Low intensity support services: a systematic literature review (Summary)

Despite some recent policy acknowledgement of the potential role of low intensity support services in assisting people to live independently, community care resources continue to be targeted mainly on high level, often crisis, interventions. Partly because of this continuing focus, there has been little consideration of the evidence of the value of low intensity services. The Centre for Housing Policy, University of York, has now undertaken a systematic research literature review of the effectiveness of such services in enabling people to live independently in ordinary housing. The review found that:

  • Users, across all types of services, consistently reported that services had a positive effect on their lives. In particular, they mentioned improved feelings of well-being and self-esteem.
  • There was a lack of good quality data on services’ effects on housing-related issues (such as the rate of successful tenancies or movements to residential care). However, qualitative research indicated that how a service is delivered (e.g. timing, amount and length of support, attitudes of staff) heightens the likelihood of the tenancy being successful.
  • Research stressed the importance of social support; however, whilst there were evident benefits from one-to-one relationships between workers and users, evidence that services have increased users’ social networks and activities was limited.
  • Few studies looked at how services affected health or the use of more acute services. However, a number of studies demonstrated that low intensity services, such as befriending, could maintain health and/or lead to an improvement in users’ own views of their state of health.
  • The review revealed limitations in existing research, including: poorly developed ways of measuring effectiveness; the small scale of many studies, making general conclusions difficult; a shortage of long-term evaluations; and a lack of control or comparison groups. More use could also be made of qualitative methods.
  • The researcher concludes that developing more robust methods of assessing effectiveness needs to take a higher priority. Service providers could contribute to this by collecting better routine information; incorporating users’ views into the designing of research studies would also give a fuller perspective.
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