In the face of major global demographic change, social care policy and practice are in urgent need of radical reform and reassessment. Rising poverty, inequality and pressure on local communities ...internationally, are also increasing the urgent need for reform. Drawing on the crisis-ridden UK experience as a case-study, this highly original book identifies the limits of the traditional welfare state in taking forward policy for the twenty-first century. The proposals amount to a renewed approach to social care, based on the philosophy of independent living as originally developed by the international disabled people’s movement and subsequently embodied in a United Nations treaty applicable to all in need of care and support. Despite wide international sign up since adoption in 2008 there is little evidence of any nation successfully delivering. For the first time, this book offers both a blueprint for an environmentally sustainable, rights-based approach to social care and a practical route to achieving it.
Social care in the United Kingdom (UK) refers to care provided due to age, illness, disability, or other circumstances. Social care provision offers an intermediary step between hospital discharge ...and sufficient health for independent living, which subsequently helps with National Health Service (NHS) bed capacity issues. UK Health Technology Assessments (HTAs) do not typically include social care data, possibly due to a lack of high-quality, accessible social care data to generate evidence suitable for submissions.
We identified and characterized secondary sources of UK social care data suitable for research (as of 2021). Sources were identified and profiled by desk research, supplemented by information from custodians and data experts.
We identified twenty-one sources; six high potential (three national, three regional data sources), five future potential, seven limited potential, and three not considered further (outdated or lacking social care data).
Despite identifying numerous sources of social care data across the UK, opportunities and access for researchers appeared limited and could be improved. This would facilitate a deeper understanding of the clinical and economic burden of disease, the impact of medicines and vaccines on social care, enable better-informed HTA submissions and more efficient allocation of NHS and local council social care resources.
This paper presents empirical findings from the comparison between two principal preference elicitation techniques: discrete choice experiments and profile-based best–worst scaling. Best–worst ...scaling involves less cognitive burden for respondents and provides more information than traditional “pick-one” tasks asked in discrete choice experiments. However, there is lack of empirical evidence on how best–worst scaling compares to discrete choice experiments. This empirical comparison between discrete choice experiments and best–worst scaling was undertaken as part of the Outcomes of Social Care for Adults project, England, which aims to develop a weighted measure of social care outcomes. The findings show that preference weights from best–worst scaling and discrete choice experiments do reveal similar patterns in preferences and in the majority of cases preference weights – when normalised/rescaled – are not significantly different.
► Illustrates key issues that are important in choosing between profile-case best-worst scaling and discrete choice experiment studies. ► Empirical research on the value of outcomes of social care reveals similar patterns in the preference weights obtained from the two approaches. ► In the majority of cases examined, preference weights are not significantly different once the weights have been appropriately normalised/rescaled.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
•The Systemic Practice Model was implemented nationwide in Finland in 2017–2018.•A pilot study evaluated the outcomes and the quantity and quality of the practice.•Systemic practice was more ...intensive than service as usual.•No differences were found in outcomes or service-user feedback.
The Systemic Practice Model (SPM) is a Finnish adaptation of the Reclaiming Social Work (RSW) model, which incorporates systemic ideas and practice into children’s social care. This study is the first attempt to evaluate the effectiveness of the RSW model outside England. The study employed a quasi-experimental repeated measures design. Questionnaires assessing child- and family-level outcomes and the quantity (i.e., number of meetings) and quality (i.e., service user feedback) of the practice were administered to social workers, children and parents twice over a six-month follow-up period. Outcome data comprise 112 cases (SPM cases n = 56, service-as-usual cases n = 56) from 18 child protection teams (SPM teams n = 9, service-as-usual teams n = 9) at three sites. The overall need for child protection decreased across the sample during the follow-up period. While the intensiveness of practice was higher in the SPM group, no significant differences were found between the study groups in practice outcomes or service user satisfaction with child protection. The limitations and implications of the study for future research are discussed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Multilevel models were used to reanalyse child welfare inequalities data.•Robust quantitative evidence for the ‘inverse intervention law’ and social gradient.•Evidence of an ‘income inequalities ...intervention law’ mirrors international research.•Average 55-75 per cent increases in CWI for one SD increases in deprivation.•Less equal/deprived LAs social gradients 5x stronger than more equal/deprived LAs.
This article addresses some potential limitations of key findings from recent research into inequalities in children’s social services by providing additional evidence from multilevel models that suggest the socioeconomic social gradient and ‘Inverse Intervention Law’ in children’s services interventions are statistically significant after controlling for possible confounding spatial and population effects. Multilevel negative binomial regression models are presented using English child welfare data to predict the following intervention rates at lower super output area-level: Child in Need (n = 2707, middle super output area MSOA n = 543, local authority LA n = 13); Child Protection Plan (n = 4115, MSOA n = 837, LA n = 18); and Children Looked After (n = 4115, MSOA n = 837, LA n = 18). We find strong evidence supporting the existence of a steep socioeconomic social gradient in child welfare interventions. Furthermore, we find certain local authority contexts exacerbate this social gradient. Contexts of low overall deprivation and high income inequality are associated with greater socioeconomic inequalities in neighbourhood intervention rates. The relationship between neighbourhood deprivation and children looked after rates is almost five times stronger in local authorities with these characteristics than it is in local authorities with high overall deprivation and low income inequality. We argue that social policy responses addressing structural determinants of child welfare inequalities are needed, and that strategies to reduce the numbers of children taken into care must address underlying poverty and income inequality at both a local and national level.
