Breakthrough 2013 (PDF) - Swansea University

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] College of Human and Health Sciences ] Children and Young People’s Health and Well-Being (CCYPHW) CCYPHW leads rigorous multidisciplinary and interdisciplinary research and evaluation through high quality applied investigations into the stages of human life from birth through to early adulthood. Research within the Centre is focused on four main themes. Children and young people’s health includes issues of obesity, cardiovascular risk factors, diabetes mellitus, metabolic syndrome, inactivity, health promotion, mental health, palliative care, perinatal care, trends and chronic conditions. Children and young people’s well-being includes children in care, child abuse, child neglect, dyslexic children, disabled children, inequalities, play and homelessness. The area of children and young people’s rights covers recognition, promotion and protection of rights. Finally, children, young people and migration encompasses identities, health, asylum seeking and conflict. Centre for Innovative Ageing The Centre for Innovative Ageing (CIA) is Wales’ leading centre for ageing studies. Founded in January 2008, it facilitates collaborations and coordinates research into various aspects of ageing, across the University. The CIA is committed to translating research into practice, making a real impact on society through interaction with policy makers, managers and practitioners. The Centre encourages collaboration between business and academia, with the intention of multiplying the benefits of public and private investment in knowledge. It also provides an exceptional training ground for researchers and postgraduates, attracting the finest students from around the globe, and preparing them for working with older people; managing and delivering services for older people; designing or manufacturing products for an ageing population; or joining the research community. The CIA has a distinctive feel – it houses an energetic group of researchers and academics who are passionate about advancing research and educational missions, yet maintain their critical curiosity, and take a perspective that examines contradictions, values, assumptions and consequences associated with ageing populations. The Centre nurtures innovation, and is a place that dares to be different, unconventional and novel. Although ageing is accompanied by biological changes, the CIA believes that, in order to understand, explain and contextualise ageing, a holistic approach is needed - one that shifts the locus from medicine and the medical model, to one that encompasses a range of disciplines and that views ageing more positively (and not as an abnormal state). It believes that by rejecting disciplinary boundaries and adopting the most appropriate methods for approaching particular research questions, it can help to place Wales at the cutting edge of multidisciplinary research in ageing. “Our strong relationship with the Centre for Innovative Ageing at Swansea University, backed by a three year research agreement, underpins what is widely recognised as a world-leading approach to policy and delivery for older people. ” First Minister Carwyn Jones, Public Services 2025 Conference, February 2012 The Centre provides the infrastructure, focus and leadership for ageing research and scholarship across the College of Human and Health Sciences, as well as Engineering and Medicine. It hosts the Older People and Ageing Research and Development Network, and the Wales Stroke Research Interest Group, and has strong links with Wales Dementias and Neurodegenerative Diseases Research Network (NEURODEM Cymru). The Centre’s current research falls into four broad areas: Civic and social engagement and participation of older people including: intergenerational relationships; social and support networks; civic participation and the disruption of these types of engagement based on personal (e.g. migration, psychological resources) and structural (e.g. multiple disadvantage, discrimination, national or local policies, transport) factors. Environments of ageing including: natural and built physical space; functional design; community; housing; climate change and extreme emergencies caused by natural and human-made events. Care provision for older people including: social care; health care; intermediate care; residential care; palliative and end-of-life care. Chronic conditions, falls and prevention in old age including: falls; stroke; cancer; dementia; depression; and health promotion. This research and the Centre’s teaching are driven by an unashamedly positive view of ageing and older people. Ageing can be a time of opportunity, growth and development. Older people, having retired, may be relatively well-off in terms of disposable income, and there are many more opportunities to engage in enjoyable activities and sought-after lifestyles. The increasingly powerful role of the older person as consumer is now widely recognized. Biological changes do occur in later life, but it is their interaction with other factors that is of most relevance to adaptation, well-being and lifestyle choices. Older people cope actively with and adjust to a whole range of changes and influences – biological, social and psychological. Under Director Professor Vanessa Burholt, members of the Centre have been involved in funded ageing research worth around £7 million over the past three years, and it has secured increased funding from Research Councils and other major funders looking for multidisciplinary collaborations and user involvement. £3.3 million has been awarded from the Economic and Social Research Council (ESRC) and the Higher Education Funding Council for Wales (HEFCW) for a five-year work programme to investigate health, well-being and cognitive function in Wales, with a focus on psychological, social and biological factors such as resilience, bilingualism, nutrition and social networks that may offer protection against, or delay the development of cognitive impairment and dementia. The CIA intends to continue to increase its research turnover, while providing researchers with an intellectually stimulating environment. Outputs from its research provide information at the vanguard of each field and are used to improve the quality of life and promote the welfare of older people. It communicates its research to policy makers, business and industry through a range of channels, including policy fora at which civil servants, Ministers and other Assembly Members are provided with up-to-date, timely and relevant research findings on the ageing population. The CIA is also creating a business network, linking industry to researchers at the forefront of research in their fields, and is developing a series of business breakfasts to engage with employers in new ways. 92 93
