SSRG Annual Workshop 2004

SSRG Annual Worshop 2004 – Effective use and dissemination of knowledge in improving practice and performance in Social Care and Health

29-31 March 2004
Collingwood College, University of Durham

The broad theme is the ‘effective use and dissemination of knowledge in improving practice and performance in Social Care and Health’.

The event will consider issues relating to:

experiences of service users
inspections of local authority services
annual statistical returns and other submissions to government
performance management and assessment
quality assurance
research and evaluation of services

Presentations

Monday 29 March 2004

A Future For Social Work In The Mainstream
Andrew Cozens & Duncan MacAulay

We anticipate the Children’s Bill (England) will have been published signalling the end of social services departments and we have known them in England. But this is part of a trend we have seen across the UK in the last 10 years.

In this joint presentation, we will aim to set out a future for social care in the

mainstream of the community and public services. We will reflect, from our different perspectives, on the direction public policy on social work and social care issues is taking in the UK and why this is an opportunity and not a threat to our perspective and values.

Changing Partners: The Impact of Choice on Health and Social Care Relationships
Laurie McMahon

Managing Social Care Information in a Changing Service Landscape
Colin McKinless and Simon Lowles

The Social Care landscape has been changing over a number of years, but the last 12-18 months in particular has seen more accelerated change. Such change presents major challenges for the way we manage social care information and this has never been as focused as it is at present.

Traditionally, the Department of Health has been our single reference point in relation to the social care information agenda. However, the Children’s Green Paper – Every Child Matters (and associated impending legislation), the NHS National Programme for IT (NPfIT), IRT, different Council organisational structures (to name but a few), now mean that our relationships have become much more complex. It can also mean that our ability to influence the IM&T agenda becomes diminished. Co-ordination of the agenda is also increasingly complex with a number of “new” Government players in the Social Care arena i.e. DfES, ODPM, DofH, LGA.

So how can we respond to this landscape and the increasingly challenging and complex agenda? The second part of this plenary session examines how we can attempt to proactively respond, and positively engage, with those people/organisations who have greatest direct or indirect influence on the social care information management agenda.

Stars, Blobs and Doughnuts – Telling the Performance Story
Maurice Bates and Tim Hind

The presentation will seek to stimulate discussion about the relationship and potential tensions between central expectations of performance management and assessment and the flexibility required to drive local action and ownership. It will be flavoured by an explanation of one Councils approach to improving performance – including some of the human problems involved.

Creating an IRT Model – Promises and Pitfalls
Debbie Jones, Mark Gurney and Julie Scurfield

County Durham is a large two-tier shire county, with communities experiencing significant deprivation and large rural areas. There are 5 PCTs and 7 district councils within the county boundary. As a non-trailblazer authority, we chose to focus our work on the IRT project in 3 pilot areas. Using a communities of practice model, we wished to explore the issues with groups of practitioners from a range of partner agencies. In addition, we commissioned a group of young people to work on the issues from their perspective and carried out some life mapping research with young people who had experienced a number of agency interventions in their lives.

Our presentation will explore the findings from these pieces of work to date. The collaborative approach we have adopted with practitioners in the pilot areas has generated some interesting findings about the potential cultural shifts that will be required in order to implement the Children Bill. The work with young people has highlighted their experiences and expectations around confidentiality and information sharing.

Modernising the Health and Social Care Workforce for Older People
Glenys Jones and Alison Tongue

Alison Tongue is leading on the Accelerated Development Programme for Support Workers in Intermediate Care which has been developed by the NHS Changing Workforce Programme. This programme is working with 50 Health and Social Care teams around the country in developing and implementing redesigned roles for Support Workers in Intermediate Care. Alison will be able to share progress and some of the outcomes from the programme.

Promoting Community Involvement in Identifying Hidden Need
David Johnstone, Kauser Ahmed and Brenda Laker

Presentation: A discussion of the challenges in finding out the needs of minority ethnic elders. The presenters will describe an approach that placed the emphasis on using the community to identify its own needs and to participate in planning how to meet the identified needs. The context is which this took place is within an indigenous community and Social Service organisation which has not been inclusive of cultural diversity.

The presenters do not regard themselves as experts, and would like the session to be participative. The presentation is intended to be a starting point for discussion and exchange of information.

New Models of Social Care and Health: The Northumberland Experience
David Parkin

Northumberland was the first, and largest, primary care based Care Trust in the Country. The Presentation will describe why Northumberland went for a Care Trust model, what it includes and how it functions before considering its early successes and what lessons might be learned.

