How should research evidence be used to improve adult social care policy and practice?

Martin Stevens

by Martin Stevens

This question has bothered me since I started as a social services research officer in 1992. Attending the NIHR School for Social Care Research (SSCR) Workshop: Maximising Research Impact in Adult Social Care last week was a chance to ponder this question and, more usefully, to hear other people’s ponderings. The event was very well attended, with a mix of academic (including Jo Moriarty, Jess Harris and me from the Social Care Workforce Research Unit) and local authority staff, with a small number of people who use services and carers. First up was a panel discussion, in which Martin Webber (York University); (Chris Rainey (West Sussex Social Services Research); and Deborah Rutter (Social Care Institute for Excellence – SCIE) gave short introductory accounts, followed by a long question and answer session. Three presentations followed: Sarah Carr (SCIE) emphasised the roles of service users and carers; George Julian (Research in Practice for Adults) gave some practical aspects using research evidence; and Jonathan Grant and Molly Morgan Jones (RAND Europe) presented various approaches to measuring research impact in social care.

Naturally, in the presentations and discussions, there was a sense of frustration about apparent lack of change over the years. Best metaphor of the day was from the Unit’s own Jess Harris, talking about the need to ‘bite people on the bottom’ when trying to encourage the use of research in policy. These feelings are understandable, the issues and barriers raised by all speakers – time, resources, attitudes of practitioners, managers and policy makers, levels of training, understanding of research methods, lack of good quality research presented in easy to understand formats, seem to have been around during my whole career as a researcher.

More positively, there was a welcome emphasis on dialogue and engagement of different stakeholders. This is valuable as there has often been a somewhat mechanical view of research evidence as a lever to change practice. This simplistic approach ignores important contextual factors, such as practitioners’ low level of discretion, making the direct application of research problematic. A focus on the need for dialogue and engagement, together with the idea of co-production, suggests an acceptance of the complexity of linking research evidence with policy and practice change.

However, I was left with three questions that need more attention in order to optimise the impact of research in policy and practice:

  • What is the most appropriate and proportionate impact we can expect from research compared to that from other influences (politics, values, professional and user knowledge), given the necessary uncertainty and contestability of research evidence in this sphere?
  • How should different kinds of evidence, which often arise from different assumptions about the nature of social world, be combined to make changes in policy and practice?
  • How can policy making be changed in order to make best use of research (in terms of timescales, but also increasing the influence of people using services, carers, practitioners and researchers)?

Dr Martin Stevens is Research Fellow at the Social Care Workforce Research Unit at King’s College London. With Jess Harris he is currently writing the final report for the evaluation of Jobs First (an initiative encouraging the employment of people with learning disabilities) for the Department of Health. He is also Principal Investigator in a study examining the vetting and barring of workers in the sector.

Why face to face meetings still matter

Jo Moriarty

by Jo Moriarty

It seems strange to begin a blog suggesting that face to face meetings are an important way of sharing research findings, but that was the conclusion I reached after our joint seminar between the Social Care Workforce Research Unit at King’s College London and researchers from the Welfare, Inequality and Life Course (VUL) work group based in the Department of Sociology at the University of Bergen, Norway.

The aim was to share our ideas and experiences. Academics are sometimes accused of working in ivory towers. This could not be said of Liv Johanne Syltevik, Kjetil Lundberg, Ann Nilsen, Bo Vignes and Karen Christensen who arrived at the Unit hotfoot from a visit to Hounslow Job Centre Plus. Liv and Kjetil explained that the visit was part of their research looking at the impact of the merger of former employment and social insurance services into a single Norwegian Labour and Welfare Administration (NAV). Martin Stevens and Jess Harris then spoke about the Jobs First project which looks at how people with learning disabilities can be supported to enter employment.

University of Bergen

University of Bergen

SCWRU offices

Our offices at King’s

The two presentations highlighted how different terms can reflect deeper differences between welfare regimes. In Norway, where most citizens would expect to receive support and assistance from the NAV over the life course, people in contact with the service are described as ‘users’. In the UK, people using Job Centre Plus are described as ‘customers’ although, for many, paid work is a form of consumption they will not experience. In a further irony, we heard how Norwegian unemployment rates are much lower compared with the UK.

