Reflection on presenting at NIHR ARC North Event – Mind the Gap: London boroughs’ ideas for adult social care research

Lucy JacobsLucy 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

Decolonising research methods and knowledge: implications for stepping into a post-doctoral role

Adele van Wyk is a Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce at King’s. (1513 words)

The Anti-racism Steering Group in the School of Global Affairs at King’s College London (@Kings_SGA) recently held a three-day ‘Decolonising Research Methods in Global Health and Social Medicine’ course (7-9 June 2022), followed by a symposium ‘Decolonising Knowledge Production’ (10 June). Both events were funded by the Faculty of Social Science and Public Policy Education Fund. Their overarching stated purpose was to bring diverse decolonising efforts and ongoing initiatives into the conversation between social science students and early career researchers. They also provided an opportunity to explore the limits of existing research methods in varying geographical locations which as I start my post-doctoral journey in the UK is highly relevant to me.

Discussions covered a wide range of topics, but frequently gravitated to matters around ethics. In this blog, I reflect on six points that stood out for me in each case ending with suggestions as to how researcher approaches may be improved.

#1. If it is not published, it is not real knowledge

Several speakers shared the opinion that knowledge that was not a) published in peer reviewed journals or b) produced in a systematic manner such as through research protocols, were not being accepted as valuable. As Nyaradzayi Gumbonzvanda (@vanyaradzayi) explained:

‘African knowledge is orally transmitted from one generation to the next, but it is only considered knowledge if it is documented.’

This suggests a significant disconnect between existing indigenous knowledge and the evidence base for it further solidifies the view of indigenous knowledge as inferior or unscientific.

  • Consider grey literature or community reports to get a better understanding of what is going on in a particular community – it might get you closer to the information than only published literature.

Continue reading

The Gallery of Spiritualities – welcome to a new exhibition in a care home

olivia luijnenburgOlivia Luijnenburg is a Research Associate in King’s College London’s NIHR Policy Research Unit in Health and Social Care Workforce. (460 words)

What is ‘spirituality’ in care? How can care home staff attend to residents’ spiritual needs? For my PhD project, I had the task of finding answers to such questions. When thinking about spirituality and spiritual needs, many people’s minds immediately go to religion and religious needs. However, what about care home residents who do not practice a religion or are not part of a religious community? We know that spiritual wellbeing is found through a sense of community, connection, nature, or the arts, which can but does not have to be of a religious nature. Surprisingly, the spiritual needs of older people in residential care have often been overlooked.

To address the lack of knowledge around spirituality in care and illuminate the intangibility of what spiritual needs might look like, I collected ‘artefacts’ from care home residents before talking with them. These could be an object, a space, a song, a person, or anything else that represented a sense of joy, peace, safety, or fond memories for the person. The ‘artefacts’ functioned as a conversation starter, as well as a stimulant to the imagination of what ‘spirituality’ might mean to the participant. They were photographed and collected in a ‘Gallery of Spiritualities’. Continue reading

Three early papers on self-neglect

At the NIHR Policy Research Unit in Health and Social Care Workforce we are undertaking two studies examining self-neglect, both funded by the NIHR School for Social Care Research. In an article published in The Journal of Adult Protection, for the project examining Adult Safeguarding Responses to Homelessness and Self-neglect, Stephen Martineau goes back to three pioneering research papers on self-neglect to consider what, if anything, they can feed into current debates. (787 words)

Patricia Shaw's contribution in the 1957 paper on ‘social breakdown in the elderly’

Patricia Shaw’s contribution in the 1957 paper on ‘social breakdown in the elderly’

While conducting a review of the self-neglect literature during this year, references to two early papers on the topic have come up repeatedly. The first, published in the British Medical Journal in 1966, by Macmillan and Shaw, is often described as the seminal academic paper in this field and drew on cases in Nottingham. The other is the Diogenes Syndrome article, by Clark, Mankikar and Gray, published in The Lancet in 1975; it derived from a study conducted in a Brighton hospital. Our new Journal of Adult Protection article examines these two articles plus a third, again by Shaw and Macmillan. This one dates from 1957 and, though it did not use the term self-neglect (rather, social breakdown in the elderly), it is the most vivid and interesting of the three.

There is a good deal of research interest in self-neglect at present. Following consultation with, and a survey of, practitioners, carers and service users (suggested by our Unit), the James Lind Alliance (2018) Priority Setting Research Partnership on Adult Social Work recommended that the topic should be a research priority. As well as the Unit’s two studies (details below), the NIHR has a call out for a study of self-neglect in the community (closing 28 January 2021). The need for such research is reinforced by Michael Preston-Shoot and colleagues’ new national study of Safeguarding Adults Reviews that were conducted between April 2017 – March 2019. SARs are commissioned where questions are raised about the way agencies involved in safeguarding have worked together in individual cases: among the 231 reviews the authors analysed, self-neglect constituted the most common type of abuse/neglect (featuring in 45% of the reviews). Continue reading

Evidence gathering in social care research. Are we looking in the right places?

John Woolham is Senior Research Fellow at the NIHR Health & Social John WoolhamCare Workforce Research Unit (HSCWRU), King’s College London. John reports from a Health Services and Delivery Research (HS&DR) Programme seminar, 15 May, which he attended on behalf of HSCWRU. (463 words)

The HS&DR is part of the National Institute for Health Research (NIHR) and is responsible for funding research in health and social care settings. Its programme aims to produce rigorous and relevant evidence to improve the quality, accessibility and organisation of health and social care services.