Tuesday 30 March

Making a Difference through Effective Dissemination? The Experience of the Joseph Rowntree Foundation
Anne Harrop and David Utting

The JRF is a leading funder of social research and development work in the United Kingdom. It is not a grant making body but works in partnership with contractors to deliver policy or practice relevant projects that have the potential to influence change. The JRF has a strong record of disseminating its research findings and this talk will illustrate some of the methods used and case study some recent successes and failures.

Mind the Gap – A Case Study for Changing Organisational Responses to Disabled Parents and their Families
Marilyn Crawshaw and Michele Wates

The increased push towards ‘evidence-based practice’ is hindered by limited research into the effectiveness of different approaches. As part of the Making Research Count (University of York) (MRC(Y)) project, the authors worked over an 8 week period with a group of twenty staff from health & social services agencies who carried operational, strategic or training responsibility for services to disabled parents & their families. The intention was to help them to increase their use of an evidence base when improving services for disabled parents. The model of intervention has been developed by MRC(Y) project staff and refined through experience gained over the three years of the project. It draws on theories from adult learning, the process of organisational change, systems centred training and SAVI (System for Analysing Verbal Interactions). It seeks to incorporate attention to ‘practice wisdom’ and service user experiences as well as formal research.

Alongside developing an intervention model, MRC(Y) project staff aim to make visible how the research evidence is appraised by the presenters they use – that is taking account not only of the methodological and interpretative approaches employed in the primary research but also its philosophical, economic and political context.

In the York regional project (which is part of a larger Making Research Count national network) two key groups of staff are used for each 8 week intervention – well-informed researchers (in this case, MW) and facilitators whose skills lay in enabling participants to ‘translate’ the research evidence into service developments (in this case, MC).

Research about parenting undertaken by disabled adults is particularly open to the danger of producing a misleading guide to understanding disability in relation to family life. If its prior assumption is that disability is a personal characteristic – whether physical, intellectual, emotional or sensory – that causes problems for the disabled person and for those who live with them, then it is typically restricted to evaluating the psychosocial adjustment of the family unit. From this perspective, the presence or absence of external supports and the nature of relationships with service providers are not seen as determining outcomes, but as indicators of the extent to which families have or have not come to terms with difficulties related to the presence of individual impairment. In line with this body of research, the development of services in the statutory and voluntary sectors has often focused on assessing the ‘capacity’ of the disabled adult to parent successfully. At the same time, too little attention has been paid to the organisational, economic and attitudinal contexts within which parenting takes place and the impact that these have on a disabled adult’s attempts to carry out their parenting responsibilities successfully. Minimising the negative impact of parental impairment becomes the focus, rather than supporting the parent to uphold the welfare of the child. Within this frame of reference, the child comes to be seen as the primary client within the family while the support needs of the disabled adult in relation to parenting remain unaddressed.

Teenage Pregnancy: Finding out the Views and Experiences of Vulnerable Young People
Jenny Wilding and Mark Barton

This workshop will discuss practical issues related to researching vulnerable young people. In particular it will explore issues related to consultation, consumer involvement, confidentiality and informed consent, drawing on the experience of researching young people’s views on teenage pregnancy in Norfolk. The research was commissioned by Norfolk Social Services and the Teenage Pregnancy Co-ordinator. The workshop will also present the findings and recommendations of the research and how they are being used.

Participants will be encouraged to share their experiences of carrying out research with vulnerable young people and other vulnerable client groups.

Tiers or Tears? The Challenge for Health and Social Services Managers in the Context of a rapidly Changing World
Paul Waddington

SSDs, PCTs and the like can be seen as specimens of a wider category of ’emergent organisations’.  These are organisations experiencing sustained pressures for systemic change from an unforgiving environment and seeking to navigate a course from a known past towards an uncertain future.

This is a milieu which presents unprecedented challenges for ‘leadership’, strategic management’ and for securing the willing participation in the enterprise of the workforce and other partners.

In this workshop, Paul Waddington will draw on his field work consultancy experience of facilitating organisational development.  He will illustrate his own learning by use of some of the images that have arisen from attempts by organisational participants to make sense of their own experience.

Working towards and Evidence Based Practice Culture
Rachael Dutton

This workshop will describe Dorset County Council’s Social Care and Health Directorate’s experience with promoting an evidence based practice (EBP) culture over the last few years.  It  will cover strategies, activities and facilities provided, report on feedback from staff surveys, as well as giving a brief overview of ‘what works in developing EBP’ from the research and grey literature.

