Our approach to developing communities of practice to foster research capacities for the adult social care workforce

Valuing research capacities in adult social care

Without access to quality research and evidence, social care practitioners can be ill-equipped to up-skill or be aware of cutting-edge innovations, and more crucially, be able to critically evaluate evidence for best practice¹¹. Robust evidence is also needed to inform the public and it is essential that people who draw on care and support and their carers have the best evidence available. At the same time, the voices of people who draw on care, support and help from carers, are an integral part of social-care related research and their inclusion in research can also ‘add value’ to contribute to the evidence base, maximising the impact of research in terms of support and interventions in the sector¹². Lastly, evidence is needed to inform people who draw on care and support along with carer communities, and their direct involvement in contributing to the evidence base is fundamental in developing services that meet their needs⁸.

Difference in research funding between care sectors

Dixon and colleagues have noted in their scoping review on the commissioning of social care research, that relative to health research, available budgets for social care research have tended to be much smaller¹. In 2022, the NIHR reported spending £90 million on social care studies over the last three years¹³. Despite this being a notable increase, NIHR has spent more than £250 million a year on all research; therefore social care research spend still remains a fraction of the overall budget¹⁴. The recent tranche of funding committed to invest in public health research under the NIHR’s Health Determinants Research Collaborations (HDRCs) was £50 million awarded to 13 local authorities¹⁵, yet, the amount of funding for the six adult social care partnerships was staggeringly lower, totalling just over £8 million under NIHR’s Health and Social Care Delivery Research Programme (HSDR). Given the social care research footprint is a rather tangled web of blurred boundaries, many areas of social care research remain unaddressed alongside the outstanding research gaps in the evidence base¹.

Issues with research capacity in the social care workforce

Prior to the establishment of the NIHR in 2006, it was recognised there was a notable gap in the range and volume of social care research, and recommendations were aimed at increasing the evidence base for social care practice⁸. However, implementing strategies targeted at encouraging front-line staff to develop their research skills and knowledge have not been prioritised. Almost a decade later, solutions to increase social care research capacity remained stagnant. A 2015 survey of 70 English local authorities (317 in total in England)¹⁶ on research capacity, knowledge, and skills use in councils with adult social care responsibilities, found that local authorities received little support or resources for investing in research capacity development, with some local authorities not believing they needed to facilitate training to enable staff to acquire and develop their research skills². Furthermore, one of the key barriers to any significant investment in research had been the austerity policies introduced by the Government between 2011 to 2015, which substantially reduced local authority expenditure by 25%. The consequences of which were felt particularly to staff research development initiatives which were seen as ‘non-essential’, and until recently, efforts to foster research capacity in social care had been pushed to the fringes^2,17.

Creating and establishing the COPs

Developing the COPs was prefaced by three online pre-engagement activities aimed at growing and developing the learning partnerships, which required a deeper mutual learning stage to help generate new ideas and research hypotheses involving engagement with social care practitioners, managers, people using services and their unpaid carers, local authority and sector stakeholders. Three large networking events were held in the first year of the project to engage managers and practitioners from the local authority and from the wider adult social care sector. These took place in July and November 2021, with a last event in March 2022. The purpose of these online events was to (i) identify and discuss priority areas in which to focus on in adult social care research in the county, and (ii) introduce communities of practice and focus on how they can support best practice and practice-orientated research.

Inquire

The first online networking event served to brainstorm and capture key research ideas and talk about the ways in which COPs can contribute to shared group learning. This was attended by 113 people from diverse backgrounds including experts by experience (people who draw on care and support and their informal carers), service providers, researchers and care commissioners. Stakeholders were invited by the innovation delivery team, based in the local authority’s adult social care and health department, a collaborative social enterprise supporting local care providers, a national not-for-profit forum promoting quality care, a UK membership body for homecare providers, and through snowballing by the project’s chief and co-investigators. As a networking exercise, to enable full engagement of all people, stakeholders were not purposively identified, and to this end, people were not asked to indicate if they were attending on behalf of a specific organisation or sector. Seven facilitated online breakout sessions were conducted and led by members of the project team. Facilitator briefing notes were compiled and the sessions were video-recorded with the permission of contributors. We produced instantaneous Word Clouds based on the discussion notes from the seven breakout discussion groups. Each group had two facilitators who took notes and saved them to a shared document. This allowed one qualitative researcher to produce the Word Clouds during the event and showcase them to the audience at the end. For example, workforce, training, wellbeing, dementia were some key words from the discussions around “what are the key research priorities in adult social care in [county name]”; with time, practitioners and user engagement frequently mentioned when discussing “how to support practice-focused research in [local authority] adult social care in [county name]”. Following the first event, the ideas from the breakout sessions were revisited and thematically coded using NVivo, when we generated additional Word Clouds on the discussion topics (i.e., "What are the key research priorities in adult social care in Kent?" and "How to support practice-focused research in adult social care in Kent?"). The Word Clouds feature in the top 70 frequently mentioned words for each question, excluding common terms like “research”, "social care," and "the". (see Figure 1 for thematic coding framework) with four research priority areas identified: (a) inter-professional working, (b) empowering under-researched groups (e.g. self-funders, self-neglect, older people), (c) enhancing workforce sustainability, and (d) co-producing social care services.

