Dr Kalpa Kharicha is Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s College London. She led the Unit’s Visa Study, the report from which was published in October 2023. (679 words)
Internationally recruited care workers made the biggest contribution to reducing vacancies in frontline adult social care in England during 2022-3; 70,000 people came to the UK to work in a direct social care role. During this time the number of domestic recruits to care work fell. Vacancies in social care are currently at 152,000.
The increase in international care workers follows changes to government immigration policy in recent years. In particular, the addition of ‘Senior care workers’ and ‘Care workers’ to the shortage occupation list (on 27 January 2021 and 15 February 2022, respectively) allows people from other countries to apply for these jobs, with a licensed UK employer and if eligible for a Health and Care Visa.
Recent announcements on immigration policy mean that from early 2024 (exact date to be confirmed at time of writing), Health and Care Visa holders arriving in the UK after that time will no longer be able to bring their dependants with them Health and Care Visa holders who are already in the UK can bring dependants whilst on their current visa.
As part of our recent research to understand the impact of the Health and Care visa system on the adult social care workforce in England, we spoke to 29 internationally recruited care workers and dependants, as well as 22 social care providers, 8 brokerage agencies and 15 sector skills experts, who shared their views and experiences with us. Continue reading
Dr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. This is the second of two blogs on Shared Lives. (1,315 words)
In a previous blog we considered the successful spread of Shared Lives (SLs) schemes as an alternative model of care that seeks to replicate ‘ordinary’ family life for adults with care needs. This model has long enticed national and local policymakers’ attention and SLs schemes are now established in most English local authority (LA) areas. However, it remains a very small model accounting for just 1 per cent of those drawing on local authority funded adult social care and less than 0.5 per cent of the workforce. Furthermore, SLs continues to be used predominantly for the care and support of people with learning disabilities (LD) despite efforts to promote its wider use for a more diverse range of people. This prompted us to investigate the challenges faced by local schemes trying to ‘scale-up’. Continue reading
Dr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. See also the second blog in this series by Dr Purcell. (1,129 words)
Innovation, or doing things differently, is commonly promoted by policymakers as a response to social challenges in the context of increased pressure on public services and stretched resources. Policy announcements on adult social care are testament to this, but we know surprisingly little about how innovations emerge and are developed, sustained, and spread. The Supporting Adult Social Care Innovation (SASCI) project – an ESRC funded study investigating innovation in adult social care in England – was set up to address this. The spread of Shared Lives (SLs) schemes across England has provided an intriguing case study. Continue reading
Ed Addison and Nathan Rosier
This blog is the third in a series of three by The People’s Recovery Project (TPRP), a charity building sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the HSCWRU Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to facilitate an event at King’s.
This blog by TPRP co-founders Ed Addison and Nathan Rosier shares final messages from this event on re-thinking approaches to supporting people to move on from multiple exclusion homelessness (MEH), with a focus on building new communities.
Blog 3: A peer-led community – improving routes into residential treatment
As we continue to develop The People’s Recovery Project (TPRP) we emphasise the importance of a peer-led community in guiding and supporting our approach. In the previous blog in this series we heard from Danny, an active TPRP community member, about his experience of street homelessness, residential treatment and recovery from addiction. Danny’s story is an example of how getting the opportunity to access residential rehabilitation can contribute to individuals making huge and positive life changes. Despite the many obstacles faced by our community members experiencing MEH, Danny is not the only one who has managed to embark on a journey of recovery. Through building a peer-led community in recovery from homelessness and addiction, we are striving to create the conditions that will allow members to use their own experiences to demonstrate to those living on the streets that a permanent recovery from street homelessness is possible. Continue reading
This month sees the start of a new study at the NIHR Health and Social Care Workforce Research Unit, King’s College London. Over the next two and a half years researchers will work with people with experience of homelessness and professionals who work with them to examine mental capacity assessments and multiple exclusion homelessness in England. Stephen Martineau, Research Fellow at the Unit, introduces the study, which is funded by the NIHR Health and Social Care Delivery Research (HSDR) Programme.
At the Unit this month we are starting a study, ‘Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England’. The co-Principal Investigators are Kritika Samsi (KCL) and Michelle Cornes (Salford & KCL), with the main researchers being Jess Harris (KCL) and Stephen Martineau (KCL). The lived-experience Advisory Group (PPIE) is led by Stan Burridge, who, as a member of the research team, will also be carrying out interviews with people experiencing homelessness. The other research team members are: Alex Ruck Keene KC (Hon), KCL and 39 Essex Chambers; Nathan Davies, UCL; Alex Bax, Pathway; Sam Dorney-Smith, Pathway.
After an evidence review, interviews with national experts and a national practitioner survey, we will focus on three contrasting sites in England – interviewing people with experience of homelessness and a range of professionals engaged in their support and care. Finally, informed by our findings, we plan to bring together stakeholders and, in consensus, revise a pre-existing capacity assessment Tools and Guidance document for practitioners working with people experiencing homelessness.