The Age of Equalities? Local Authority Strategies for its Older Black and Minority Ethnic Citizens
Jill Manthorpe

This paper reports the findings of a survey of UK local government bodies undertaken in summer 2003 through Better Government for Older People.

The survey asked councils to identify their strategies, plans and priorities in respect of older citizens from black and minority ethnic groups. The survey (n=128) revealed that while one-third local councils were actively working on strategies, a similar proportion had no plans to develop overarching responses.

Many councils reported a need for support in this area. They were keen to hear from similar councils (in terms of rurality, demographic characteristics). They were interested in learning how to work with very diverse communities and how to help develop cultural competence and capacity. However, they often considered issues only in relation to social care and did not consider broader areas of local authority or the contribution and resources of older people from black and ethnic minority groups. This paper identifies ways forward.

Ingredients for Change: A Conceptual Framework for Getting Evidence into Practice
Jo Rycroft-Malone

There is a growing emphasis on evidence based practice, at both a policy and practice level as witnessed by a range of developments and initiatives. The key issue is how to ensure implementation of such initiatives. Policy frameworks typically seem to indicate that the implementation of evidence into practice follows a straightforward, logical and rational model from production, to dissemination and then implementation, audit and improvement. However, examples and experience from practice suggest that getting evidence into practice is a messy and complex process which cannot be explained by simplistic processes. This presentation will outline a project being carried out by a team at the Royal College of Nursing Institute which is attempting to explore and explain the reality of implementing evidence based practice.

The PARIHS project (Promoting Action on Research Implementation in Health Services) draws on experiences of working with practitioners in a range of clinical settings to support the implementation of clinical guidelines, practice development, audit and quality improvement initiatives. Phase I of the project involved the development of a conceptual framework which represents the interplay and interdependence of the elements that influence the effective uptake of evidence into practice (Kitson et al 1998, Rycroft-Malone et al 2002). The framework shows that the implementation of evidence into practice is a function of the relationship between three core elements – the level and nature of evidence, the context or environment in which the evidence is to be applied, and the way in which the process is facilitated. These elements have also been subject to concept analysis. Phase II tested the content validity of the framework. The findings from Phase II builds on the theoretical and practical underpinning of the work completed in Phase I and is informing the development of a self assessment tool that practitioners can use to review and plan their own strategies for implementing evidence into practice.

This presentation will provide an overview of the framework developed for getting research into practice (Kitson et al 1998, Rycroft-Malone et al 2002). The implications of these findings for the ongoing development of the model will also be explored. Potentially this framework offers an innovative approach to implementing evidence into practice because it challenges some commonly held assumptions whilst aiming to provide some practical assistance to those beginning to plan change strategies.

Project Team: Alison Kitson, Gill Harvey Brendan McCormack Jo Rycroft-Malone, Kate Seers, Angie Titchen & Carole Estabrooks

National Evaluation of the Children’s Fund: Methods and Progress
Paul Mason and Rachael Hek

Our workshop will be an opportunity to learn about the methods and progress of the National Evaluation of the Children’s Fund and take part in a practical exercise. We will provide an overview of the National Evaluation of the Children’s Fund project (NECF), covering design, methods, challenges, and early messages. We will then discuss our methods for working with children, and there will be an opportunity to take part in a practical example of this work. There will be opportunities for questioning and discussion about both NECF in general and the work with children.

Improving Older Peoples Services: An Overview of Performance
Ian Bainbridge

The SSI National report on older People’s services (Nov. 2003) was the first SSI report that integrated data from Performance Assessment and inspections. The combinations of quantitative and qualitative approaches gave a new sense of the progress and the short falls that were identified.

Among the generally positive findings however are some areas of serious concern where older people are not served well and /or systems need to be improved. Despite this the report finds that promoting independence is making some progress from rhetoric into reality.

Effectiveness of User Involvement in Promoting Change: Reviewing the Evidence for Older People’s Services
Karin Janzon

The workshop will consider the results of a research review commissioned by the Social Care Institute for Excellence (SCIE) to explore what is currently known about the ways and the extent to which older service users have been able to influence and shape social care services. A key dimension of the review was the active involvement of two reference groups of older people, who were able to place the review findings in the context of the day-to-day experience of older people receiving social care services.

