Improving routes into sustained recovery for people experiencing street homelessness: introducing The People’s Recovery Project

Ed Addison and Nathan RosierThis blog is the first in a series of three by The People’s Recovery Project (TPRP), a charity that aims to build sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the NIHR SSCR funded Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to host an event at King’s with invited stakeholders. This was an opportunity to share ideas with a wide spectrum of perspectives from across the homelessness and substance misuse sectors, including safeguarding, commissioners, health, mental health, grassroots organisations, experts by experience and researchers. This blog by co-founders Ed Addison (left) and Nathan Rosier highlights messages from the 2023 event and introduces TPRP’s work. Continue reading

Tracing the significance of executive functioning among people experiencing homelessness

Carolin Hess is a PhD student in the NIHR Policy Research Unit in Health and Social Care Workforce who has been awarded Doctoral funding from the NIHR School for Social Care Research, commencing February 2023. (896 words)

Carolin Hess

In the latest webinar in the HSCWRU Homelessness series, 225 participants joined Ellie Atkins, a senior social worker and Safeguarding lead, for a presentation which asked, What does research and expert practice tell us about the importance of executive functioning assessments? The topic builds on themes from last month’s webinar, exploring mechanisms of agency and choice, and how self-neglect among homeless populations can be addressed by strengthening safeguarding responses.

The presentation opened with the question of why the Everyone In Initiative, a £3.2 million emergency fund set up during the COVID-19 pandemic to house people in the UK who were rough sleeping, did not end rough sleeping for all individuals. The scheme was widely hailed as a success, with organisations praising the unprecedented effort and rapid response to homelessness through increased partnership working and communication, which supported over 30,000 people into accessing accommodation. Continue reading

Agency and choice in multiple exclusion homelessness

Carolin Hess is a PhD student at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (583 words)

Carolin HessAs part of the NIHR Policy Research Unit in Health and Social Care Workforce Homelessness Series, Research Fellow at the Unit, Jess Harris, and Stan Burridge (public contributor) recently presented ‘lived experience’ perspectives from the emerging findings of an NIHR School for Social Care Research funded national study of homelessness, self-neglect, and safeguarding. The event, held on 25 April, was attended by over 180 people.

In light of a recent report that revealed that 1313 people died while homeless (including people sleeping rough, in emergency or other insecure settings) in the UK during 2022, an 85% increase on the number recorded in 2019, the research could not be more timely.

Bringing together the voices of multi-disciplinary practitioners and people with lived experience, the study findings highlight the complexities of safeguarding but also offer suggestions on how to strengthen safeguarding responses and more effectively support people who face multiple exclusion homelessness (MEH). Continue reading

What’s New? LGBTQ+ in Social Work Practice Education, Placements, and the Assessed Supported Year in Employment

Victoria Grimwood is a Pre-Doctoral Local Authority Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (304 words)

Victoria Grimwood

Victoria Grimwood

In the recently published Social work in England: State of the nation 2023 report Social Work England, the regulatory body of social work in England, announced an intention to increase the focus on equality, diversity and inclusion, and a commitment to the development of improved standards in education and training for the profession. As many in social work have observed, the social work profession is more diverse than the general population in England in relation to ethnicity, gender identity and sexual orientation.

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What happens in English generalist day centres for older people? Findings from case study research

Katharine Orellana is Research Fellow and Jill Manthorpe is Director at the NIHR Policy Research Unit in Health and Social Care Workforce at King’s. (420 words)

Cover of a research report with a photo of two people conversingA new report aims to improve the understanding of day centre services for older people among social care and health professionals and potential collaborators.

The Covid-19 pandemic led to a greater appreciation of everyone’s need for in-person, face-to-face contact and the difficulties facing some older people when they could no longer meet other people in their day centre when these closed temporarily. Now is the time for professionals to re-examine the value and broader use of these services, and their buildings and activities. Rather than continue to view day centres to be resource-heavy or expensive services, the focus could shift to what they do, and could offer – to individuals, their staff and volunteers, the social care sector, the wider community, local councils, the NHS, and the education sector.  They have great potential to make preventive and early intervention approaches promoted by policy a local reality.

This report provides a rich, pre-Covid pandemic account of four very different English day centres for older people. It sets out their main characteristics, aims, approach, locality, interiors, formal and informal care provided, opening hours, available ‘extras’, charges made to attenders and, finally, ‘typical days’ at each. Continue reading

COVID-19’s Third Anniversary: Their Story of Wellbeing and Coping from the Health and Social Care Workforce

The Health and Social Care Workforce Wellbeing and Coping Study has published its Phase 6 Report and Executive Summary. Researchers found the workforce faces continuing substantial pressure, staff shortages and is finding it difficult to cope. In this post, we summarise our findings.

Prof Jill Manthorpe, Director of the NIHR Policy Research Unit in Health and Social Care Workforce at King’s, is a co-investigator on this collaborative research project, involving also researchers from Queen’s University Belfast and Bath Spa University. The study is led from Ulster University (Dr Paula McFadden is Principal Investigator).(1604 words)

Report coverThe 6th Phase of this UK-wide multi-disciplinary study explored the impact of providing health and social care in the post-pandemic era from November 2022 until January 2023. The analysis builds upon the findings from five earlier Phases, beginning during May 2020 following the first wave of the COVID-19 pandemic in the UK. We received 14,400 survey responses from social workers, social care workers, nurses, midwives, and allied health professionals. We conducted 18 focus groups with frontline workers, managers, and Human Resource professionals.

