Ann Rosengard

Bio: Ann Rosengard is an academic researcher. The author has contributed to research in topics: Government & Mental health. The author has an hindex of 5, co-authored 7 publications receiving 138 citations.

Embarking on self-directed support in Scotland: a focused scoping review of the literature

Abstract: 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 England, and from consumer-directed-care and cash for counselling. The review was undertaken to inform an evaluation of the early adopters of SDS, funded by the Scottish Government 2009–2011, and was updated with later literature. It focused on the evidence base available to inform the Test Sites' (pilot local authorities) efforts to reduce bureaucracy or ‘red tape’ for people choosing their own social care and support; the available evidence about leadership and training to support these changes and about the use of specific transitional funding to ease the process of implementation. The findings of the literature review around these three themes are presented a...

Self-Directed Support: A Review of the Barriers and Facilitators

Abstract: This is a report on the published literature on the barriers and facilitators of self- directed support. It was undertaken to inform a research study funded by the Scottish Government 2009-2011 that is evaluating initiatives in three local authorities. These initiatives aim to improve take up of self-directed support for people eligible for social care and other public funds. The three test site areas are working to reduce bureaucracy; to make the processes easy and 'light touch'; and to provide training and leadership to people working on these developments. Scottish Government has provided extra money to assist these three authorities and to help people in other areas learn from their experiences.

Partners in care?: views and experiences of carers from a cohort study of the early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003

Abstract: Carers are seen as legitimate stakeholders in wider policy processes and increasingly as ‘co-producers’ and key providers of care. Mental health carers, however, especially those caring for relatives subject to compulsory care and treatment, often feel overlooked and marginalised, caring in complex circumstances with little or no professional support. The Mental Health (Care & Treatment) (Scotland) Act 2003 (MHCT Act) implemented in 2005 aspired to change this for the better. This article focuses specifically on findings from seven focus groups and 10 individual interviews with 33 carers from three Health Board areas and the State Hospital in Scotland. Interviews were conducted at two stages during 2007 and 2008 as part of a wider study. Participating carers were supporting relatives who were under different compulsory measures and so had experience of new procedures under the MHCT Act. The data were gathered as part of a cohort study exploring service users’, carers’ and professionals’ early experiences of the Act’s implementation. A topic guide was used to explore the impact of compulsion on carers; the ‘Named Person’ role; Mental Health Tribunals; the principles underpinning the MHCT Act; and suggestions for improving the law. The study found that new provisions, in particular the Named Person role and Mental Health Tribunals, had resulted in positive change. However, many carers still felt isolated and unsupported. They remained critical of the lack of consultation and involvement at both individual and collective levels. Few were aware of their right to a carer’s assessment and many were sceptical that this would make any difference. Acknowledging the study’s limitations, we discuss the implications for practice in light of broader policy agendas of personalisation, recovery, recognition for carers and promotion of more community-based mental health services.

When self‐directed support meets adult support and protection: findings from the evaluation of the SDS test sites in Scotland

Abstract: 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 interviews at two time points with adult protection leads in the test sites. These interview data are set in the context of Scottish developments in adult support and protection.Findings – Self‐directed support and adult protection had not been joined up initially. In the three Scottish test sites those responsible for adult safeguarding had not been engaged with the changes. They were unclear about the new systems and were concerned about the implications of reduced monitoring of risks. Shared training between those implementing self‐directed support and those carrying out adult protection work was viewed as a way of bridging these different areas of practice through ...