Figure 1. Research priority areas identified at Kent Research Partnership’s first networking event.

We invited stakeholders who had previously attended the first networking event to a second online networking event, taking place in November 2021, which was promoted widely via our local networks including the local authority, an independent body supporting local care providers, NIHR Applied Research Collaboration [withheld] partnership and the HEI. We had 117 registered attendees overall, again from diverse backgrounds including experts by experience, service providers, researchers and commissioners. For the second event, the same approach was enlisted for reaching out and involving people, as described for the first networking event. The purpose of this second event was to (i) present and discuss the four identified research priorities and (ii) develop the communities of practice with regard to organising and facilitating the sessions. The attendees had the opportunity to give their initial responses to the identified research priorities and indicate how the COPs could be best facilitated through two separate breakout sessions. The first online breakout session involved an open discussion with the facilitators asking attendees ‘what do you think of these research priorities?”, with a video recording of discussions being undertaken with the permission of contributors.

Following the first breakout session, attendees were asked to indicate their responses to the research priorities through a ranking exercise, which was set up using an online survey tool called Qualtrics and the weblink for responses was made available at a specific time point during the breakout session (see Figure 2). Responses were received from 52 attendees, with results indicating that enhancing workforce sustainability was ranked highest overall, followed by co-production in social care services and empowering under-researched groups being closely ranked as second and third priority areas respectively, and effective inter-professional working designated least overall priority. The results were not representative of all respondents’ views but provided indicative scores of the shared priority setting exercise.

Figure 2. Priority area ranking exercise results identified at second networking event (N=52).

Before the second online breakout session commenced, the live results of the research priority ranking exercise were shared with the attendees, followed by a short discussion on the proposed aims and scope of the COPs with an opportunity for attendees to ask questions. In the second breakout session, attendees were asked ‘how can we translate the research priorities identified into Communities of Practice?’ The discussions were video recorded with the permission of contributors.

Design

After the second networking event, an ordering and thematising process took place to take on board feedback from attendees to help define COP activities and roles to support its goals. The recorded discussions and responses from the second breakout session were organised into themes and helped to identify key issues of concern or domains for the COPs. The themes were arranged under two broad ‘rooves’ of the community (house) as shown in Figure 3 and were titled: (a) Supporting people with complex needs throughout the lifespan (shortened to ‘Complex Needs’), and (b) Enhancing, diversifying and sustaining the social care workforce (shortened to ‘Workforce’). An inductive-deductive approached was used in the thematising process, with inductive coding themes emerging from the facilitated discussions, and deductive coding themes being derived from the coding framework developed after the first networking event²⁴. Three shared principles were identified as ‘foundation stones’ for each COP: Co-Production; Equality, Diversity, Inclusion and Intersectionality, and Practice-Oriented Approach, which were underpinning themes that were identified from the initial ordering and thematising exercise and intersected across both COPs (see Figure 3).

Figure 3. Communities of Practice ‘Houses’ outlining domains.

Prototype

A third online networking event occurred in March 2022 with the primary purpose to initiate the COPs around the two COP domains, with the express purpose to allow attendees to ‘try-out’ a COP through a mini session of both groups. A total of 83 people attended (experts by experience, service providers, practitioners, researchers and commissioners). For the third event, the same approach was enlisted for reaching out and involving people, as described for the first and second networking events. We brought together and launched the COPs at this third event when the houses were presented and a Google Jamboard (a digital whiteboard suitable for online collaboration) was used in each breakout room to identify more ideas into each of the houses. A variety of topics were discussed under each themed domain. Examples are represented as evolving bubbles in Figure 3, with distinct sizes (dependant on the scope of the question and number of COP members who were interested in it), different levels of focus (narrow/broad) and mapped against different timelines. The latter acknowledges that COP members would not focus on all interest areas at the same time, whilst also recognising the interrelation of specific topics within a COP through connections.

Along with the two online break-out sessions enabling attendees to discuss the topics and try-out the COPs (with a record of discussions being undertaken using the same approach as the first and second events), they were also asked to participate in a short-survey to record which domain attendees shared a common area of interest in. Two people selected ‘other’ as an option, one stating they would like a community of practice focusing on ‘how to promote research in social work?’, which was deemed within the scope of the Workforce COP. The second person suggested a COP on the ‘long term impact of long COVID especially in young people and its effects on mental as well as physical health; likely future implication for social care’, which was assigned to the Complex Needs COP. The information collected at this last networking event showed that interest belonging to either one of the COPs was evenly split, therefore the COP domains seemed to have salience and suitability with the attendees to enable the final launching for the COPs to take place in the forthcoming months.

