0
7 December 2012
Evidence in Social Welfare Policy & Practice
 Discussing need for good evidence in
social care
 Some of the challenges in
disseminating evidence in the social
care s...
7 December 2012Evidence in Social Welfare Policy & Practice
3
1. Cost
2. Numbers of people using
social care
3. Size of th...
 £17 billion spent on adult
social care in 2010-11 (NHS-IC,
2012)
 Excludes amounts spent by
people paying for their
own...
 1.46 million adults
in England whose
care wholly or
partly funded by
their local council
in 2011-12 (NHS-IC, 2012)
 Har...
 At least 2 million people work in social
care in the UK (Moriarty, 2010)
 29.56 economically active people in
UK (ONS L...
 1,603,000 people
work in adult social
care in England
(Eborall et al., 2010)
 Divided between
larger direct care
workfo...
7 December 2012Evidence in Social Welfare Policy & Practice
8
1. Progress in terms of the
evidence base
2. Why do we need ...
 Jacobs et al asked to
‘describe the state of
social care services for
older people at the turn of
the 21st century’ (200...
 ‘The review has also identified
weaknesses in the evidence base, both
in terms of gaps and in respect of the
quality of p...
 National Institute for
Health Research
School for Social
Care
Research (NIHR
SSCR) launched in
2009
 Aims to improve th...
 DIVERSITY of sector
 Only 12 per cent of people working in
adult social care work for a local council
 Overwhelming ma...
 Training is longstanding issue
 Professional qualifying training
› Social workers
› Occupational therapists
› Nurses wo...
0
1000
2000
3000
4000
5000
6000
7000
Combined
pathway
Leadership
and
management
Mental health Practice
education
Social wo...
 Amounts to just under 12k enrolments
 Represents about 14 per cent of those
working in statutory social work with
child...
 NHS offers opportunity for staff to
register for Athens password
› Only comparatively small number of social
workers in ...
 Less than a third of the
workforce have a NVQ 3
qualification or equivalent
(Hussein & Manthorpe, 2012)
› Lower levels o...
7 December 2012Evidence in Social Welfare Policy & Practice 18
‘There is induction training when you first start,
which co...
7 December 2012Evidence in Social Welfare Policy & Practice 19
Picture accompanying Daily
Telegraph article by Max
Pembert...
7 December 2012Evidence in Social Welfare Policy & Practice 20
‘Again, it’s finding a
starting point and
access to
informa...
7 December 2012Evidence in Social Welfare Policy & Practice 21
‘I go through all sorts of information. I will go onto
a go...
 ‘Well, we had someone whose husband had
had a stroke. And again they are mid 50s
and they were happily living their live...
 BCD Associates
(2011) showed how
hard it was for older
people to find out
about care homes
from council
websites
 Looke...
 Evidence is there but differential
access
› Between different types of worker
› Between different people using services ...
0
20
40
60
80
100
16-24 25-34 35-44 45-54 55-64 65-74 75+
Ever used internet
Source: ONS, Statistical bulletin: Internet A...
7 December 2012Evidence in Social Welfare Policy & Practice
26
1. Need to link evidence with
improvements in service
quali...
 ‘Overall CQC is finding that
the increasing complexity
of conditions and greater
co-morbidities experienced
by people ar...
 Evidence base for social care is
increasing
 Covers topics that are important and
relevant to people’s lives
 Particul...
 The preparation of some of the material in this
presentation was made possible by a grant from
the National Institute fo...
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Evidence in social care: what do we know?

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Discusses 'state of play, in terms of evidence in social care - where we have information, where there are gaps. Presentation from conference held at the British Library in December 2012 looking at evidence in social care.

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Transcript of "Evidence in social care: what do we know?"