The purpose of the seminar was to enable HS&DR to better understand the needs of evidence users, with a particular focus on social care, and how the HS&DR programme can respond to these needs. Continue reading

Getting the message about assistive technology and telecare: new guidance

John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. (592 words)

Last week I was invited to speak at the launch of ‘Help at Home – use of assistive technology got older people’ a review of current research evidence published by the National Institute for Health Research Dissemination Centre. My presentation discussed some of the findings from research I’d done last year as part of the NIHR School for Social Care Research funded UTOPIA project, which gets a mention in the review.

This review is timely and welcome. There has been considerable investment by local authorities in assistive technology and telecare at a time of unrelenting austerity. The research evidence to support this investment offers mixed messages, and local authority commissioners don’t have access to research findings, or even if they did, the time to read them. Worse, at least some of the information about telecare’s impact that is accessible is misleading. Local authorities are also under pressure: increasing demand for care and support, particularly from growing numbers of older people, and cuts to adult social care budgets that are unprecedented in their scale.

Is assistive technology and telecare the solution? Local authorities are keen to use it to promote independence, keep people living safely in their own homes and to reduce burdens facing family carers, which will, of course, also save money. These are all worthy objectives, but as the review suggests, more likely to be achieved by local authorities that pay good attention to the infrastructure within which assistive technology is used, rather than just the devices themselves.

The review makes the important point that much research in this field to-date appears to have focused on ‘high end digital technology’ rather than evaluating the impact of more basic technologies to help with everyday life; and more focus on the development of prototype technologies than real world testing. There are also some real challenges laid out for local authorities or other organisations that provide telecare services. For example, it reflects concerns by older people, highlighted in one international study that technology will be used as a substitute for hands on care. This is precisely what is happening in many local authorities in England at the present time. Another challenge from research is the suggestion that assessment and installation are seen as sequential one-off events (‘plug and play’) when getting the best out of it means seeing these as on-going processes, and that even simple technologies should be seen as a ‘complex intervention’. How does this compare with practices in hard pressed local authority adult social care departments at the present time?

Anyone working in this field or who is using, or thinking of using, technology, should find this report contains valuable insights, even if some of them are challenging. Research reviews can be dry-as-dust, of interest only to the scholarly or the assiduous and with little of value to care professionals. This review is readable and relevant. It offers clear summaries of current research evidence and there are also clear messages about what needs to happen for telecare to make an effective, optimal contribution towards the care and support of older people. It deserves to be widely read and for key messages to be addressed in practice.

John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. John’s presentation from the day.

The author’s own work, cited here, is independent research funded by the National Institute for Health Research School for Social Care Research. The views expressed in this blog post are those of the author and not necessarily those of the NIHR/SSCR, NHS, the National Institute for Health Research or the Department of Health and Social Care.

 

‘Carelessness does more harm than a want of knowledge’ —Benjamin Franklin

Dr Mary BaginskyMary Baginsky is Senior Research Fellow at the Social Care Workforce Research Unit at King’s College London. (1,005 words)

I have been conducting research for more years than I am prepared to admit – sometimes to myself. Much of it has been qualitative in nature, although often as part of a mixed approach methodology. So quantitative data have helped to define the issues to be explored in more depth through interviews and focus groups, for example, or qualitative work has been used to help identify the issues that should be explored through a survey. I am used to weighing concepts such as reliability, validity and generalisability when designing and carrying out projects and reporting their findings, whatever their provenance. I am also as fallible as anyone in not seeing an inherent flaw – that is where the wisdom of colleagues and, however imperfect, the peer review process can be invaluable. However, my experiences of the past few years have given me cause for concern. In conducting a review of evidence on an area where I have been working I have been shocked by some of the things I have found. It has led me to wonder if I would find the same level of errors if I looked long enough in other papers, books and articles. Continue reading

Child protection social work: call for study participants

Nicola Anderson is a child protection social worker who is also conducting a study of what affects child protection social workers working directly with parents. If you would like to take part or learn more about the research please contact Nicola: nicola.anderson@study.beds.ac.uk (441 words)

Engaging parents in direct work is an important part of working in child protection. Sometimes it can be a very difficult task as social workers are entering people’s private family life and interventions can feel invasive. Parents are justifiably reluctant to allow this. Parents can express their feelings to the social worker involved and this can sometimes become aggressive. Social workers meet aggression so often that reducing aggression has now become part of social work (Taylor 2011). Schools of thought are that social workers contribute to parents’ negative feelings as a result of their communication or practice styles. There are movements towards changing the way social workers communicate and work with families with the emphasis on respect, listening and ensuring parents understanding of and involvement in plans and processes, for example motivational interviewing and signs of safety. Continue reading

Personalisation: towards evidence that counts

Dr Martin StevensMartin Stevens is Senior Research Fellow at the Social Care Workforce Research Unit at King’s. (811 words)

Personalisation has been a dominant theme in social care policy for 25 years and has also been a strong theme for the Social Care Workforce Research Unit. In addition to our involvement in the Evaluation of the Individual Budgets pilots in 2008 (Glendinning et al 2008), the Unit has completed studies on Risk, Safeguarding and Personal Budgets; personalised employment support: Jobs First; and, on Personal Assistants and Personal Budgets. The Unit has published extensively on this topic, which has also been identified as a context in many other studies. Continue reading

Research ‘showcase’ at the Department of Health and Social Care

John WoolhamJohn Woolham is Senior Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. (637 words)

I was invited to speak last month at a seminar organised by the School for Social Care Research (SSCR) at the Department of Health and Social Care (DHSC). The purpose of the event was to ‘showcase’ research SSCR have funded over the last couple of years and to further cement links between researchers and policy-makers. Continue reading