this paper is to discuss “system transformation” in the context of different workforces and organisations seeking to support people experiencing multiple exclusion homelessness (MEH). From a relational and integrated care perspective it aims to identify barriers to achieving more effective ways of working in the prevailing...

Purpose – The purpose of this paper is to consider the experiences of carers caring for an adult child, particularly as they affect the transition from midlife into older age. It explores aspects affecting the vast majority of carers, such as accessing information and services, but focuses on the specific concerns of those caring for a child with...

While there is increased recognition of the role of family carers in supporting adults with social care needs, some groups of carers are overlooked or hidden from professional view. Carers of people with substance misuse problems may be among this group since they are at risk of feeling guilty and stigmatised; targeting and eligibility criteria may...

Michelle Cornes, Helen Mathie, Martin Whiteford, Jill Manthorpe & Michael Clark (2015) The Care Act, Personalisation and the New Eligibility Regulations: A discussion paper about the future of care and support services for homeless people in England. London: SCWRU, KCL

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 experienci...

Outreach is advocated as a way of improving the uptake of services among underserved populations and of filling the gaps between mainstream services and the populations they are intended to support. Despite the policy emphasis on providing better help for family carers, research consistently shows that many of those providing unpaid care to a famil...

This article presents findings from a focused scoping review of the published literature on self-directed support (SDS), the term adopted by the Scottish Government to refer to its policy to improve social care outcomes and choices for people using publicly funded services and to distinguish it from personalisation, the term more commonly used in E...

Purpose – The purpose of this paper is to consider what implications the government's policy of personalisation has for social care workers in terms of the skills that they need to achieve more personalised support for people using services and family carers. Design/methodology/approach – A total of 86 semi-structured interviews were undertaken wi...

Abstract Within homelessness services recent policy developments have highlighted the need for integration and improved collaborative working and also, the need for "Psychologically Informed Environments" (PIES) in which workers are better equipped to manage the "complex trauma" associated with homelessness. Drawing on the findings of an evaluation...

'Recovery' is a key concept in the organisation and delivery of interdisciplinary support for people experiencing multiple exclusion homelessness (MEH, that is, situations where homelessness overlaps with a range of other complex problems such as mental health issues and drug and alcohol dependencies). At the level of individual support planning, p...

Purpose – The paper aims to ascertain how local authorities and other services are responding to central government strategies to make support for family carers a priority. Design/methodology/approach – A web-based audit of local authority public information for carers was undertaken ( n =50). The sample covered different parts of England and diff...

This article describes a Dementia Focused Performance Management Programme run for care home managers in the north-west of England. The programme highlighted the challenges faced by managers in terms of complying with policy changes and providing adequate supervision and training for care staff in dementia care. It proposes ‘turn around simulations...

Purpose – People with a dual diagnosis or other multiple and complex needs often require support from a range of services and agencies. Social policy has focused on achieving an integrated response from practitioners; however, service responses to this group frequently remain fragmented. Practitioners supporting these clients are likely to need kno...

Successive governments have highlighted the importance of the knowledge economy to future economic growth. Arguably this approach has under-estimated the need to ensure that so-called basic jobs, for example, in retail, hospitality, or care work are delivered effectively and that there are enough people willing to work in these sectors. More specif...

One of the solutions to the shortages of social workers in England has been to employ social workers on a temporary or locum basis, often these social workers are called agency social workers as their contract of employment is with a employment agency rather than the social work employer. This paper explores the background to the use of agency soci...

There is increasing evidence that many homeless people have multiple and complex needs but are excluded from social work support. The data on which this paper draws are part of a study investigating service interfaces and interprofessional working that took place in three areas of England in 2009–11. This paper reports and discusses the ways in whi...

There has been growing concern that English local authorities are over reliant on temporary staff to meet the shortage of social workers. This has been criticised as inefficient and costly while leading to problems of continuity and consistency for people using social work services. Focussing on recent policy and the implementation of new administr...

Purpose - The purpose of this paper is to ascertain how local authorities and other services are responding to central government strategies to make support for family carers a priority. Design/methodology/approach - A web based audit of local authority public information was undertaken (n=50) searching for Carers’ Registers and carer related infor...

Purpose This paper aims to explore the possible connections between self‐directed support and adult support and protection, both of which are important policy developments in Scotland. Design/methodology/approach The authors draw on findings from the national evaluation of the test sites or pilots of self‐directed support in Scotland and interview...

Purpose Little is known about the implications of employing agency staff on safeguarding or the reasons why employers recruit staff from agencies who specialise in supplying staff to the sector or why social care staff work for such agencies. This paper aims to present findings from a study of agency workers in social care services in England. Des...

Purpose This paper aims to present findings from a service user controlled research project; essentially it seeks to provide commentary by older people on their experiences as visitors to hospital or as patients receiving visitors. Design/methodology/approach The method of data collection was to facilitate discussions (focus groups) with diverse o...

