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The impetus to work across boundaries is a longstanding theme in British public policy. Critical commentary has emerged from different perspectives, but has not provided empirically based analysis of joint working across different sectors and spheres of practice. In this article we present findings from an evaluation of joint working in the Supporting People Health Pilots. These raise questions about why some agencies – primarily in the voluntary sector – appeared to be more effective than others at working across boundaries. These questions and the broader implications of the findings for the voluntary sector are analysed.
One of the ethical dilemmas facing researchers and social researchers is the most appropriate way of researching the relationship between old age and death. This chapter reviews the ethical issues that arose when developing the methodology for a one-year pilot study exploring the lives of one hundred people over the age of eighty. These ethical issues included whether older people with dementia can or should consent to research participation; whether it was right to obtain proxy consent from carers; how the ethical issues that emerge were addressed and resolved through a Research Ethics Committee (REC); and how the researchers dealt with ethical issues as they arose within the research interaction. The research project discussed in this chapter aimed to explore the issues of old age and death from the perspective of older people. By listening to the accounts and narratives of older people, the chapter aims to gain a better understanding of their involvement in key decisions made about their lives by health and social care professionals. While older people were the focus of this study, they were also actively involved in the project advisory group, helping researchers to plan and fine-tune the research methodology.
The adult social care sector in England has been encouraged to increase the role of volunteers in service delivery. To understand the volunteer role in care delivery and its impact upon paid care work, we undertook 94 qualitative interviews in seven care settings for older people in England. While the boundaries between care worker and volunteer were clearly established in some organisations, they were more indistinguishable in others. We discuss how both clear and murky boundary making, especially regarding ‘emotional’ and ‘bodily’ aspects of care, can contribute towards paid care work’s invisibility, lack of recognition and poor remuneration.
Faced with unprecedented challenges, the adult social care sector in England has seen increasing attention given to the potential of volunteers to contribute to service provision. This article reports the findings of a qualitative study that explored the contribution made by volunteers to social care services for older people. The article draws attention to the difficulties associated with recruiting and training volunteers to work in the sector, particularly during a period of reduced public expenditure, which is putting the sector under strain. Given the challenges faced, the article considers whether it is appropriate to involve volunteers in care work.
Older people’s perspectives on their experiences of ageing and dependency shed light on the complex nature of dignity as a personal and social concept. In this study, participants revealed how, as they became dependent on others for support and care, their lives felt increasingly precarious and their sense of dignity was challenged. Influenced by their life-course experiences as well as by their social circumstances, their response to this challenge included both perseverance and adjustment to change. The attitudes and behaviour of others, including those of professionals, contributed in crucially important ways to maintaining their sense of identity and dignity.
Using data from the Department of Health funded study ‘Making the most of policy evaluations’, this paper explores the views of those working within the policy process about the role of evidence. It highlights a tension between formative and summative uses of research, which appeared to be exacerbated by a lack of clarity surrounding the objectives that policy leads had for the research. Additionally, the data reveal an uncertainty about the status of ‘pathfinder’, ‘demonstration’ and ‘pilot’ sites within the policy process.
