Priority 5 from the Social care and support for older people PSP

UNCERTAINTY: How can social care best support older people with complex needs (e.g. people who need support from a range of health and social care services)?  (Priority 5)
Overall ranking 5
JLA question ID 0102/5
Explanatory note Practitioners asked about how best to support people with complex needs to deliver the outcomes these individuals wish for. They also asked how to ensure this care is more fairly commissioned and funded, so that staff can receive extra training and meet the additional support needs of this group of older people 

Sadler E, Potterton V, Anderson R, Khadjesari Z, Sheehan K, Butt F, et al. (2019) Service user, carer and provider perspectives on integrated care for older people with frailty, and factors perceived to facilitate and hinder implementation: A systematic review and narrative synthesis. PLoS ONE 14(5): e0216488.  ~  Gridley, K., Brooks, J. and Glendinning, C. (2014), Good practice in social care for disabled adults and older people with severe and complex needs: evidence from a scoping review. Health Soc Care Community, 22: 234-248. doi:10.1111/hsc.12063 ~ Bunn F, Goodman C, Russell B, Wilson P, Manthorpe J, Rait G, et al. Supporting shared decision-making for older people with multiple health and social care needs: a realist synthesis. Health Serv Deliv Res 2018;6(28) 

Health Research Classification System category Generic health relevance 
Extra information provided by this project
Original uncertainty examples How social care can support adults with more complex needs to meet their personal outcomes. ~ The effectiveness of programmes such as Fullfilled Lives in supporting citizens with dementia to live independently. ~ At present in Domiciliary Care we support some people with very complex needs commissioned by  Health Authorities. These involve a lot of hours spent on setting up the packages, a lot of additional training and more governance once the packages are running and yet in my are the cost at which this care is comissioned at is often lower that the rate whch basic homecare support packages are comissioned at. Could there be some work done on what is a fair price for this care so that we can recognise the increased complexity of this work and reward our staff accordingly. 
Submitted by 3 x practitioners 
Project information
Project unique ID 0102
Project name Setting priorities for social care research in Wales
Total number of uncertainties identified by this project. 35  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 16 & 17 September 2020