In 2018, Social Care Wales published Social care research and development strategy for Wales 2018−2023; in partnership with Health and Care Research Wales. This set out the ambition to see research evidence embedded in both practice and policy in social care and social services in Wales.
Evidence-based or evidence-informed practice should lead to better outcomes for people who use social care and support. In reality, there are challenges with putting evidence into practice, and it is hard to be certain when and how investment in social care research is making a positive difference to outcomes.
From existing research, we know that using different types of evidence can be challenging for a variety of reasons. Barriers include:
- the high volume of evidence and research, which is too difficult to stay on top of
- a lack of support for putting evidence into practice, even when it is available in a summarised and usable format
- research findings which quickly become out of date.
At the same time, things that help with evidence use include:
- making sure that research reports include clear messages for practitioners
- combining formal research and evidence with professional judgement and the local context
- opportunity, motivation and skills in the social care workforce to use evidence
- strong relationships between researchers, practitioners and policymakers.
This study focused specifically on the challenges and enablers to using evidence in social services and social care in Wales. People we spoke to raised some of the points above but talked specifically about what they meant for people working in social care in Wales. They also made new observations that were specific to working in Wales.
A steering group, made up of representatives from local authorities, research, the Welsh Government, third sector, regional partnership boards, Social Care Wales and SCIE, helped shape this research.
Overview of the project
Social Care Wales commissioned this research to explore how people working in social services and social care in Wales understand and use ‘evidence’. Our definition of evidence includes formal research, the voices of people who use services and carers, and wisdom and knowledge from practitioners, organisations and policymakers.
The Social Care Institute for Excellence (SCIE) carried out the research, and findings are helping Social Care Wales to shape its strategy and approach for supporting evidence use.
Most of the data was collected through in-person, semi-structured focus groups between January and March 2020, with some further work into September 2020. This phase of the research was with frontline staff, managers, and others working in local authorities, and with people working in policy or research. In the next phases of the research, we will talk to provider organisations and organisations led by people and carers who use care and support services.
Factors influencing evidence use
Participants described barriers and facilitators to evidence use:
- Time: lack of time and ‘headspace’ was a consistent theme, being a particular barrier for frontline staff. Policy and other decision-makers felt the lack of time to reflect on findings, including from research they themselves had commissioned, could hinder its implementation.
- Access: lack of access to journals, databases and other information sources due to paywalls was highlighted as a key barrier.
- Usability: people called for summarised, succinct evidence, with practice messages drawn out. This applies to a range of evidence types, including practice guidance, research and legislative knowledge.
- Applicability: evidence was said to be much more useful and impactful if it applied to day-to-day work. People also highlighted a lack of Welsh-specific evidence.
- Trusted evidence: people often struggled to find or determine whether research was trustworthy and appropriate for their aims. Researchers highlighted that limited funding and timescales could reduce evidence quality.
- Skills and qualifications: lack of skills and confidence in finding and using evidence and undertaking research was a consistent theme.
- Motivation, buy-in and mindset: ‘research-mindedness’ of an organisation could be shaped by individuals, and the reliance on individual motivation meant a lack of a formal structure for research use within organisations.
- Relationships and knowledge sharing: relationships were seen as crucial − discussion with colleagues was seen as critical to frontline practitioners. Sustained relationships between researchers and policymakers/practitioners were seen to promote well-planned research which was more likely to have impact.
- Legislative and policy context: legislation and policy knowledge are central to local authority staff who predominantly serve a statutory function. However, many were nervous about being challenged on their choice of research evidence, particularly in the court arena.
- Values and lived experience: social work and social care promotes the use of ‘service user voice’ as a type of evidence. Although legislation and policy emphasise service user and carer perspectives, the values of respect and empowerment were also important in incorporating the views of people with lived experience.
- Leadership and culture: seen as important and a key driver of research mindedness within organisations and whether time was carved out to engage with evidence.
- Funding: often viewed as a barrier to the production and evaluation of research and evidence − accessing, searching, quality-checking and understanding it, as well as applying evidence in practice.
Initiatives and ideas to support evidence use
Participants explored which initiatives currently work well to support evidence use in Wales, as well as ideas for the future to increase evidence use further.
