Anna Moran

This paper explores factors associated with successful utilisation of allied health and social care assistants in community based rehabilitation services. Interviews and focus groups were conducted with 158 professionally qualified and assistant staff from 11 older people’s interdisciplinary community rehabilitation teams. Assistants were perceived as a focal point for care delivery and conduits to enabling a service to achieve goals within interdisciplinary team structures. The study identifies eight mechanisms to promote the successful utilisation of assistants: 1. Multidisciplinary team input into assistant training and support; 2.Ensuring the timely assessment of clients by qualified staff; 3. Establishing clear communication structures between qualified and assistant staff; 4. Colocation of teams to promote communication and skill sharing; 5. Enabling staff to work to their full scope of practice; 6. Facilitating role flexibility of assistants, while upholding the principles of reablement; 7. Allowing sufficient time for client interaction; 8. Ensuring an appropriate ratio of assistant to qualified staff to enable sufficient training and supervision of assistants. By upholding these mechanisms, there may be potential to increase the efficiency and productivity of assistant and professionally qualified staff in community based rehabilitation settings.

Rationale, aims and objectives  Support workers are the largest single group of staff involved in the delivery of health and social care in the UK; however, their roles are heterogeneous and are influenced by several contextual factors. The aim of this study was to elucidate the contribution of the elements and context of work undertaken by support workers in health and social care.Methods  Thematic review of the literature 2005/2006, updated in 2008.Results  A total of 134 papers were included in the review, from which we identified four domains of work and four core roles of support workers. The four domains of support worker work are direct care, indirect care, administration and facilitation. The four ‘core’ attributes of support worker roles were being a helper/enabler, a companion, a facilitator and a monitor. The more ‘technical’ components of support worker roles are then shaped by contextual factors such as staffing levels and the delegation processes.Conclusion  Despite the heterogeneity of support worker roles, there are some uniting ‘generic’ features, which may form some or all of the role of these practitioners. Contextual factors influence the specific technical aspects of the support role, accounting in part for their heterogeneous role.

The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples’ community and intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples’ community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service-users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a ‘service pro forma’ which can be used as a basis to describe and compare a range of services. We propose that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies.

... Project team (alphabetical order) James Buchan, Simon Dixon, Pamela Enderby, Caroline Mitchell, Anna Moran, Susan Nancarrow, Stuart Parker  August 2006 ScHARR (Sheffield School of Health and Related Research), University of Sheffield ...

... Project team (alphabetical order) James Buchan, Simon Dixon, Pamela Enderby, Caroline Mitchell, Anna Moran, Susan Nancarrow, Stuart Parker  August 2006 ScHARR (Sheffield School of Health and Related Research), University of Sheffield ...