Change Model Stage 2: Mobilising the evidence

How to Mobilise the evidence

With growing pressures and often insufficient funding for social care, it is even more important that scarce time and resources are focused on things that might make a real difference – change should always be evidence-informed.

Evidence in adult social care should include:

  • different types of research
  • the lived experience of people who draw on care and support or who are carers
  • the practice knowledge of people working in adult social care
  • diverse perspectives and experiences

Evidence should be gathered sensitively, considering the risks of power imbalances, unheard voices and discriminatory bias.

Different groups may value different types of evidence, for example, those based on stories or economic impacts. Taking a broad approach can give a more thorough perspective.

Evidence does not always provide a clear ‘answer’ – but often it gives you a sense of what might be fruitful, a starting point for dialogue and further questions to help you make progress together. Evidence helps to achieve outcomes which matter to people who access and work in social care – so should inform day-to-day activities and decisions.

Examples within IMPACT

The PA Wellbeing Demonstrator started from the position that enhancing PA well-being will be beneficial for both PAs and their employers. To improve understanding among PA stakeholders of what ‘well-being for PAs’ means and how it could be improved, the project undertook a review of international literature and established two expert groups to ground the evidence in lived experience and practice knowledge.

Combining published evidence with lived experience and practice knowledge enabled the evidence to be grounded in real-life issues. Co-producing the recommendations helped to provide credibility with key stakeholders by aligning with the value-base of the independent living movement. The evidence was provided in an accessible, easy-to-read format in advance of group meetings to enable people to understand the evidence.

The facilitation skills of the IMPACT Coaches were valued by partners, including their ability to engage ‘thoughtfully and inclusively’, whilst having a budget to pay people for their participation was also a critical enabler in the project.

The Facilitator project in Moray was focused on tackling loneliness among older people living in a rural area. To build on insights from research, and to understand local resources and experiences, the project sought to map the approaches currently available in Moray.

This started with an evidence review, web searches, visiting communities (exploring notice boards and in conversation with local people) and speaking with people involved in delivering services and approaches (local authority, NHS, church and community).

The Facilitator then met with older people, their families and those who provide support to seek their views on factors which lead to loneliness; what helps people feel connected; and what would reduce loneliness in Moray. The project focused, initially, on Speyside and Buckie and their surrounding areas – allowing for comparison between a rural farming and a coastal fishing community. This was then widened to include Elgin due to the concentration of services and activities for specific groups of people in the town.

The experiences and views of other groups of people, for example, people with learning disabilities or sensory impairment, individuals living with dementia and their carers and other minority groups such as the LGBTQ+ community were also actively sought.

All four UK nations are characterised by alarmingly high levels of people with learning disabilities and autistic people admitted to long-stay hospitals, with an average stay of 3 years (and more). Often discharge plans are delayed due to lack of adequate community services.

At the first meeting, the members of the local Network groups discussed the evidence review and their experiences of long-stay hospitals and late discharge for people with learning disabilities/autistic people. Between the second and the third meetings, Networks used the initial review and their subsequent discussions to start identifying the key areas where they wanted to see changes. Changes between meetings included building connections with other organisations, benchmarking their practices against the ‘10 top tips’ for helping people to leave hospital (from the original evidence review), organising demonstrations (i.e. more ‘direct action’) and holding a conference at the Scottish Parliament.

It became clear from the Network meetings that the issues and challenges are collectively felt across the four nations, and a collaborative approach could be effective in raising awareness and encouraging local and national action. This has included the production of a film highlighting the issues, developing case studies of effective examples, and setting up a community of practice. ‘Turning up the volume’ on lived experience and practice knowledge alongside research evidence has led to clear and impactful actions and practical ways forward.

The transition to adulthood for people leaving care is often ‘accelerated and compressed’ as adults with care experience often take on responsibilities of adulthood at an earlier age compared with their peers. To understand how this could be improved, the Care Leavers’ Project started with an evidence review, drawing on evidence from across research, practice and lived experience. This identified several areas where adults with care experience may benefit from support, including psycho-emotional readiness, relational and material support. It was able to identify mechanisms important for strategic change including dynamic leadership, collaboration, maximising data use, planning, attentiveness to identity and co-production.

In addition to the evidence review, the Senior Strategic Improvement Coaches engaged with care experienced individuals who raised key issues that they felt were important to their experiences of adulthood but were under-represented in the evidence review: identity, place and transport, pregnancy and parenthood

This culminated in several sense-checking meetings with stakeholders, including a local steering group in Fife, individual meetings across Coventry, and the development of an initial theory of change for the IMPACT project moving forwards.