Award Title: Examining Impact of Local Area Coordination as a Preventative Intervention in Adult Social Care
Funder: Department of Health and Social Care

Abstract: The UK government posits prevention as a potential solution to the ASC crisis and key to transforming ASC systems. The transformative potential of preventive interventions lies in their ability to relieve demands and financial strain on formal services, while simultaneously developing more effective systems of support and empowerment for citizens and communities. Currently we lack a detailed understanding of how, why and under what circumstances prevention can improve the lives of ASC service users and reduce the need for statutory services. This proposal addresses this important evidence gap by examining the impact of one particular model of prevention, Local Area Coordination (LAC).This prospective and retrospective study investigates whether and how LAC impacts upon the lives of people who engage with the service and the communities in which it operates.      This project is a unique collaboration between academics, LAC managers, frontline staff, voluntary/community organisations and people who participate in LAC services. The research will:    Provide the first comparative analysis of well established LAC programmes.  Utilise qualitative data from LAC participants to inform the development of a cost consequence framework addressing a significant knowledge gap on the impacts of prevention.  Situate its impact by comparing the experiences of those who engage in LAC with those who have disengaged addressing gaps in knowledge around causality and the counter-factual.  Embed service user involvement; both through the service user advisory board and through the participatory action research approach to reflect their voices.      This project will examine LAC through the integration of participatory action research and nested economic study approaches. The research combines quantitative and qualitative examination of secondary process and LAC system level data, alongside experiential qualitative data gathering on the LAC network in place and on participants' experiences of LAC and the outcomes they perceive it to produce. These data, alongside the review of secondary data sources, are used to develop the cost consequences analysis framework. It is this distinctive combination of methods which will produce a more extensive examination of the effectiveness of LAC; both in terms of its capacity to deliver benefits to the lives of service users (and the communities they live in) and as a preventive intervention.       With increased emphasis on preventative ASC approaches and community based programs in the aftermath of COVID-19, this research will provide timely analytical findings to strengthen and inform policy in this field. Our trusted relationships with the National LAC network and broader relationships with both practitioners and national policy makers through both our Enabling Social Action and COVID-19 projects, provide the foundations for ensuring that the findings can have direct impact on decision-making. The findings will provide a stronger evidence base for understanding how, why and under what circumstances LAC can make a difference to ASC provision and create an analytical framework which can be applied to other preventative interventions.

Lay Abstract: Demand for Adult Social Care services are increasing, however the funds to support this are limited. National and local governments are looking for ways to tackle this challenge. One key approach is to look at what early support they can give to people to help them avoid needing to use more services later on. These types of services are called  preventative interventions . As well as helping to reduce the demand on social care services, it is suggested that these types of support can also be good for communities and give people more of a say over services. The challenge however is that money needs to be found for these new services, but we are not sure how effective they are, why they work, and in what situations. To understand this we need to do new research on these preventative schemes.    This research looks at one type of preventative scheme called Local Area Co-ordination. It was introduced in the UK in 2012 and is currently used by 13 local authorities. This system has a basic set of guidelines for local authorities. Doing research on Local Area Coordination gives us a good opportunity to compare how it is used and what effects it has on different people s lives in different locations. We will be working with all the members of the Local Area Coordination Network, but the research will focus in particular on the way the scheme is used in Leicestershire, York, Derby and Thurrock.  This research is important as we need to be clear about the benefits that preventative schemes can offer to people who use services and to how local authorities provide these services. The research will ask:    How people experience local area coordination  What shapes whether or not people have a positive experience  Whether Local Area Coordination prevents people from having to use other social care services.   By asking these questions the research will understand where Local Area Coordination works well and why, and how it could be improved. It will also help us to understand whether these types of schemes provide an effective way to support social care services.  Because it is difficult to be able to prove whether or not providing these types of support actually stops people from needing other services later on, the research is using a range of different tools and expertise.    We are talking to people about their experiences of the scheme and how they think it has helped them.  We are talking to the teams who provide Local Area Coordination to understand how they make Local Area Coordination work.  We also have economics experts to try to understand the costs and the benefits that the scheme creates.

Research Activity Codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health Categories: GENERIC HEALTH RELEVANCE