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Abstract Prior to the COVID pandemic, staffing levels, staff turnover and vacancies in adult social care and social work within the UK were a major concern, with staff experiencing high workloads, ...burnout, stress and poor morale. The paucity of published evidence in a rapidly evolving contemporary situation indicated the suitability of a scoping review. Systematic searching produced evidence published between 1 December 2019 and 9 May 2023. Out of ninety-seven articles retrieved, the final analysis included thirty nine articles. To report the review findings clearly and accessibly, the analysis used the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework. Abundant evidence emerged on psychological distress and the impact of COVID-19 on the working environment for social care and social workers, but a paucity of psychosocial resilience, supporting social care managers, Personal Assistants and moral injury. Social care needs and the statutory duties of social work are likely to become even more intense. The COVID pandemic magnified a chronic lack of funding, staffing, support and regard for adult social care, with no future planning compared to the NHS. This legacy and backlogs of social care assessment and service delivery are of concern despite the proposed actions of the Adult Social Care Reform Act in England.
Abstract There is a growing emphasis on prevention to reconcile demographic pressures, resource scarcity and expectations of better quality care and support. The Care Act 2014 placed a statutory duty ...on English local authorities to prevent and delay the development of needs for care and support. However, evidence suggests that the prevention approach has secured less impact than intended. Given that existing approaches have achieved such limited results, new ways of addressing this apparently intractable challenge should be considered. We argue here that theory-based models that support the understanding of, and responses to, implementation barriers and facilitators can provide tools to support the development of more successful implementation. Drawing on in-depth interviews (n = 20) in selected English councils and analyses of their policy documents, we explore the ‘Ready, Willing and Able’ (RWA) model, which posits that those three preconditions must be satisfied before new practices can be implemented sustainably. We argue that RWA can provide a straightforward and parsimonious framework for identifying implementation barriers and facilitators. Using the model to identify potential bottlenecks prior to the implementation can help local actors clarify baseline barriers to progress. RWA could help to inform opportunities to target identified problems, by reinforcing facilitators and moderating barriers.
Young people who are care experienced are overrepresented in the criminal justice system and in general have worse outcomes in education than their non-looked after peers (DfE & Hinds, 2019; Prison ...Reform Trust, 2017). Recent evidence has reported that children who have a social worker (classified as child in need or those with a child protection plan), but who do not enter the care system, can have worse outcomes in education than those children who are looked after (DfE, 2019b). There remains little research evidence about the extent to which children with a social worker become involved with criminal justice services or how the age, duration and nature of formal social care service involvement may impact on education and offending outcomes. Researchers have been challenged by the lack of a sufficiently sized quantitative data, that crossed social care, education and offending domains. In work funded by ADR-UK, the present research project uses the newly linked DfE-MoJ administrative dataset to explore how different forms of formal social care services involvement impacts on education and criminal justice outcomes. Multi-level models will explore the role of formal child social care services amongst other multi-systemic risk and protective factors for education and offending. The presentation of his work will include preliminary statistics and insights into the challenges and potential further use of the linked dataset for researchers.
Abstract
Although prisoners have significant care needs and are particularly vulnerable following release, there have been longstanding concerns about their social care. Among its provisions, the ...2014 Care Act defined the responsibilities of local authorities for identifying and meeting the social care needs of prisoners. Here, we report the findings of a national survey of local authorities undertaken in 2016, which explored the early arrangements put in place following the Care Act for prisoners on release. Eighty-eight of 158 local authorities responded, including 81 per cent of those with prisons in their catchment area. Key themes included difficulties with case finding, with a reliance on referrals from other agencies, although provision for those already known to local authorities generally worked well. Other themes were difficulties in sharing assessments and information between local authorities, and problems with care planning and co-ordination with other agencies. We discuss some of the tensions and challenges inherent in implementing the Act and highlight areas requiring attention, including the need for more robust case finding and systems for information transfer. We also suggest measures to strengthen arrangements.
Exclusion from school is associated with health, well-being and social detriments and disproportionately affects vulnerable children. No study in England has examined the total cumulative risk of ...exclusion across secondary school among children with a history of children's social care (CSC) or special educational needs (SEN).
To assess the risk of any secondary school exclusion among adolescents receiving CSC or SEN services compared with their peers.
An administrative data cohort study comparing children in English state schools (n = 1,031,500) with no history of CSC or SEN provision with children who had received different levels of CSC and SEN in combination. Outcomes were proportions of students with any fixed-term or permanent exclusion in years 7 to 9 (age 11 to 14) and years 10 to 11 (age 14 to 16).
Overall, 13 % of children were excluded at least once across years 7 to 11. CSC exposure was associated with exclusion risk: 32 % of children in need (or formerly in need) and 40 % of current or former children looked after and those subject to child protection plans were excluded at least once across years 7 to 11, compared to 12 % of the non-exposed group. After adjusting for confounders, children with SEN history were more at risk of exclusion, regardless of CSC exposure category (except for exclusions among children looked after during years 10 to 11). Rates of exclusion varied significantly between local authorities.
Large inequalities in school exclusion rates between CSC-exposed and unexposed children were observed, with even higher rates observed for children with SEN history. These inequalities undermine the right to education of these vulnerable groups of children.
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