With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005-2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified seventy-seven relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people’s mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

Background: Social prescribing is encouraged to promote well-being, reduce isolation and loneliness. Traditional, generalist day centres for older people could be suggested by social prescribing, but little is known about their clientele or their outcomes. As part of a larger study of the role, outcomes and commissioning of generalist English day centres for older people, the characteristics of attenders at 4 day centres, their reasons for attendance and outcomes were explored. Methods: This mixed-methods study used qualitative interviews and standardised tools within an embedded multiple-case study design. Semi-structured interviews with older day centre attenders (n = 23, 62% of eligible attenders) of 4 day centres in southeast England, recruited purposively to reflect organisational differences, were analysed. Results: Participants reported non-elective withdrawal from socialisation following health or mobility decline, or losses. Apart from living arrangements and marital status, attenders' profiles differed between centres. Access had been mostly facilitated by others. Day centre attendance enhanced quality of life for this group of socially isolated people with mobility restrictions and at risk of declining independence and wellbeing. The positive impact on attenders' social participation and involvement and on meaningful occupation was significant (p-value < 0.001, 99% CI), with an average ASCOT gain score of 0.18. Ten outcome themes were identified. Conclusion: Outcomes of day centre attendance are those targeted by social care and health policy. Centres were communities that 'enabled' and offset loss or isolation, thus supporting ageing in place through wellbeing and contributed something unique to their attenders' lives. By monitoring attenders' health and wellbeing and providing practical support, information and facilitating access to other services,

This article reports selected findings from a scoping review of the literature about care home managers in England. The review was undertaken between December 2013 and April 2014, with searches conducted in December 2013, and completed in July 2014. Its aim was to identify the characteristics of care home managers, descriptions of their leadership and managerial roles, their experience, skills and support, and the managers' perceptions of their work and status and to identify knowledge gaps. The databases searched included Web of Knowledge, EBSCO, ASSIA, Embase, AgeInfo, NHS Evidence, Social Care Online and the publication platforms IngentaConnect, Wiley Online and JSTOR together with specialist sites and national information providers. Sixteen relevant studies directly about care home managers, reported in 24 articles, were identified. A further body of literature pertinent to the questions was located (n = 84), including sector reports, professional press, expert opinion, enquiries and reviews, and other material, which also informed the review. A consultation exercise with stakeholders informed the findings of the review. The review found that, despite frequent allusions to their impact on organisational culture, few studies have focused on care home managers, and, such as there are, mainly relate to managers of care homes for older people. This is despite managers' major responsibilities for the care of many frail and disabled people.

Objectives The Covid‐19 pandemic has taken a heavy toll on many people living with dementia and carers. Caring for a person living with dementia at home with limited avenues for support and a break challenged many carers. Care homes in England closed to visitors, with very few offering opportunities for a short‐stay. We investigated impact of Covid‐19 on views and expectations of carers of people living with dementia about residential respite. Methods/Design Qualitative interviews with 35 carers were conducted March–December 2020: 30 women and 5 men, with ages ranging 30–83 years. Interviews explored experiences, views of residential respite, and expectations post‐Covid. Data were thematically analysed and salient concepts were drawn out and discussed within the research team and study advisers. Results Three themes were identified in transcripts, relating to impact of Covid‐19 on views and expectations of respite: (1) Carers described regularly negotiating risks and stresses of Covid, weighing up how to prevent infection and changing family arrangements to facilitate caring; (2) Carers were balancing different needs, prioritising needs of their relatives while bearing the impact of cumulative caregiving responsibilities. (3) Uncertainty about future residential respite continued, in terms of availability, ongoing restrictions and trustworthy information sources. Conclusions Residential respite is a positive, acceptable option for some carers to get a break from caring. Covid‐19 may have heighted some of caregiving stressors and there may be an increased need for a break. Views of care homes developed during the pandemic suggest that individual confidence to use respite may need to be rebuilt.

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 reports and discusses the results of a rapid review of international early policy responses for the protection of social care systems after the World Health Organization (WHO) announced that SARS-CoV-2 had evolved into a pandemic. Literature was collected in March 2020. Method: Rapid online review of government responses to the SARS-CoV-2 pandemic using official government statements and press reports from 13 countries. Findings: The analysis of early responses in and about social care to the pandemic suggested an initial focus on avoiding the outbreak of the virus in care homes, with first steps being to limit visitors in these contexts and considering ways to isolate residents with symptoms or a confirmed infection. Responses to protect people receiving social care in their homes and schemes to support informal or family carers were less prominent. Limitations: Only publications in the public domain and in local languages of the 13 countries were considered for this analysis. It is possible that further strategies and responses were not made available to the public and are therefore not included, which limits this article's scope for analysis. Implications: The findings of this article can support reflection on the trajectory of policy responses to the threats that SARS-CoV-2 poses to social care. They can thereby potentially inform planning and policy responses for enhanced pandemic preparedness and stronger social care systems in the future.