The study provides a unique opportunity to gain in-depth understanding of how the pre- and post-pandemic times have impacted on health and social care workers’ working life, as well as effects on their own health and well-being. Our Phase 6 report presents survey findings collected over the six-months from the end of 2022 and up to early 2023. They reflect a difficult time of unprecedented industrial action in the NHS and continuing pressures on health and social care services. During this Phase, life was returning to pre-pandemic norms for most people in society, there were few remaining public restrictions, the use of face masks had generally ceased, although still being recommended in health and social care encounters and settings. Health and social care services were therefore adapting themselves to a post-pandemic time at the same time as still caring directly for people with illnesses related to Covid-19, and delays in seeking healthcare. Other impacts of the pandemic have placed increasing pressures on health and care services, such as sickness absences, staff vacancies, and retention problems, with mental health problems and new conditions such as ‘Long-Covid’, now affecting workforce stability.

Multiple workplace factors are described as a ‘vicious cycle’. For example, increased job-related pressures, exacerbated by staffing shortages and vacancies (increased use of agency or locum staff) add to job stress and this affects staff’s mental health and well-being. Some respondents indicate lasting or new depression and anxiety, or long-standing distress or trauma because of working through the pandemic. While the survey found many staff had made use of employer’s support services, not everyone sees them as accessible or helpful. Investment is still needed here; the report’s authors recommend. Continue reading

Supporting people who identify as LGBTQ+

Victoria Grimwood

Victoria Grimwood

Victoria Grimwood is a Pre-Doctoral Local Authority Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (448 words)

Skills for Care, the strategic workforce development and planning body for adult social care in England, has undertaken to support key equality, diversity and inclusion priorities in the social care workforce. The organisation has been reaching out to those seeking equity change to ensure that the workforce is empowered to work alongside all those who draw on services in a person-centred way that focuses on what matters to them, and acknowledges their identities.

On 22 February, during LGBT+ History Month, Skills for Care hosted a well-attended virtual launch of its new learning framework for knowledge, skills and values for working affirmatively with LGBTQ+ people in later life.

The development of the framework was led by Professor Trish Hafford-Letchfield from the University of Strathclyde and Lawrence Roberts, the Pride in Ageing manager for the LGBT Foundation, a national charity delivering advice, support and information services to LGBT communities. Continue reading

Going into the Care Closet?

Dr Cat Forward is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (420 words)

As part of LGBTQ+ History Month, Lambeth Libraries hosted an event organised by Lambeth Links, talking about the issues surrounding the needs of LGBTQ+ individuals in later life. A panel chaired by Robbie de Santos (Stonewall, Director of Communications and External Affairs) shared their experiences of contact with the health and care system.

Ted Brown has been an active member of GLF (Gay Liberation Front) since 1970. He is currently campaigning against LGBTQI+ elder abuse following the experiences of his partner in residential care. He shared the experiences they had following Noel’s diagnosis of dementia and his subsequent interactions with health and social care services. Ted spoke of the advice they were given to ‘de-gay’ their house prior to care staff’s arrival to minimise any potential homophobia, and of the lack of staff awareness of issues relating to LGBTQ+ couples. He is continuing to raise awareness of issues such as these and spoke of wanting to work with local organisations to improve staff training and awareness. Continue reading

Working with fathers to protect vulnerable babies from harm

Dr Mary Baginsky,Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce. (414 words)

Dr Mary Baginsky

Dr Mary Baginsky

The Child Safeguarding Practice Review Panel’s report The Myth of Invisible Men: Safeguarding children under 1 from non-accidental injury caused by male carers, published in late 2021, examined safeguarding of children under the age of one year from non-accidental injury caused by male carers.  In summary, the data showed that men are more likely to be perpetrators of physical abuse and harm to babies than women. It indicates that birth fathers are much more likely to be the perpetrator than other male figures. Importantly, whilst just over 50 per cent of families were involved with local authority children’s services (either through early help services or children’s social care), this means nearly 50 per cent of the cases considered as part of the review were only ever known to universal services. Continue reading

‘Opening the door’ to employment in healthcare: People with lived experience of homelessness

Cover of a reportThe NIHR Policy Research Unit in Health and Social Care Workforce has published an evaluation of an access to employment programme in the NHS targeted at those with lived experience of homelessness. The pilot programme involved the homelessness charities Pathway and Groundswell and five NHS Trusts in England. Report author, Ian Kessler, here outlines the programme and the main findings of his evaluation.

Ian Kessler is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. He is also Professor of Public Policy and Management at King’s Business School. (1,016 words)

Widening participation in the healthcare workforce has long been an important policy objective in the NHS. This has been reflected in an equalities, diversity, and inclusion agenda traditionally centring on gender and race, and more recently on young people with disabilities with the introduction of supported employment programmes by NHS Trusts, such as Project Search and Choice. However, the pursuit of widening participation is a rich policy space, connecting to an increasing range of workforce and broader service priorities.

Framed as ‘anchor institutions’, playing a key role as local employers, NHS Trusts have been encouraged to develop workforces which reflect, in socio-economic and demographic terms, the communities they serve. This role overlaps with moves to bring into the NHS workforce people with lived experience of various health conditions as a means of delivering patient-centred services and more effectively addressing health inequalities. Such moves have been especially evident in the introduction of the peer support worker role in mental health (which our Unit evaluated many years ago). More prosaically, but perhaps most pressing, the search for workforce diversity and inclusion addresses the recruitment and retention challenges faced by healthcare employers, with those at the margins of employment representing a new and reliable source of labour. Continue reading