An MCA roundtable

Posted on December 2, 2025 by Stephen Martineau

Stephen Martineau reports from a gathering held at Melbourne House, King’s College London on 26 September 2025. (1884 words)

Introduction

The Mental Capacity Act 2005 and homelessness study is an ongoing examination of the mental capacity assessment of people in England who are homeless and who have experienced other forms of disadvantage. The research team have conducted a national practitioner survey (674 responses) and interviews with experts (n=13). The core of the study has involved interviews in three local authority sites with people with lived experience (n=32) and with practitioners (n=46). Together with expert collaborators, we are developing practice guidance. The project ends in March 2026.

Mid-way through the analysis of the site interviews we invited a group of experts in the field of mental capacity, homelessness – or both – to discuss some of the emerging findings. In particular, we asked this roundtable to think about the ‘diagnostic’ or ‘impairment’ part of the definition of incapacity in section 2(1) of the Mental Capacity Act 2005 (MCA). We met to do this at Melbourne House, King’s College London on 26 September 2025.

We are hugely grateful to those people who came along for this half-day event. In addition to thinking about the place of substance use, executive dysfunction and trauma in these assessments, participants also considered when MCA assessments may be misused, or where the Act may be the inappropriate ‘prism’ through which to decide practice approaches. The purpose in this blog post is to summarise the observations that were made during the roundtable – hopefully not, in the act of synthesis, doing damage to the particular points being expressed. It is worth stressing that the following is not a ‘consensus statement’ and, although we list the participants at the end of the post, we all contributed on the understanding that none of the views recorded in any subsequent publication, including this one, would be attributed to any individual who took part. Continue reading →

New research shows how better pay and training could rescue social care in England

Posted on November 15, 2025 by Stephen Martineau

Republished from the LSE Business Review Blog (12 October 2025).

Low pay, job insecurity and post-Brexit recruitment challenges are plaguing the adult social care sector in England. With rising demand and chronic underfunding, work conditions are only getting worse. Andreas Georgiadis and Andreas Kornelakis suggest ways to improve the situation, including better pay and training.

Adult social care suffers from a long-standing “workforce crisis” in England. Recent reports from industry bodies highlight the challenges to the sector’s workers and their ability to offer high quality care. Staff in social and health care are overworked, exhausted and stressed, sometimes to the point of becoming ill, leading to absenteeism or quitting altogether.

Increased workloads and time pressures arise partly due to increased demand for services by a rapidly ageing population. At the same time, over half of adult care providers said they faced challenges recruiting new staff; 31 per cent struggled to retain employees. Difficulties in recruitment and retention intensified after Brexit, as the sector relied heavily on migrant workers.

It is widely known that adult care is one of the lowest paying jobs in the UK. Forty-three per cent of all adult social care workers in England are paid below the real living wage. It will continue to be challenging for care providers to retain pay differentials between those on the wage floor and those with more experience and qualifications. But pay levels are not the only challenge for care workers, as they also face problems of job insecurity and unpaid overtime.

For example, most of those who do home visits are not compensated for the time they spend travelling to homes, which can make up to a fifth of their working day. The use of contingent contracts in social care may deliver some cost savings for providers, but has the drawbacks of job insecurity for workers, and concerns about service quality. Continue reading →

The important role of homecare workers in dementia palliative care and interventions to support them

Posted on September 26, 2025 by Stephen Martineau

Fatima Mujtabah, right, recently graduated from King’s College London in Adult Nursing. (797 words)

Dementia Palliative Care and Homecare Workers

Dementia is a term used to describe a range of conditions affecting the brain that get worse over time. With no cure, dementia is a life-limiting condition, but few people recognise this. As such, the care needs of people affected by dementia are not always met. It is reported that around 90,000 of people diagnosed with dementia require formal social care and about 2/3 of this population live and die at home. This highlights the importance of homecare in the provision of high-quality palliative and end of life care. Yet, current research shows that people with dementia who live at home are more likely to receive poorer quality end-of-life care compared to those in formal care settings such as care homes. Homecare workers have a central role in allowing people to die within their own homes. Continue reading →

At HSR 2025: On new roles in UK health and social care

Posted on August 1, 2025 by Stephen Martineau

Dr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. Antonina brought together contributions for this blog from the other presenters at this Health Services Research conference session in Newcastle. (773 words)

One of the core functions of conferences is to allow colleagues to present and discuss work in progress. Here we share the results of a fruitful session where colleagues researching the introduction of new roles in health and social care saw many important parallels that will help them in developing and sharpening their analysis.

On the 2 and 3 July 2025 Newcastle University hosted the 18^th annual Health Services Research conference. It featured nine thematic streams including Person Centred Care, Workforce, Digital, Social Care and Health Inequalities. Delegates had an opportunity to attend research discussions and Pecha Kucha sessions (short form presentations), workshops (e.g., ‘How do we know if HSR impacts on Policy?’ led by Unit Director Professor Annette Boaz), plenary sessions (e.g., ‘The 2030 workforce: how will innovative research deliver impact’?), meet ups (e.g., for Early career researchers) and to view research posters.

One of the research discussion sessions in the Workforce stream featured four presentations related to various new roles being developed in UK health and care services. Unit researcher Dr Antonina Semkina presented on the ‘New Roles in Health and Social Care: What is the nature of new care coordinator roles?’ project that she is conducting as part of the Health and Social Care Workforce Policy Research Unit programme of work. The research project, developed in collaboration with the Unit Public Contributors Involvement and Engagement group, focuses on what kinds of new care co-ordinator roles are being created, what tasks are delegated to them and the implications for various stakeholders (e.g., colleagues’ workload). Continue reading →

The role of relationships when women navigate experiences of homelessness and violence

Posted on July 15, 2025 by Stephen Martineau

Carolin Hess in Rabat

PhD student at King’s, Carolin Hess, reports from the International Sociological Association Forum.