The central question for the review was whether, and in what ways, involvement of older people has succeeded in promoting change and enhancing quality in social care services. The main conclusion is that, while involvement has resulted in considerable knowledge development about what older service users value, this understanding has yet to percolate into the delivery of mainstream social care. Whilst progress has been made in listening to users, there is now a need for a step change in how social care agencies respond to the messages from older service users.

Further details: www.care-equation.co.uk

Developing Research-Informed Practice in Child Care Social Work Teams
Sandra Wallis

My presentation centres on a two-year project working with childcare teams in a local authority social services department that was aimed at encouraging the use of research materials to inform social workers’ day-to-day practice. The project was delivered by organising and setting up practice development groups (PDGs) in seven of the teams, each of which I facilitated for a period of six to nine months.

Group meetings were held fortnightly during this time and lasted two hours. Within the PDGs, social workers’ live cases were used during group discussions to identify what research was needed to move the case forward. Data for the evaluation was collected by means of participant observation, the administration of standardised measures of team functioning and follow-up interviews. The session will report on some of the more interesting findings that emerged from the initiative and will also set aside some time for questions about Research Informed Practice.

Its Easier When you Know How: The Value of Research Skills Training
Chris Russell

I hope this session will be as lively and interactive as the training workshops that led to it! My aim is to highlight the need for, and benefits of, research skills training for those involved in social care. This is based on a retrospective review of two programmes of research skills training held in Kent and West Sussex. The Kent workshops took place over five years and involved several hundred staff, including practitioners, managers and support staff. The West Sussex workshops were subsequently followed by an in-house training programme involving user-researchers, which illustrated the benefits of widening the field.

My presentation will cover

  • What research knowledge and skills participants brought to the training
  • What sort of research tasks they were engaged in, in the workplace
  • What benefits they derived from the training

Discussion will focus on ways forward in promoting research skills training in Social Services Departments and the wider social care arena.

Using Knowledge in Policy and Practice
Amanda Edwards

Simple title – of course people make use of knowledge in policy and practice but what counts as knowledge?  Do people have access to the best available knowledge?  Are they using of the full range knowledge on a subject – is this possible?  Or is knowledge away, undigested, in different places.  Do people instinctively prefer one source or type of knowledge over another?  The list of questions could go on.

This presentation will start by exploring what we mean by knowledge, taking a quick look at definitions and analyse the current needs.  It will examine how we use and develop knowledge, and argue for the cricitical distinction between knowledge and judgement.  The presentation will then take a practical turn with suggestions on how to create the conditions which people use knowledge to learn and change and in which knowledge is useable and accessible in social care.  It will describes SCIE’s contribution – including work on e-learning and models for research use in social care.

Debate: Social Services Departments have Reached their ‘Sell-by’ Date and Should be Disbanded
Peter Kemp, Director of Social Services, Durham County Council will argue for the motion.
Ray Jones, Director of Adult and Community Services, Wiltshire County Council, will argue against the motion
Paul Waddington, University of Central England will ensure that there is fair play!

Wednesday 31 March

Comprehensive Performance Assessment (CPA) 2005 – The Way Ahead
Abdool Kara

My presentation will cover the key proposals we have set out in the CPA – the way ahead consultation document, and headline the critical issues coming through from the consultation responses and what changes, if any, we will make as a result.  I will also include some details on the forward programme of development activity through to the launch from 2005.  I do not think that there will be any need for my presentation to be submitted to the editorial board of the SSRG journal!

Performance, politics and People: Creating Organisations with Attitude
Jeff Chandra

In my presentation I will be referring the models of scoring and performance management that have emerged in organisations over recent times, with particular reference to health and local government services. I will be discussing the extent to which the forces (political and otherwise) that have driven organisations in this direction have been forces for good or ill in delivering high quality public services. I will also be alluding to the internal dynamics that such forces have unleashed and whether they contribute to organisational success over the long term.

Finally I shall attempt to identify some of the key elements of an “organisation with attitude” focussed on consistent achievement of high quality service delivery.

Where next for Public Sector Targets?
Ruth Alaile and Marilyn Lister

Targets are invaluable and here to stay. Used well they drive improvement and increase accountability. However it is widely recognised that the current nationally set targets regime needs to change if some of the criticisms are to be addressed and sustainable improvement is to be addressed across all localities. Targets in the public sector, Audit Commission, September 2003

We all know that when used in the right circumstances, targets can drive public service improvement. But what are these circumstances; and in what instances do we need to use or rely on other mechanisms? What does the increased focus on choice and localism mean for nationally set targets?

This small group/workshop will explore some of these issues.