Karen Christensen and Ann Nilsen

Prof. Karen Christensen (left), who chaired the seminar at the Unit on 26 September, is Visiting Research Fellow at King’s. With Prof. Ann Nilsen

We talked about similarities too; in the use of mixed methods in research about transitions to adulthood and family carers and how older migrants in both countries often face similar issues. Karen mentioned the possibility that people might take up transnational care careers, working in the sector in different countries. As Shereen Hussein explained her analysis showing how some care workers in England earn less than the national minimum wage, I started wondering how average care worker wages compare across the European Economic Area.

Kjetil Lundberg and Bo Vignes

Kjetil Lundberg and Bo Vignes; Prof. Liv Johanne Syltevik in the background

You can learn a lot about the ways in which different countries organise care and support by reading journal articles and attending conferences. However, at conferences, time for discussion is often limited. This is generally because of the need to negotiate labyrinthine venues. I once attended a conference where you needed to be a time traveller to go to the place where refreshments were served and return to the building where presentations were taking place in time for the next session. We’re increasingly aware of the potential for researchers and practitioners from different countries to use social media for discussion. However, there is something about meeting face to face that promotes dialogue. It’s also much nicer to eat real homemade cake and muffins than to experience them virtually! We are all looking forward to keeping in touch and building connections between the two units.

Jo Moriarty is a Research Fellow at the Social Care Workforce Research Unit at King’s College London and tweets as @Aspirantdiva. Jo’s study of family carers, which she introduced at the seminar, has started reporting.

VUL group with Professor Manthorpe

Bo Vignes, Kjetil Lundberg, Prof. Jill Manthorpe (Director of SCWRU), Prof. Liv Johanne Syltevik, Prof. Karen Christensen and Prof. Ann Nilsen


On being a boundroid

by Jill Manthorpe

Boundroid? Why haven’t I heard this term before? Listening to the speakers at the Transforming Adult Social Care Workforce Conference yesterday, this word featured prominently. It was used to describe people whose working lives have spanned social and health care and continue to think about the connections. They may be the future.

Researchers too can be boundroids and that’s what we need to be when thinking about evidence and practice; about policy and implementation; social care and social work; home care and care homes. We need to know a bit about each and a lot about some of these subjects.

The Adult Social Care Workforce Conference is an annual event where the spotlight is not on social care funding or reorganisation alone but on the workforce (1.68 million people according to Skills for Care). This year three themes stood out. There was the confirmation that ‘Leadership’ in social care has been a problem and is now the solution. The L word is used rather than management to emphasise that leadership is everybody’s business. When did this happen and what does it mean? For me this change was captured visually by Debbie Sorkin from the National Skills Academy. She has collected several photos of the social care workforce and remarked on how often the pictures portray staff sitting down and not looking directly to camera. We’ll certainly keep a lookout for such images in our own presentations to see if there are subliminal threads of invisibility.

A second theme that can usually dampen the spirit of any conference was that of integration. How right Andrea Sutcliffe of the Social Care Institute for Excellence is to say that this word can usefully be abandoned for ‘joined up’ in many instances. As researchers we don’t want to be integrated but ‘joining up’, and building mutually informed relationships seems to be the way to go.

This conference heard about the specifics of workforce investment from Glyn Mason of the Department of Health, whose experience in practice and management is always remembered by conference participants who have worked with him in far flung places over the years. With all the media coverage of complexities of the social care funding reforms it is easy to see the Care and Support White Paper as an empty vessel. But there is 60 years’ worth of reform in it and a separate chapter on the workforce is only one place where the workforce features. After all, social care is a ‘doing’ word not an object, as my classroom teachers might have said. Two groups are mentioned in particular – apprentices and care ambassadors. But under every proposal are workforce implications. Who, for example, will work in the expanded housing with care services? Who will carry out the promised carers’ assessments for all? And why was migrant working not really addressed?

Being a boundroid is a characteristic of social care work of any type and style. Maybe the challenge will be to ensure that other sectors see this as a useful attribute too.

Professor Jill Manthorpe is Director of the Social Care Workforce Research Unit, King’s College London.