Launch and grow

The COPs were launched online in June 2022, with an organised schedule of dates planned across the first year occurring on a monthly basis. Due to the COVID-19 pandemic, all of the COP sessions were organised online and have continued to function online, as this has offered the flexibility of attending in and around work or care commitments. We also consulted COP members on their preferences of time of meeting, and jointly decided to hold these meetings in the middle of the day to enable practitioners to attend during lunch times. The format of each COP has focused around a presentation by one or more speakers on a topic relevant to the domain. Talks for the ‘Complex Needs’ COP have included: choice, control and direct payments, work transitions between children’s and adult’s services, supporting moves of older people between care settings, inclusive social care practice and commissioning, and technology use in adult social care. For the ‘Workforce’ COP, topics have included: recruitments and retention issues (e.g. what we can do to make working in social care more attractive for young people), workforce concerns from a provider/funding perspective, spotlight on research embedded in care homes, workforce data, career development pathways, support for care workers, and experiences and expectations sought from social care.

Engagement and facilitation

The importance of engagement and facilitation of the COPs are critical to their success (Padilla et al., 2021). Yet, the constraints on sector staff time have required a rethink of how the COPs would traditionally have been organised and facilitated. The partnership’s team members based at the HEI and local authority have acted as convenors, providing a space for both the organisation and facilitation of discussions across the two COPs. This has helped maintain regular effective communication and continuity, keeping channels for shared learning open and making sure presentations address the needs of COP members²⁵. Membership of the ‘Complex Needs’ and ‘Workforce’ COPs have reached up to ~115 to ~118 respectively, and some people are members of both, whilst others only belong to one. The decision to hold the COPs online was initially a consequence of the COVID-19 pandemic, in place to limit physical interactions, but has allowed for the involvement of a broader range of stakeholders and COP members. The virtual platform has helped facilitate accessibility of the COPs to members using communication technology, carers and cared for people based at home and for a time-poor sector, namely the social care workforce. Importantly, successful use of virtual platforms for the COP meetings as well as for discussions and document share in between the meeting, hinged upon bespoke training sessions on using Zoom, MS Teams and Glasscubes platforms (five sessions in total), as well as in one case a researcher visiting an expert by experience in their home to assist with digital set up and discuss optimal ways of using communication devices (e.g. speaking aids and text readers). Outside of COP meetings, researchers also worked with the experts by experience group (all of whom attend one or both COPs) by seeking routine feedback and amending how COPs are run accordingly. For example, additional IT training sessions, diversifying ways in which COP members are invited to the meetings and varying days of the week when COP meetings take place were all introduced as a result of this.

During COP meetings, the facilitator role has ensured that members are given the chance to speak, supported by an additional team member responsible for checking the web-chat function in order to address any questions raised by COP members²⁶. Discussions for each COP have involved working together to identify evidence gaps, with the view to plan research projects that are relevant to the community’s goals and interests. The opportunity for COP members to develop a research idea independently into a social care research project has been set in motion through the availability of research and training fellowships (up to £90,000 each), which COP members can apply to. These fellowships aim to bridge the training and skills gap for social care practitioners interested in research, thereby both fostering and supporting research capacity development from within the group (see Kent Research Partnership fellowship information video). At the time of writing, 20 sessions for each of the COPs have taken place which have enabled COP members to share knowledge and experiences fully engaging in a rich dialogue about key concerns and challenges, airing issues and brainstorming ways forward, and providing insight of ways to support best practice and practice-orientated research.

Enrichment and online resources for supporting collaboration

Using cloud-based collaboration platforms to support online research communities provides a mechanism to encourage working together. Enabling the storing and sharing of information outside of an organisation’s firewall, in a space that is safe and accessible for all users based within or external to an organisation has encouraged ongoing engagement with the COPs. Each COP has a dedicated workspace enabling COP members who have joined to share thoughts, post interesting information and announce relevant opportunities. Supporting accessibility and increased functionality for COP members is paramount, and introductory training sessions are vital to induct new users to engage with the online platform. In order to facilitate buy-in and grow membership of the COPs, videos have been created explaining what the role and function of the COPs are to encourage new members to join²⁷. Creating a COP handbook has provided all members a focus on the group’s guiding principles, rules of conduct, membership entitlements, operationalising the group according to ethical principles, as well as outlining the logistics of how to join online. Using an online platform has shown how an online space offers both COP facilitators and members a vehicle to communicate regularly between COP meetings, support direct discussions, and undertake knowledge sharing and networking between our COP members and ultimately democratises knowledge-exchange for COP members, involving all corners of the sector experts by experience and social care practitioners and managers.