This article draws on preliminary findings from a two-year exploratory study to describe how different agencies and professionals work together to identify and manage the intersections between homelessness and other facets of deep social exclusion. We assess the extent to which current practice is informed by policy frameworks for ‘personalised and...

This article focuses on people with learning disabilities and their families who employ care or support workers using public (government) and/or private (self and family) funds. Such consumer-directed support takes place in England through personal budgets and direct payments. Research and material relevant to these employment relationships were ex...

This article questions whether traditional management approaches will be sufficient to deliver change when it comes to implementing personalisation, and outlines an alternative approach based oncollaborative working in 'communities of practice'.

Commissioning of services has become integral to the role of those in the health and social care profession and a plethora of guidance on commissioning exists to aid professionals in this strategic activity. As part of a study of the Care Services Improvement Partnership (CSIP), the evidence base of published generic social care commissioning guide...

As part of the consultation around the review of the guidance document No Secrets (Department of Health, 2008a) in England, a project was commissioned to listen to the views and experiences of a group of older people living in a rural community. This article reports on the consultation process and findings. Messages for the review are identified th...

This article provides an insight into the support needs of health and social care commissioners seeking to develop world class commissioning competencies and the role of service improvement agencies in meeting these needs. Reporting findings from the evaluation of one service improvement agency based in England, we focus on the 'improvement support...

Options for Excellence Building the Social Care Workforce of the Future (DfES/DH 2006) sets out an ambitious agenda to reduce over reliance on temporary staff supplied through private employment agencies. The vision is that by 2020 those receiving care will be able to count on continuity in the person providing their care and that non-profit rather...

At a time of increasing interest in mental health in later life, the role of public health approaches is potentially heightened. This paper draws on interview data with older people living in London to consider the interplay between personal and public approaches to health and well-being. The interviews were under taken as part of the midpoint revi...

Improving access to culturally-appropriate services and enhancing responses to the needs of older people from black and minority ethnic backgrounds were among the aims of the National Service Framework for Older People (NSFOP) that was introduced in England in 2001. Progress in meeting the aims of the NSFOP was evaluated by a mid-term independent r...

Aim This article explores the involvement of older people in research and inspection, reflecting on the learning from the recent ‘joint review’ of the National Service Framework for Older People in England. Methodological context Working in 10 different localities, the ‘joint review’ comprised a formal inspection of health and local council service...

A transformation of healthcare is underway, from a sellers' market to a consumers' market, where the satisfaction of the patient's needs is part of the definition of quality. Patient satisfaction surveys are widely used to judge service quality, but clinicians are sceptical about them because they are too often poorly designed measures that do not...

Background A transformation of healthcare is underway, from a sellers' market to a consumers' market, where the satisfaction of the patient's needs is part of the definition of quality. Patient satisfaction surveys are widely used to judge service quality, but clinicians are sceptical about them because they are too often poorly designed measures t...

In this article we report findings from a small scale user-controlled study which explores involvement and engagement in terms of the legacy of the National Service Framework for Older People (NSFOP) and the new opportunities that are opening up around community well-being and active citizenship. A key finding of the study is that, when participati...

This paper draws on the evaluation of the impact of the English National Service Framework for Older People (NSFOP) on the experiences and expectations of older people, four years into its ten-year programme. The NSFOP focuses on achieving cultural changes so that older people and their carers are treated with respect, dignity and fairness. The eva...

The government's reimbursement policy, whereby local councils face fines if a patient cannot be discharged from hospital because they are waiting for an assessment etc, introduced new pressures into a system that was already fraught. One of the policy's aims is to allow people to exercise ‘genuine choice’ as regards their ongoing and longer-term ca...

Addressing the problems of meeting the needs of ageing populations in rural areas is recognised as a political and service delivery challenge. The National Service Framework (NSF) for Older People (NSFOP) set out a series of service standards to raise quality, to redress variations in service use and to enhance the effectiveness of services across...

Evaluation of the impact of the National Service Framework for Older People (NSFOP) on the experiences and expectations of older people, 4 years into its 10 year programme. the NSFOP is a comprehensive strategy designed to promote fair, high quality, integrated health and social care services for older people in England. It emphasises (i) the need...

To ensure that older people have access to all the advice, information and support they need nurses are increasingly expected to work with volunteers and the wider Voluntary and Community Sector. This article charts some of the current issues facing the sector so that nurses can collaborate more effectively, respect the contribution that volunteers...

English This article reports on an innovatory partnership between regulatory bodies and researchers to assess progress in improving NHS, local authority and other services for older people in 10 different parts of England. It discusses how consultation exercises held as part of local inspections that fed into a national review of the National Servi...

This paper draws on the findings of a review of regulation of professionally qualified teachers, social workers and other staff in social care. It charts the process of developing and implementing both professional and wider workforce regulation in England, focusing on the implications for generic and integrated working and the development of cross...