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Does Smaller mean Better? Evaluating Micro-Enterprises in Adult Social Care

越小就意味着越好吗？

基本信息

批准号：
ES/K002317/1
负责人：
Catherine Needham
金额：
$ 45.56万
依托单位：
University of Birmingham
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2013
资助国家：
英国
起止时间：
2013 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FK002317%2F1
关键词：
Does Smaller mean Better Evaluating

项目摘要

Are care services best delivered through very small, locally-based services that are 'close to the user' or do large organisations offer more efficient and effective care? As care for older and disabled people in England is becoming more personalised and deregulated, it is important to move beyond the anecdotal claims about small, innovative micro-enterprises and establish an evidence base. The government's Big Society and personalisation agendas are encouraging more very small organisations to get involved in supporting older people and people with disabilities. Within social care, personalisation has led to more people being given control over their own care budget, with the freedom to purchase support from lots of different types of service provider. Micro-enterprises are one of the types of organisation that people can purchase support from. Buying support might mean purchasing domiciliary care (someone to come to the house to provide help with dressing and washing) or paying to attend a day centre. However, it might mean purchasing something very different. One micro-enterprise provides dance classes, for example. It might also involve purchasing something which is better suited to your care choices as a person from an ethnic minority, or as someone who is lesbian, gay, bisexual or transgender. There is often an assumption that 'smaller is better', because small organisations may be more flexible and innovative. However it is also possible to argue that larger organisations will perform better because they can use economies of scale and deploy a wider range of resources. Existing studies of size and performance do not usually include very small organisations like micro-enterprises, making it hard to draw conclusions about the link between size and performance. Using interviews and surveys with 108 service users and carers in 27 case study organisations, across three local authorities, this research will compare outcomes and value for money across micro, small, medium and large care providers (defined by the number of staff working in them). It will:- Use interviews to talk to service users and carers about their experience of using the service- Use a survey to get comparable data between service users across the case study organisations, and compare that to findings in the national Adult Social Care Survey conducted each year by the Association of Directors of Adult Social Services (ADASS) on behalf of the Department of Health. - Involve some 'non-traditional' service users - black and ethnic minority people; lesbian, gay, bisexual and transgender people - to assess how far micro-enterprises are better than larger organisations at providing tailored support. - Compare the prices charged for services in the case study organisations with the outcomes reported by users to see how far organisations are delivering value for money. Talking to users is likely to be particularly effective when other service users do the interviews. This is because interviewees may be more comfortable speaking to other service users and the user-interviewers can design interview questions that get to key issues from their own experiences. The project will recruit and train service users and carers as co-researchers, involved in research design, interviewing, data analysis and dissemination of findings. The project aims to produce findings that are of direct relevance to local authorities, service users and other organisations as they commission care services, and to social entrepreneurs as they develop provision. It also aims to deepen social scientific knowledge of the relationship between organisational size and performance in welfare services, of relevance to academics working in fields such as social policy and public management.

护理服务是通过非常小的、靠近用户的本地服务提供最好的，还是大型组织提供更有效率和效果的护理？随着英国对老年人和残疾人的护理变得更加个人化和放松监管，重要的是超越关于小型创新微型企业的坊间说法，建立一个证据基础。政府的大社会和个性化议程正在鼓励更多非常小的组织参与到支持老年人和残疾人的工作中来。在社会护理领域，个性化导致更多的人可以控制自己的护理预算，可以自由地从许多不同类型的服务提供商那里购买支持。微型企业是人们可以购买支持的组织类型之一。购买支持可能意味着购买居家护理(有人来家里帮助穿衣和洗衣)或付费参加日托中心。然而，这可能意味着购买一些非常不同的东西。例如，一家微型企业提供舞蹈课程。它还可能涉及购买更适合你作为少数民族，或者作为女同性恋、男同性恋、双性恋或变性人的护理选择的东西。人们经常认为“越小越好”，因为小型组织可能更灵活、更具创新性。然而，也有可能辩称，规模较大的组织会表现得更好，因为它们可以利用规模经济，部署更广泛的资源。现有的关于规模和绩效的研究通常不包括微型企业等非常小的组织，因此很难就规模和绩效之间的联系得出结论。通过对三个地方当局的27个案例研究机构的108名服务使用者和护理人员的访谈和调查，这项研究将比较微型、小型、中型和大型护理提供者(由在其中工作的人员数量定义)的结果和物有所值。它将：-通过访谈与服务使用者和照顾者交谈他们使用这项服务的经验-通过一项调查，在整个案例研究组织中获得服务使用者之间的可比数据，并将其与成人社会服务主任协会(ADASS)代表卫生部每年进行的全国成人社会关怀调查的结果进行比较。-让一些非传统的服务用户--黑人和少数民族；女同性恋者、男同性恋者、双性恋者和变性者--参与，以评估微型企业在提供量身定制的支持方面比大组织强多少。-将案例研究组织中的服务收费与用户报告的结果进行比较，以了解组织在多大程度上实现了物有所值。当其他服务用户进行采访时，与用户交谈可能会特别有效。这是因为受访者与其他服务用户交谈可能会更自在，而用户面试官可以根据自己的经验设计面试问题，触及关键问题。该项目将招募和培训服务使用者和护理者作为共同研究人员，参与研究设计、访谈、数据分析和研究结果的传播。该项目旨在产生与地方当局、服务用户和其他组织委托提供护理服务时直接相关的调查结果，以及与社会企业家制定提供服务时直接相关的调查结果。它还旨在加深对组织规模与福利服务绩效之间关系的社会科学知识，对从事社会政策和公共管理等领域的学者具有相关性。