  1. 1. 7 December 2012 Evidence in Social Welfare Policy & Practice
  2. 2.  Discussing need for good evidence in social care  Some of the challenges in disseminating evidence in the social care sector  Need to think beyond academic users to general public – especially people using services and carers  Mainly focusing on support for adults 7 December 2012 2Evidence in Social Welfare Policy & Practice
  3. 3. 7 December 2012Evidence in Social Welfare Policy & Practice 3 1. Cost 2. Numbers of people using social care 3. Size of the workforce
  4. 4.  £17 billion spent on adult social care in 2010-11 (NHS-IC, 2012)  Excludes amounts spent by people paying for their own care  Excludes expenditure on social security and housing supporting people with social care needs 7 December 2012Evidence in Social Welfare Policy & Practice 4
  5. 5.  1.46 million adults in England whose care wholly or partly funded by their local council in 2011-12 (NHS-IC, 2012)  Harder to estimate self funders › Around 440,000 self funders (Institute of Public Care, 2011) 7 December 2012Evidence in Social Welfare Policy & Practice 5 Image from Swansea council website
  6. 6.  At least 2 million people work in social care in the UK (Moriarty, 2010)  29.56 economically active people in UK (ONS Labour Market Statistics, 2012) › 7 per cent of labour force (Hussein, 2012)  NHS headcount 1,182,933 in August 2012 (NHS-IC, 2012) 7 December 2012Evidence in Social Welfare Policy & Practice 6
  7. 7.  1,603,000 people work in adult social care in England (Eborall et al., 2010)  Divided between larger direct care workforce and smaller numbers of professional and managerial posts 7 December 2012Evidence in Social Welfare Policy & Practice 7
  8. 8. 7 December 2012Evidence in Social Welfare Policy & Practice 8 1. Progress in terms of the evidence base 2. Why do we need to improve access to social care evidence
  9. 9.  Jacobs et al asked to ‘describe the state of social care services for older people at the turn of the 21st century’ (2009) › Retrieved 7000 references › 234 articles in peer reviewed journals › Most were descriptive › Methodological quality varied › Few RCTs/quasi experimental studies 7 December 2012Evidence in Social Welfare Policy & Practice 9
  10. 10.  ‘The review has also identified weaknesses in the evidence base, both in terms of gaps and in respect of the quality of published studies; in these areas, policy and practice appears to have advanced without research evidence’ (p526)  ‘Without an adequate evidence base, however, policy makers and commissioners will struggle to ensure that service improvements can be made with finite resources’ (p527) 7 December 2012Evidence in Social Welfare Policy & Practice 10
  11. 11.  National Institute for Health Research School for Social Care Research (NIHR SSCR) launched in 2009  Aims to improve the evidence base for adult social care practice in England 7 December 2012Evidence in Social Welfare Policy & Practice 11 http://www2.lse.ac.uk/LSEHealthA ndSocialCare/aboutUs/NIHRSSCR/ home.aspx www.sscr.nihr.ac.uk
  12. 12.  DIVERSITY of sector  Only 12 per cent of people working in adult social care work for a local council  Overwhelming majority in private sector › Ranges from large private equity companies to small ‘mom and pop’ care homes › 40,626 establishments (Eborall et al, 2010)  About 25 per cent in voluntary sector (Eborall et al, 2010)  Policy of personalisation has led to increasing numbers of self employed people – no precise numbers 7 December 2012Evidence in Social Welfare Policy & Practice 12
  13. 13.  Training is longstanding issue  Professional qualifying training › Social workers › Occupational therapists › Nurses working in care homes  BUT access to continuing professional development is variable 7 December 2012Evidence in Social Welfare Policy & Practice 13
  14. 14. 0 1000 2000 3000 4000 5000 6000 7000 Combined pathway Leadership and management Mental health Practice education Social work with adults Children, young people, their families and carers 7 December 2012Evidence in Social Welfare Policy & Practice 14
  15. 15.  Amounts to just under 12k enrolments  Represents about 14 per cent of those working in statutory social work with children and adults (Moriarty, 2012)  Although need to take account of those holding predecessor awards and undertaking other types of CPD, most CPD is probably self directed 7 December 2012Evidence in Social Welfare Policy & Practice 15
  16. 16.  NHS offers opportunity for staff to register for Athens password › Only comparatively small number of social workers in NHS benefit from this  Much larger numbers working for local authorities › Cuts in local authority training budgets › Cuts in local authority research staff 7 December 2012Evidence in Social Welfare Policy & Practice 16
  17. 17.  Less than a third of the workforce have a NVQ 3 qualification or equivalent (Hussein & Manthorpe, 2012) › Lower levels of training in dementia care workforce, although supporting people with very complex needs › New framework is QCF 7 December 2012Evidence in Social Welfare Policy & Practice 17
