Caroline Norrie (left) and Michelle Cornes are, respectively, Research Fellow and Senior Research Fellow at the Social Care Workforce Research Unit. (666 words)
A Transformative Research Fund grant has been awarded to researchers from the Social Care Workforce Research Unit (SCWRU) at King’s College London to pilot an educational drama initiative in a care home in Cumbria. Care home staff, multi-agency colleagues (such as GPs and physiotherapists) and residents will hopefully volunteer to take part in a drama called Let’s Talk, which is designed to stimulate discussion about working relationships. As well as piloting the drama, three interprofessional, reflective ‘Community of Practice’ (CoP) meetings will be held which will act as a forum to discuss care home practices and ideas for change.
Let’s Talk originated in the USA (Gordon, 2014) and was adapted for the UK social care context by a social enterprise organisation, Dignity in Dementia. Let’s Talk uses role play, workshop discussions and a range of other tools to challenge the traditional hierarchies played out in social care (known to impact adversely on quality and safety). Role play situations will be devised for volunteers, for example a care worker will be asked to play the role of the GP and vice versa; or a local authority commissioner will be asked to play the role of a care home resident. The advantage of using this approach is that it dramatizes potentially difficult and also ‘abstract issues’ and allows people to discuss them hypothetically without blaming colleagues.
This type of study falls into the ‘action research’ methodological tradition. Researchers work alongside participants in a CoP with the aim of bringing about change and those same researchers describe this process. CoPs were originally proposed by Wenger (1998) to describe groups of people who share a concern, a set of problems, or a passion about a topic and who want to deepen their knowledge and expertise by interacting on an ongoing basis.
Unusually, the funding for this pilot is related to another project. Professor Nik Rose from the Department of Social Science, Health and Medicine at King’s, was recently awarded a large ESRC grant, which came with the stipulation that £50,000 of it should be used to establish and fund a Transformative Research Fellowship Scheme for interdisciplinary research in the social sciences. This fund is being managed by the Policy Institute at King’s. The Let’s Talk pilot is one of four projects that have been funded by the Transformative Research Fellowship Scheme.
The difficulties care homes face, such as problems recruiting staff and reductions in council funding, are seldom out of the news. Care home managers are sometimes viewed as being task-focused, concerned with contracts and running a business rather than about care practice and relationships. The Francis report into the abuse and neglect at the Mid Staffordshire NHS Foundation Trust highlighted problems of safety and quality in care homes in England (Francis 2013). The government’s response to this report was the Berwick Review. This focused attention on personal development and workplace learning rather than managerialism and performance indicators. Another linked and interesting area has to do with the degree of strategic integration and dovetailing locally between arrangements for ‘quality assurance’ and ‘safeguarding’ in social care; ‘patient safety’ in health; and ‘regulation’ by the Care Quality Commission.
Cumbria was chosen as the location for the pilot as Michelle Cornes from SCWRU is Facilitator of the ‘Cumbria Registered Social Care Managers Network’, which is collaborating in the study. Also taking part in the research are nurse practitioners employed in a care home improvement pilot in Kendal, and Dignity in Dementia. These participants have a shared interest in workplace learning in care homes. They have been involved in the initial adaptation, piloting and evaluation of the Let’s Talk drama and the accompanying training pack as well as the facilitation of active learning in care homes.
SCWRU researcher Caroline Norrie will carry out an evaluation of the initiative, which will explore how effective Let’s Talk is as a learning tool. Participants will be asked to fill in a before-and-after questionnaire and participant interviews will be undertaken after two months to explore any longer term outcomes.
Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery Office.
Gordon, S. (2014) ‘Bedside manners: a dramaturgical approach to exploring interprofessional collaboration’, Journal of Interprofessional Care, 28(5) 490-491.
Wenger, E (1998) Communities of Practice: Learning, Meaning, and Identity, Cambridge: Cambridge University Press.