The Care Pathways Model as a Quality Assurance Tool in Health and Social Care: The Experience in Torfaen

Karen Stephens and Katy Burch
Research has identified that guidelines and standards are more likely to be effective in improving practice quality if they take account of local circumstances, are disseminated actively, and are implemented and monitored using patient or service user-specific reminders or prompts. Katy Burch will outline the rationale behind the development of an innovative application of the Care Pathways approach to influencing and managing continuous improvement in practice quality across health and social care teams.

A staged approach to implementing the tool will be described, with a particular emphasis on:

  • The ‘nuts and bolts’ of successful implementation;
  • Engaging with and motivating staff to change their practice;
  • Maintaining focus on the quality of patient/user and carer experiences;
  • Monitoring agreed standards effectively;
  • Expanding and developing successful pathways.

Torfaen Social Services Department has successfully piloted the Care Pathways approach within adults and children’s services. Karen Stephens will explore the limitations of other quality assurance tools and models for social care settings, and how the Care Pathways approach was able to engage successfully with teams to bring about positive change. Karen will also describe how Torfaen plans to build on its achievements to date, including development of the model across professional boundaries.

Slimming, Speeding and Insomnia: Surviving and Celebrating Performance Management and Inspection
Laura Middleton, Moya Sutton and Tony Foy

A light -hearted look at the impact of the SSI on social services departments, with a serious message. Knowsley has progressed from being a Council dissatisfied with its performance in social care, to one celebrating a hard won 3-star status in just two years. The journey has challenged the way the Council faces the significant deprivation found in Knowsley – the ‘Knowsley Way’ is no magic formula: but the lessons learned and messages from our experience contain all the components of a successful model for working with inspection and performance management agencies and systems. The unique partnership work in Knowsley is vital to continuing to address health and social care inequalities, but is there a cloud on the horizon? Will the new arrangements for health and social care performance management help? The presentation concludes with a look at the challenge for health and social care agencies facing a new way of inspecting and managing performance.

Trying to do a jigsaw without the picture on the box: Delivering and Sustaining Multi-Agency Environments to Support Social Care
Rob Wilson

This presentation will cover the challenge of delivering and sustaining environments to support the creation and re-configuration of Multi-Agency working. It will present work from two projects the EPSRC AMASE (system integration project) and the ODPM Framework for Multi-Agency working project (ODPM National project). The FAME project is seeking to design a generic framework aimed at local government and its partners to support the implementation of joined up working. The framework will include guidance on legal powers and responsibilities, governance, information sharing and identity management which the Newcastle University Social and Business Informatics (SBI) team have identified as key issues underpinning the delivery of multi-agency co-ordination and care.

The presentation will outline the framework, its deliverables and potential application in more detail. The framework is a formative and evolving piece of work and the presenters are keen to gather the responses of the SSRG audience in order to reflect the concerns of those working in management, practice and facilitation roles in the full range of sectors working in social care.

Web-Based Statistical Returns for Children’s Services: Questions and Answers
Annie Sorbie, Gideon Ovadia and Tony Choueiri

The Department of Health has introduced new web-based technology for all child-level returns, covering looked after children for the year ending 31 March 2004. This will enable Local Councils to load their data onto a website and to undertake on-line error corrections. This session will explore how the technology works and how to enter, amend and submit data.

Surviving the Future: Protecting and Promoting Social Work and Social Care Principles and Competencies in the New Organisational Configurations
Ray Jones

For the past thirty years social services departments in England and Wales, and Social Work Departments in Scotland, have been primary host organisations for social care and where social work has been the dominant profession. No more!

Even the Government’s terminology has changed with CSSRs replacing SSDs, recognising the trend which has already taken place, hastened by local government reform in the late 1990s, with social services responsibilities within local authorities being linked in new departments with other responsibilities (especially housing). The Children’s Green Paper, Children’s Trusts and Care Trusts take us further down the road of the demise of separate social services departments, as do relatively new (but unstable) funding streams and initiatives (such as Sure Start and the Children’s Fund).

Within the changing organisational configurations, where social care and social work may not be the predominant interests, are there particular attributes of social work and social care to be protected and promoted? What are these attributes…values and principles, knowledge and competencies? And how best to ensure their profile into the future?

After three days when these themes will have permeated the SSRG Annual Workshop this final session will seek to give some summary comments (and even more personal reflections!) to take away and back to our changing contexts, fired up with a mission to champion social care and social work and to engage constructively in shaping the future.