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A major element of modernising English adult social care is the introduction of individual, user-directed budgets. The Social Policy Research Unit (SPRU) led a major, multi-method and multi-centre research programme evaluating the Individual Budget (IB) pilot projects in England; and a linked study of the impact of IBs on family carers. Through this, SPRU has influenced: the content of the Department of Health's (DH) good practice guidance for personal budgets; the DH's approach to piloting and evaluating NHS Personal Health Budgets; the Department for Work and Pensions (DWP) piloting and evaluation of `Right to Control' trailblazer projects; and, the agenda for an Audit Commission investigation into financial management of personal budgets. Most importantly, it has helped shape the agenda for national and local organisations striving to successfully implement personal budgets, particularly for older people.
The law regulating social care services for disabled and elderly adults, and their carers, had been unreformed for over 60 years. Reform had been inhibited by the law's complexity, the rapid growth in community dependency (due to deinstitutionalisation and the growth in the numbers of elderly people) and the lack of political consensus on the direction reform should take. Fundamental demographic and societal change over the last 20 years has made the failure of the legislation to address the support needs of unpaid carers and those for whom they care an even more pressing issue. As a result of a sustained period of research, academic publication and Parliamentary action by Clements, this area of law is now being reformed. Both the Westminster Parliament and the National Assembly in Wales have been scrutinising Public Bills (the Care Bill 2013 in England and, in Wales, the Social Services and Well-being (Wales) Bill 2013). Despite significant social policy research on this fundamental issue, Clements was almost alone in highlighting the legal dimensions. He thereby made a major contribution to public discourse on this question and played a key role in bringing about legal change.
This case study demonstrates how programmes of research led by the University of Sheffield since 1995 have generated theoretical models and implementation tools that have had considerable significance and reach in a diverse number of areas.
There have been impacts on:
The importance of person-centred social support has been recognised by successive governments as central to the development of effective and supportive social care services. The research led by Brunel and funded by the DoH and the Joseph Rowntree Foundation, made a substantial contribution to the enhancement of UK social care policy and practice in relation to the personalisation agenda. Parliamentary committees and policy consultation used the research to develop new social care policy. Standards of service care delivery were developed and implemented in partnership with service users; these were adopted at a policy and practice level. The development and use of evidence based practice guides, training programmes and web resources facilitated the successful adoption and implementation of person-centred support nationwide. In summary, public debate was influenced, equality and empowerment for service users was advanced, national policy and practice enhanced, health and welfare improved and economic impacts achieved.
Publication of the first major piece of research on young adult carers [YACs] has led to recognition of a `new' group of carers in policy and practice, and the development of two new psychometric instruments.
Raising awareness with Government, policy makers and service providers, has resulted in the provision of new services and support and further education provision for YACs across the UK, and the psychometric tools are now being used extensively by organisations including Comic Relief, The Government Innovation Fund, the BBC, and in a dozen countries.
Adult Social Care (ASC) is a growing sector which currently employs 1.6 million care workers and benefits 1.8 million care recipients. Research carried out by Manchester Metropolitan University (MMU) into the recruitment, development and retention of ASC workers has had a direct impact on ASC policy, management practice and human resource (HR) practice.
In the area of health, welfare and public policy, the primary research impact was on the Adult Social Care Recruitment and Retention Strategy 2011. Among ASC managers and HR practitioners, the research findings informed and stimulated debate over the conduct of ASC work and the benefits of good HR practice.
The research has led to the design of a new clinical pharmacy service model, centred on community pharmacies, to improve the care of patients with palliative care needs living in the community. This resulted in better provision of information for patients (and their carers) and new training resources and staff development opportunities for the multi-disciplinary palliative care team. Funding has been secured to rollout the new service across NHS Greater Glasgow and Clyde Health Board (NHS GGC - 1.2M population) in 2013. The research has also supported a successful bid to explore the service model in a remote and rural Health Board (NHS Highland) and has informed specific programmes of Macmillan Cancer Support UK, pharmacy workforce planning, and the Boots Macmillan Information Pharmacists initiative.
The Personal Social Services Research Unit (PSSRU) at the University of Manchester (UoM) has run a programme of research examining community care of older people since 1996. The findings have informed key government decision-making around two important national policy initiatives between 2008 and 2013: (1) the development and implementation of Personal Budgets in Social and Health Care and (2) National Strategies to improve Dementia Services. This has affected the national provision of social care for older people and other adult social care users. In 2011-12, there were over 1.2 million people in England receiving social care affected by these policy changes (over 800,000 aged 65+), with a cost of £6,600m spent on their care (NHS and Social Care Information Centre).
The issue of spiritual care is enshrined within both health and social care policy in Scotland. Both sectors often struggle to meet these needs. This impact case study relates to two unique initiatives arising from the research of Swinton that have sought to address this gap in knowledge and practice. The Kairos Forum for People with Intellectual or Cognitive Disabilities has focused on putting academic research into practice for issues relating to spirituality and intellectual disabilities. The Community Chaplaincy Listening Project has taken chaplaincy provision and spiritual care and extended it into the community. Together these initiatives have contributed to better practice in relation to healthcare (especially relating to mental health) and the lives of people with disabilities, for the NHS, churches and social care.
The research has had significant impact in the UK on the development of social and spiritual support for people at the end of life and their families. With Professor Holloway as Social Care Lead on the National End of Life Care Programme (NEoLCP) since 2009, the research has underpinned the launch of a framework for the delivery of social care at the end of life which is now in its second phase of implementation. The framework is endorsed by the Association of Directors of Adult Social Services and has led to local and regional Action Plans and social care practice initiatives. The research on spirituality has led to scoping and training initiatives in healthcare practice and in the funerals industry within the UK and internationally.