] College of Human and Health Sciences ] Supported living environments for older people A programme of research into the acceptability and suitability of supported living environments for older people was initiated at Bangor University in 2000-2002 under the leadership of Professor Vanessa Burholt. It was backed by a grant, Housing for an Ageing Population: Planning Implications (HAPPI), funded by the National Institute for Social Care and Health Research (NISCHR). A publication on research undertaken at Bangor University NISCHR for a project entitled Extracare: meeting the needs of fit or identified the preferences of older people for certain features of frail older people? This research sought to establish whether supported housing and what models of care may meet these Extracare accommodates the changing needs of both fit and frail preferences. Extracare sheltered housing was judged more likely to older people, particularly those with cognitive impairments. It also meet needs in six key domains than either sheltered housing or asked if complex integrated health and social care could be residential care. delivered in Extracare; it sought views of managers and social workers; it queried quality of life and experience of fit and frail older The Welsh Government subsequently pledged £41 million for the people in Extracare schemes, compared to residential and home provision of Extracare housing. Guidelines for Developing Extra care; it questioned Extracare cost effectiveness compared with Care Housing in Wales stated that Extracare schemes should residential and home care, matching residents of similar frailty; and it “take into consideration the likely impairments that residents will evaluated specific policy and practice implications for Wales. experience with increasing age and frailty”. However, the burgeoning provision of Extracare in Wales was not evaluated The research found that Extracare sheltered housing provides for as it was implemented, and it was not clear whether it proportionally fewer frail older people than the other care accommodated the changing needs of both fit and frail environments. It also found evidence that older people with older people. cognitive impairment were systematically excluded from these living environments through assessment and admissions processes Between July 2008 and June 2010 Swansea University’s Professor that consider these settings inappropriate for those ‘who may pose Burholt and Professor Judith Phillips obtained £231,560 from a risk to themselves or others’. It was also revealed that Extracare sheltered housing provided the conditions for increased social interaction which was particularly effective for older widows, although increased interactions did not necessarily lead to high quality and emotionally satisfying social relationships. As a result of the findings, eight recommendations were given for changes in guidelines regarding the development of Extracare provision, and local Registered Social Landlords (RSL) and private landlord practices for the provision of Extracare. These recommendations were supported by the National Partnership Forum for Older People in Wales which advised the Minister with responsibility for Older People to adopt them. During the course of research it became clear that several local authorities were closing local residential care homes and remodelling facilities to provide Extracare sheltered housing for older people. Closure of care homes has high policy relevance because of the impact on the well-being of older people, and potential litigation. Welsh Government guidelines introduced in May 2009 provided an opportunity to examine how care homes are closed and explore the process from the view of various stakeholders. In collaboration with the Older People’s Commissioner (OPC) in Wales, Professors Burholt and Phillips obtained funding from NISCHR to examine the closure of care homes for older people in Wales. Findings identified substantial gaps in local authority protocols and practice employed during care home closures. Researchers drafted new guidance for the Welsh Government entitled: Escalating concerns with, and closures of, care homes providing services for older adults. This comprised two separate documents dealing with escalating concerns, and with the closure of care homes. This wide-reaching research has had, and will continue to have, significant impacts on the organisational activity of Extracare sheltered housing providers, local authorities and policymaking through the adaptation and adoption of amended guidelines. The Older People and Ageing Research and Development Network Cymru organised regional seminars with the Office of the Older People’s Commissioner in Wales for practitioners and policymakers with an interest in supported living environments. Seminars consisted of preliminary findings regarding the closure of residential care facilities in Wales (including remodelling to Extracare), a summary of the findings of the Extracare project, an overview of recommendations, and a presentation on how Extracare facilities could be adapted for older people with mild to moderate cognitive impairment. In 2010 and 2011, Professor Burholt and Dr Paul Nash presented recommendations from the Extracare project in meetings with RSLs (Coastal Housing, Cymorth Cymru), and provided evidence to Gwynedd Housing Review, the South East Wales Improvement Collaborative (SEWIC) and the Commissioner for Older People in Wales. The latter led to collaboration with the Older People’s Commissioner on research on the closure of care homes. Evidence of the influence on RSLs, SEWIC or Gwynedd Housing Review is not yet available. Professor Burholt is the research member on the National Partnership Forum for Older People in Wales and in July 2011 presented the recommendations from the Extracare project to the Forum. Recommendations were accepted by the group and the Minister for Older People (Gwenda Thomas AM) was advised to adopt the recommendations. Knowledge gained from the programme of research is currently being used to inform the private sector, with Professor Phillips advising Garn Goch, and Professor Burholt advising 55 Plus on new build projects. Evidence from the project of care home closures will be presented at a series of OPAN/OPC seminars and will feed into the Social Care Review on Residential Care. Extracare: meeting the needs of fit or frail older people? was led by Professor Vanessa Burholt in collaboration with Professor Judith Phillips. The Swansea University team included members of the Centre for Innovative Ageing (Dr Paul Nash (lead researcher); Dr Shane Doheny; Dr Christine Dobbs; Dr Hannah Marston); the Centre of Social Work and Social Care (Dr Sherrill Evans) and Centre for Health Economics (Professor Ceri Phillips). This team also collaborated with Dr Sinead O’Mahoney (Llandough Hospital, Cardiff). 94 95
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