Evaluation of self directed support test sites in Scotland

Abstract: ■ Those who accessed SDS packages during the test sites, were positive about their support and satisfied with the flexibility and choice that SDS had provided. ■ The test sites improved access to SDS especially for people with learning disabilities, but did little to promote SDS to other groups, for example, those with mental health problems, from Black or Minority Ethnic groups, older people, those who have addictions or homeless people. ■ In spite of considerable Scottish Government investment in SDS test sites, fewer than 150 new individual SDS arrangements were set up. This suggests that significant time and investment in infrastructure are needed to implement major policy initiatives. ■ None of the test sites had directly addressed issues around mixed funding packages, so the potential to integrate or join up funding streams e.g. with the NHS, could not be assessed. ■ The paradox at the heart of SDS was a (mis)perception by staff, service users, and carers of SDS as an alternative to, direct services and even, Direct Payments (DPs). New and parallel SDS systems to those delivering DPs were created by the test sites. ■ Active promotion of SDS, including DPs, increased the numbers of people opting for payments instead of direct services to pay for more flexible, individualised care and support. ■ All test sites invested in specialist SDS teams and project managers to support development of new systems and administrative processes, as well as generating a body of practice expertise. Consequently, some service users, carers and professionals perceived SDS as separate to both Social Work support and DPs. ■ None of the test sites was able to cut ‘red tape’ or reduce bureaucratic or administrative requirements. Instead, by designing new support systems for SDS, they experienced a (possibly temporary) increase in bureaucracy associated with assessment and resource allocation. ■ Only one of the test sites used test site monies to invest in strategic service development. ■ By the end of the test site period the 3 local authorities had resolved to move towards mainstreaming SDS with support from their senior management and Councillors. Evaluation of Self-Directed Support Test Sites in Scotland

Evaluation Methodology Basics: The Nuts and Bolts of Sound Evaluation

Abstract: Our online web service was introduced by using a wish to work as a comprehensive on the web electronic digital collection that gives access to many PDF file e-book catalog. You could find many kinds of e-guide as well as other literatures from your documents data base. Particular preferred subjects that spread out on our catalog are famous books, solution key, assessment test questions and solution, guide sample, training information, test test, user handbook, consumer guidance, support instruction, repair handbook, and so forth.

Exploring the Relationships between Choice and Independence: Experiences of Disabled and Older People

Abstract: Extending choice and control to the users of publicly funded services is a cornerstone in the personalisation agenda. It is assumed that giving service users greater choice and control will promote users’ independence. As service users are increasingly given the responsibility to determine their support, social work practitioners need to work differently with service users in order to provide personalised support in exercising choice. This requires practitioners having a nuanced understanding of people’s concepts of independence, how people make choices about support services and how those choices can impact on their perceived independence in the longer term. This paper reports new findings from a longitudinal qualitative study of choice and control over the life course in England. Semi-structured interviews were carried out with fifty adults and older people experiencing fluctuating support needs and/or a sudden deterioration in health. The paper discusses the relationships between choice and independence as experienced by disabled and older people. The findings show that independence is not a fixed concept, but is relative and multidimensional. There are multiple relationships between the choices people make and the consequences of those choices for people’s subjective views of their independence. The paper concludes by highlighting the implications of findings for the role of social work practitioners.

Subjective experiences of compulsory treatment from a qualitative study of early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003

Abstract: Compulsory psychiatric treatment is highly contested, and little research has focused specifically on direct experiences. The Mental Health (Care & Treatment) (Scotland) Act, 2003 introduced new roles and provisions including community treatment orders, and was designed to increase participation, ensure treatment was beneficial and was the 'least restrictive' alternative. This article draws on findings from semi-structured interviews with 49 individuals, who had experienced compulsion under this new legislation during 2007-2008, that were part of a broader cohort study. Interviews with service users were conducted at two stages with 80% agreeing to be interviewed twice. The sample included people on a variety of compulsory orders from four Health Board areas, some of whom had been detained for the first time, while others reported 'revolving door' experiences. Peer researchers who were mental health service users carried out the interviews in partnership with professional researchers. The findings suggest that legislation had a limited impact on participation in the process of compulsion. Consensus was that although service users felt there was increased opportunity for their voices to be heard, this was not matched by having increased influence over professional decision-making, especially in relation to drug treatments. According to people's direct experiences, the passing of the legislation in itself had done little to change the dominant psychiatric paradigm. While providing a foundation for improving the process of compulsion, the findings suggest that as well as legislative reform, fundamental shifts in practice are needed both in terms of the nature of therapeutic relationships, and in embracing more holistic and recovery perspectives.