Background Day centres are a substantial element of community-based support for older people in many countries. However, assumptions that they are an outdated or costly service model have resulted in many centre closures in England. The perspectives of 42 people attending, providing, making referrals to or purchasing places at four diverse day centres for older people were collected in interviews. Using these data, we explore day centres’ relevance to social workers’ efforts to promote person-centred support for older people enabling them to maintain or improve their well-being. These are explored from the perspectives of choice, control and person-centredness and local authority responsibilities for shaping the care market under the Care Act 2014. Findings Attenders highly valued centres’ congregate nature and the continuity they offered which contributed to the development of person-centred relationships. Attenders exercised choice in attending day centres. Social work staff were more positive about day centres’ relevance to personalisation than those responsible for making decisions about the shape of local care services. Applications With social isolation recognised as a serious risk of old age, the value of togetherness in group environments may need highlighting. Enactment of personalisation policies need not necessarily lead to individualisation; day centres may be community-based assets for some. Those shaping the care market may be encouraged to acknowledge wider outcomes, and frontline social workers may benefit from hearing positive experiences that may help in the development of effective care plans for older people who would like to benefit from day centre participation.

ObjectivesTo investigate residents’ and relatives’ views and experiences of handovers in care homes. This paper reports residents’ and relatives’ awareness of handovers, knowledge of and views on handover practices and purpose, and views on handover effectiveness. Outcomes, safety and satisfaction in clinical settings are influenced by shift handovers. Despite this link with quality, residents’ increasing support needs and the provision of 24 hours care in care homes for older people, little is known about handovers in these settings from a resident and visiting relative perspective.SettingFive purposively sampled care homes for older people in South East England.ParticipantsHome managers (n=5), residents (n=16) relatives of residents (n=10) were interviewed; residents (n=15) and their interactions with staff were observed during handover periods. Participation was voluntary and subject to consent. Residents were identified by managers as having mental capacity to take a decision about participation which was then assessed. An ethnographic approach to data collection was taken, preceded by an evidence review.ResultsShift handovers were largely invisible processes to participating residents and relatives, many of whom had given little thought to handover practice, logistics or effectiveness prior to study participation. Their awareness and understanding of handovers, handover practices, and handover purpose and effectiveness varied. There appeared to be an underlying assumption that administrative procedures in care homes would operate without input from residents or relatives. A small number of residents, however, were highly aware of the routine of handovers and the implications of this for the timing of and response to their requests for care or support.ConclusionsThe care home setting and perspectives of the effectiveness of handovers may influence awareness of, knowledge of and levels of interest in involvement in handovers.

BACKGROUND Social prescribing is encouraged to promote well-being, reduce isolation and loneliness. Traditional, generalist day centres for older people could be suggested by social prescribing, but little is known about their clientele or their outcomes. As part of a larger study of the role, outcomes and commissioning of generalist English day centres for older people, the characteristics of attenders at four day centres, their reasons for attendance and outcomes were explored. METHODS This mixed-methods study used qualitative interviews and standardised tools within an embedded multiple-case study design. Semi-structured interviews with older day centre attenders (n=23, 62% of eligible attenders) of four day centres in south-east England, recruited purposively to reflect organisational differences, were analysed. RESULTS Participants reported non-elective withdrawal from socialisation following health or mobility decline, or losses. Apart from living arrangements and marital status, attenders’ profiles differed between centres. Access had been mostly facilitated by others. Day centre attendance enhanced quality of life for this group of socially isolated people with mobility restrictions and at risk of declining independence and wellbeing. The positive impact on attenders' social participation and involvement and on meaningful occupation was significant (p-value <0.001, 99% CI), with an average ASCOT gain score of 0.18. Ten outcome themes were identified. CONCLUSION Outcomes of day centre attendance are those targeted by social care and health policy. Centres were communities that ‘enabled’ and offset loss or isolation, thus supporting ageing in place through wellbeing and contributed something unique to their attenders’ lives. By monitoring attenders’ health and wellbeing and providing practical support, information and facilitating access to other services, centres offered added value. Attendance needs to be set in the context of other social engagement and care provision which may not overlap or duplicate centre support. Professionals may wish to explore the benefits of social prescriptions to day centres but should map local centres’ provision, engage with their organisers, and seek information on attenders, who may differ from those in this study.