Leadership and culture
Some highlighted the need for leadership and oversight of activity in the ‘social care evidence’ domain in Wales to join up related work, maximise impact and reduce duplication.
Participants also discussed how to develop a ‘research-minded’ culture in organisations such as local authorities, at both the team and organisational level. Ideas included discussing research and evidence in supervision, supporting attendance at events and conferences, and carving out time for engaging with evidence and reflection.
Methods for accessing and exploring evidence
An online resource was one of the strongest suggestions across stakeholder groups. It would be a central, consolidated, accessible resource summarising relevant, up-to-date and trustworthy evidence. Some also called for a searchable resource of all current, completed and planned research projects to avoid duplication and increase opportunities to build links. Challenges with central resources and the high volume of information out there was also noted.
Face-to-face training: A strong theme amongst local authority stakeholders was that training worked best when it had practical application and gave tools for use in practice.
Local authority or inter-agency initiatives: any local authority stakeholders gave examples of internal and inter-agency events, including conferences, inter-team days/awaydays, group supervision and reflective sessions. Some non-frontline staff also called for better data sharing between agencies, to collate knowledge and avoid duplication, sometimes case based. These initiatives required good relationships and supportive leadership.
Events and collaboration across practice, policy and research
Examples and suggestions for events and collaboration included:
- ExChange – this existing forum was seen as useful, including the opportunities to ask researchers questions and draw links to practice.
- Communities of Enquiry – were valued, especially the interactive and supportive nature of these events, in which people explored evidence.
- Practice networks – were seen as useful opportunities to share best practice.
- Embedding research into existing networks and work programmes – was suggested as a way to engage new people in research and knowledge sharing.
- Sustained collaboration and joint working – were suggested by researchers as means to increase mutual understanding and strengthen links, especially as networking was seen as insufficient. For example, researchers might spend a day a week in policy or practice settings or vice versa.
Practice research and co-production
Participants widely called for a structure and strategy around research in local authorities, which would enable more practice research. Some called for replicating the schemes, structure and funding available in the health sector.
Specialising and development
Many suggestions for enabling and increasing evidence use amongst practitioners and teams focused on individuals upskilling and specialising, seen as a way of addressing low confidence and motivation. Linking this to existing appraisal and continuing professional development processes was recommended.
Funding and database access
The structural issues of funding cut across many of these ideas and initiatives. Specific suggestions included the funding of evidence or research leads within local authorities and other organisations, more funded opportunities for local authority staff to study, long-term funding of innovative services, and resources and capacity amongst policymakers to implement research findings through a strengthened implementation infrastructure. People from all stakeholder groups called for practitioners and policymakers to have access to journals and other evidence databases. However, many also noted that journal articles were not sufficiently usable and condensed for practitioners.
Guiding principles and recommendations
The steering group of Social Care Wales, SCIE, representatives from local authorities, research, government, third sector and regional partnership boards, came together to discuss the key findings and suggested initiatives for improvement. Together, this group co-developed six recommendations and four guiding principles that underpin them.
Guiding principles underpinning all recommendations:
- Relationships are central: interpersonal relationships and collaboration are important in enabling people to access, understand and use evidence.
- Partner and collaborate: maximise collaboration between practice, policy, research and people with lived experience, when designing services, undertaking research and developing and sharing evidence.
- Practible and tangible: evidence, whether communicated in training, written summaries or through other methods, should provide practical and applicable knowledge and/ or tools to help use by social care staff.
- Take a whole-place approach: recognise barriers and facilitators across the system, including leadership, culture and practical/ structural factors. Make links between local, regional and national levels.
- Identify opportunities to facilitate collaboration, networking and knowledge sharing across research, policy and practice. Build on existing networks and models.
- Explore opportunities for a central, digital resource providing access to relevant, up-to-date, trustworthy evidence in a clear and summarised format. First explore whether access to existing digital resources would meet this need. Additionally, address access to journals.
- Consider developing a searchable resource of all current, completed and planned research projects in Wales. Additionally, consider developing a strategy and structure around opportunities for practice research within local authorities.
- Enable practitioners to gain specialist knowledge, via qualifications, post-qualification and ongoing training and development.
- Take a whole-systems approach by supporting leaders to establish learning cultures.
- Investigate and identify solutions for the structural barriers to evidence production and use in local authorities − sufficient time and appropriate funding.