I am grateful to have received a SSPP PGR grant to attend the ISA (International Sociological Association) Forum in Rabat, Morocco (6.-11^th of July 2025).

With over 4,000 presenters from over 100 countries, and a (multilingual) schedule running from 9am to 8pm over five days, the conference offered a great overview of current debates in sociology and an excellent environment for connections. I attended presentations and met other scholars working on (women’s) homelessness, healthcare access and social policy in the UK and internationally. Some interesting conversations following these sessions sparked ideas for future research and potential collaborations. Being in Rabat and having some time in the evenings to drink mint tea together and explore the medina (old city) and local food, added to the experience.

At the forum, I also had the opportunity to present findings from my doctoral research project on “the role of relationships when women navigate experiences of homelessness and violence”. I presented in a session on Bodies, (trans) Genders and Violences, alongside researchers exploring the materiality of the gaze, conceptualization of violence, and experiences of (trans) bodies. With about 15-20 people attending the session, the subsequent discussion provided some helpful new perspectives on gender and performativity.

I would like to thank the SSPP, as well as my NIHR doctoral fellowship for their financial support to attend the conference and to make it possible for me to travel overland from London via Paris and Madrid. While a slower, and often more expensive way to travel, taking train, bus, and ferry felt like a more memorable and sustainable choice, allowing me to appreciate the distance (and providing ample of time to get some work done along the way!).

Carolin Hess is a PhD student at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s.

Dementia Community Research Network Annual Community Engagement Event!

Posted on June 1, 2025 by Stephen Martineau

Geeti Kabra reports from the event

The Dementia Community Research Network (DCRN) is a growing network of researchers, public contributors, and community-based dementia support services working together to improve dementia care and research in South London. The DCRN aims to make dementia research more inclusive, accessible, and relevant to diverse communities.

With thanks to generous funding from the NIHR, as a part of the National Festival for Applied Dementia Research, the DCRN hosted its second community engagement event on Monday, 19 May. In line with our goal of community engagement, we chose a venue in the heart of South London, Stanstead Lodge, a charity for people over the age of 50. The aim of the event was to bring together people affected by dementia, local service providers, and academic researchers, in an effort to facilitate exchange of information.

This year, we were pleased to welcome over 80 people, including those affected by dementia, carers, members of the public interested in dementia charities and care partners. We were proud to host stalls from our community partners, including Age UK, Arts for Dementia, Home Instead and Butterfly Café, Join Dementia Research, and Two Mindful Bees. Researchers from King’s College London and Queen Mary University of London also showcased their work at stalls including stalls from the Cicely Saunders Institute and its Public Involvement Forum, the Health and Social Care Research Workforce Unit, and the CARE Network. We welcomed some new organisations this year, including Imago, supporting unpaid carers, and Age Exchange, hosting social activity reminiscence arts groups for people living with dementia and their carers.

People at a gathering Continue reading →

In recognition of the contribution of older people’s day centres to preventive agendas

Posted on May 15, 2025 by Stephen Martineau

Katharine Orellana

Katharine Orellana, Research Fellow at the Health and Social Care Workforce Research Unit at King’s, introduces a new article she co-authored with Kritika Samsi, Senior Research Fellow at the Unit: Older people’s day centres’ preventive work: views of day centre providers and their stakeholders. (576 words)

We asked older people’s day centre stakeholders and others working in health and social care about their views on day centres’ preventive function. Our findings, published in the International Journal of Qualitative Studies on Health and Wellbeing, highlight how work undertaken in day centres falls under the radar as a systemic contribution to the prevention agenda within health and social care.

Despite repeated government focus on growing community health and care services and current preventive efforts aiming to reduce pressure on the NHS and to move more care into the community, there has been a failure to invest in day centres.

Our research aimed to further understandings of how day centres can contribute to health and social care’s preventive agenda. We identified perceived strengths and opportunities at all three levels of prevention: primary (prevent), secondary (reduce) and tertiary (maintain). There were also systemic opportunities, such as day centres being in a position to capture and use evidence, and more joined-up working. Continue reading →

Widening Participation and Apprenticeships in health and social care: Report and Call for Research Participants

Posted on May 9, 2025 by Stephen Martineau

Cat Forward reports from a roundtable event held by the NIHR Policy Research Unit in Health and Social Care Workforce as part of two studies in its current programme of work – on Widening Participation and Apprenticeships. If your NHS Trust or Integrated Care System is interested in taking part in these studies, do get in touch with catherine.forward@kcl.ac.uk. (414 words)

As part of its core programme of work, the Unit hosted a hybrid roundtable event on 2^nd April 2025 with 88 online and in-person attendees from NHS trusts, NHS-England, local authorities, academia, public representative bodies and the charity sector. The event titled “Refreshing approaches to Widening Participation and Apprenticeships: The New Agenda?” sought to facilitate discussion about existing Unit work, to share current and best practice in Integrated Care Systems and Trusts, as well as discussing directions future research might take. Continue reading →

Health & Social Care Workforce:

Welcome to the blog of the NIHR Policy Research Unit in Health and Social Care Workforce at King's College London