About a decade ago in the London Borough of Lambeth, a review into the death of a 63-year-old man who had been sleeping on the streets recommended work on ‘understanding how the Mental Capacity Act (2005) [MCA] can be used to safeguard people in this context.’* One consequence came in the form of a pioneering Tools and Guidance document – now in its third edition (2017) – that places the MCA in context with the Mental Health Act 1983 (MHA), risk assessment, adult safeguarding and hospital admission procedures, all calibrated for those working with people who are street sleeping. Continue reading
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. She reports from a recent webinar, the latest in the Unit’s Homelessness series. (920 words)
The webinar, attended by over 200 people, presented emerging findings from an innovative study ‘Addressing Homelessness in Social Work Education’, conducted by Jess Harris and Karl Mason and funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research (SSCR).
The study delved deeper into an aspect of a previous study on Safeguarding responses to homelessness and self-neglect, which examined why social workers, including those in safeguarding roles, may be inadequately prepared for working with people experiencing homelessness. The study is also connected to a previous webinar on a study on the ‘Homelessness Social Worker Role’ which explored the experiences and support needs of specialist homelessness social workers, as well as the systemic barriers they face. This earlier webinar revealed that many social workers reported limited exposure to homelessness-related topics during their qualifying courses and uncertainty about their role in this area. Continue reading
Lucy Jacobs is a Senior Social worker with London Borough of Bromley Adult Social Care currently undertaking a Pre-Doctoral Local Authority Fellowship in the NIHR Health & Social Care Workforce Research Unit, King’s College London. (1192 words)
I was delighted to have been selected as one of the Local Authority Presenters to speak at the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North Thames (NIHR ARC North Thames) event held on the 18 May 2023 entitled ‘Mind the Gap: London Boroughs’ ideas for adult social care research’. The event was split across a morning and afternoon session. It was hosted by the Care Policy Evaluation Centre. Co-organisers, alongside the NIHR ARC North Thames, were made up of the following: the NIHR ARC South London, the NIHR ARC North West London, the CRN North West London and the NIHR School for Social Care Research.
I felt honoured and nervous (in equal measures) to have been given the opportunity to present my topic in the morning session. Dr Sarah Jasim from the Care Policy Evaluation Centre opened the event on behalf of the organising team and introduced the ‘World Café’ session format. The three local authority thought leaders (which included my humble self) would briefly introduce our local topics of interest and stay at our tables where attendees would subsequently rotate between the discussion tables every 30 minutes. I had never been a presenter in a ‘speed dating’ (or 30-minute speed date if you like) styled event prior to this, so it was quite exciting for me as an early researcher. Needless to say I thoroughly enjoyed it. Continue reading
This blog is the second 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. This blog by TPRP co-founders Ed Addison and Nathan Rosier shares further messages from this event and focuses on ‘lived experience’.
The People’s Recovery Project event at HSCWRU brought together individuals from across the homelessness and substance misuse sectors, and within the group were many people with both expertise and lived experience. From the foundation of TPRP, at the core of development has been the involvement of people with lived experience of both homelessness and substance use. At the event we heard from community member Danny who has been supporting the development of the charity over the past year, and who spoke of his personal lived experience of addiction and of being on the streets:
I was homeless in Westminster for about 20 years. In this time, I was in and out of homelessness services, police custody and incarcerated in prison on a number of occasions. I never wanted to go to rehab and did not see this as an option. The first time I went was due to a drug rehabilitation requirement issued by the court, and it was a way of getting me out of prison. I was not ready for rehab at this point.
When you are accessing different homelessness services, such as hostels and day centres, it is really difficult to access rehab: you have to jump through so many hoops. It felt like there was always a constant block and if it was not the limitations of one service it was due to the requirement of another organisation, or legislation that says you have to have a local connection, live in the right catchment area, or meet a certain criteria. Continue reading
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. (701 words)
Over 280 participants joined Ben Scher, a PhD candidate in Social Intervention and Policy Evaluation at the University of Oxford and outreach worker at St. Mungo’s, for the latest webinar of the HSCWRU Homelessness series on how low-barrier drug interventions can reach people experiencing homelessness and drug-related harms. Presenting findings of his doctoral project, which compares the lived experience of street-based drug dependency based on people’s access to low-barrier overdose prevention centres (OPC) across sites in Vancouver (Canada), Birmingham (UK), and Athens (Greece), he provided ethnographic evidence on the effectiveness and feasibility of implementing OPCs.
OPCs are “safer consumption spaces” where drug consumption is monitored by medically-trained professionals. Substantial observational evidence across the 15 countries currently operating OPCs has demonstrated how these centres can be successful in preventing fatal overdoses, reducing risk of blood borne diseases, and increasing safer injecting practices and engagement with substance treatment services. Continue reading
This 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