  18. 18. 7 December 2012Evidence in Social Welfare Policy & Practice 18 ‘There is induction training when you first start, which covers medication and how to fill I the sheets what you can and can’t give. Moving and handling. Using hoists and slide sheets and everything. Obviously personal care. Food hygiene. Just across the board really with a bit of everything…It lasts for a week, four days, sorry. Once you’ve done the indoor training, if you like, you then go out for four shadow shifts with another carer [care worker]…. If you need any more help or you don’t feel that you are ready to go out on your own, one of the supervisors would perhaps come out with you until you are comfortable that you can do it on your own’. (LoCS interviewee)
  19. 19. 7 December 2012Evidence in Social Welfare Policy & Practice 19 Picture accompanying Daily Telegraph article by Max Pemberton in June 2009 ‘I sometimes think people don’t recognise that they are carers themselves, even though they maybe kind of know they are, but they are so busy just doing that role that they don’t always see themselves as that person’ (WORKER 2)
  20. 20. 7 December 2012Evidence in Social Welfare Policy & Practice 20 ‘Again, it’s finding a starting point and access to information. It is very limited. There is probably a lot of information out there, but you’ve got to know where to go and look for it’ (CARER12) ’There is no information. It’s like treading through treacle (CARER1)
  21. 21. 7 December 2012Evidence in Social Welfare Policy & Practice 21 ‘I go through all sorts of information. I will go onto a government site and then find out the information and then go and try and pare it down…. And then when I get fed up and then I will go onto the Carer Centre to see if they’ve picked up on it. You often see White Paper predictions and that and you think…How is it going to come down to us?... Is it going to work for carers?’ (CARER1)
  22. 22.  ‘Well, we had someone whose husband had had a stroke. And again they are mid 50s and they were happily living their lives and been working and everything and then suddenly had this stroke. Their whole lives were turned upside down and because of the stroke as well he had some brain damage. And so now this gentleman unfortunately is in residential care and the lady has to start and rebuild her own life now and start thinking how she is going to manage on her own (WORKER6) 7 December 2012Evidence in Social Welfare Policy & Practice 22
  23. 23.  BCD Associates (2011) showed how hard it was for older people to find out about care homes from council websites  Looked at information for carers – especially carers’ registers - similarly variable 7 December 2012Evidence in Social Welfare Policy & Practice 23
  24. 24.  Evidence is there but differential access › Between different types of worker › Between different people using services and carers  Carers from black and minority ethnic groups seem to have greater problems accessing information (e.g. Adamson, 2001) 7 December 2012Evidence in Social Welfare Policy & Practice 24
  25. 25. 0 20 40 60 80 100 16-24 25-34 35-44 45-54 55-64 65-74 75+ Ever used internet Source: ONS, Statistical bulletin: Internet Access Quarterly Update, 2012 Q1 7 December 2012 25Evidence in Social Welfare Policy & Practice
  26. 26. 7 December 2012Evidence in Social Welfare Policy & Practice 26 1. Need to link evidence with improvements in service quality
  27. 27.  ‘Overall CQC is finding that the increasing complexity of conditions and greater co-morbidities experienced by people are impacting on the ability of care providers to deliver person- centred care that meets individuals’ needs. It is also seeing increasing pressures on staff, both in terms of the skills required to care for people with more complex conditions and in terms of staff numbers’ 7 December 2012Evidence in Social Welfare Policy & Practice 27
  28. 28.  Evidence base for social care is increasing  Covers topics that are important and relevant to people’s lives  Particular need for resources such as British Library Social Welfare Portal and Social Care Institute for Excellence for groups unable to access other resources  Need strategy that will help reach these groups 7 December 2012Evidence in Social Welfare Policy & Practice 28
  29. 29.  The preparation of some of the material in this presentation was made possible by a grant from the National Institute for Health Research (NIHR) School for Social Care Research on social care practice with carers.  We acknowledge the contribution of the Policy Research Programme at the Department of Health for its support for the Unit  The views expressed in this presentation are those of the author and not necessarily those of the NIHR School for Social Care Research or the Department of Health 7 December 2012Evidence in Social Welfare Policy & Practice 29
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