Award Title: Understanding and using people’s experiences of social care to guide service improvements:could an effective and efficient co-design approach be translated from health to social care using the exemplar of loneliness?
Funder: Department of Health and Social Care

Abstract: Local authorities need to find new ways of collecting and using data on people’s experiences of social care to improve service design and quality. We propose to adapt and test a service improvement approach successfully used in health care settings. We will use loneliness as our focus. Loneliness affects many people and is important to local policy makers. Based on rigorous qualitative research the approach will use carefully selected extracts of people describing their social care experiences in the form of a 20-25 minute film to prompt discussions about how services can be improved. Importantly these discussions involve local authority staff and lay people working as equal partners. _x000D_
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There are two stages: 1. DISCOVERY. Interviews with a national sample of 40-50 people exploring their experiences of loneliness and social care, and with 20 social care staff to explore opportunities for service improvement around loneliness. Interviews will be filmed or audio recorded if the person prefers, typed in full and analysed for ‘touch points’ which show positive care moments or areas where services could be improved. A 'touch points' film will be produced. 2. CO-DESIGN involves separate feedback workshops with staff and social care users followed by a joint meeting where the film is shown to both. Participants work together to agree a list of priorities to put in place for improving services._x000D_
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Interviews will include those who are less often heard in research e.g. learning disabled people and people from black and minority ethnic groups. Doncaster will be the test site for stage 2 because loneliness is a high risk in many parts of the city and tackling it is a priority for the local authority. Given the challenges that social care research faces in engaging practice and the time it can take to build and sustain links with local authorities it is important to have a willing organisation who are interested in research and are committed to the topic area._x000D_
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Working with social care service improvement colleagues from adult social care and Doncaster residents who experience loneliness, we will use observations and interviews to study how improvements are made over a nine month period. Key questions will include i) whether this approach using a film based on a national interview study of social care users and staff perspectives of loneliness would work in a local setting and ii) whether this quality improvement approach is acceptable, or needs adapting, for wider use in social care. _x000D_
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Outputs: a section on loneliness based on analysis of the interviews with around 250 film, audio and text extracts published on a new website Socialcaretalk.org; recommendations for the use of this service improvement approach in social care; conference presentations; a new interview collection for the Health Experiences Research Group data archive for secondary analysis; end of project event; three academic papers._x000D_
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Anticipated impact: Local authorities need new ways of collecting and using data on people's experiences of social care to improve service design and quality. Our study will draw on and adapt as appropriate an approach from the healthcare improvement field to address this need. The touch point film will be transferable for use in improvement initiatives across other local authority settings. The project will provide valuable learning beyond the immediate project outcomes through a wider engagement strategy with social care partners.

Lay Abstract: BACKGROUND:Local authorities (LAs) need to find new ways of collecting and using data on social care users' experiences to improve service design and quality. Our study will draw on and adapt as appropriate an approach from the healthcare improvement field to address this need using loneliness as a focus. Loneliness can have a well documented and recognised significant negative impact on the health and quality of life. As a result many and varied preventative and case finding activities are being instigated in the community however there is little evidence to support their effectiveness. Exploring how evidence is created and considered is therefore of great importance._x000D_
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AIMS: to assess whether an effective and efficient co-design approach ‘accelerated experience based co-design'(AEBCD) can be translated from health to social care. _x000D_
OBJECTIVES:_x000D_
1.To understand how loneliness is i) characterised and experienced by people who are in receipt of social care in England and ii) characterised by social care staff and the voluntary sector_x000D_
2.To identify how services might be changed to help tackle the problem of loneliness experienced by users of social care_x000D_
3.To test with one LA whether an approach to service improvement, known to be effective in health care, could be adapted for use in social care_x000D_
4.To disseminate all study outputs and publish resources on a newly established Socialcaretalk.org platform for public, family carers, service users, voluntary organisations, researchers, teachers, policy makers and providers and wider._x000D_
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METHODS: In-depth interview study involving a national sample of 40-50 social care users who experience loneliness and 20 social care staff who provide support or manage these services with a remit to tackle loneliness from LAs, private/voluntary sectors. Data will be analysed thematically using a grounded theory approach. A catalyst film will be co-produced capturing touch points (good practice points or examples where services could be improved) from the interview data. Doncaster will be used as the test site for the AEBCD process which will involve workshops with service users, staff and the identification of service improvement priorities. Evaluation of this approach will adopt methods used successfully in the evaluation of AEBCD in health settings including ethnographic observation, attending planning meetings and co-design groups. Our focus will include the acceptability of the approach to social care staff and what adaptations might be needed for future use in social care._x000D_
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ANTICIPATED IMPACT AND DISSEMINATION: Outputs include a new section on loneliness on Socialcaretalk.org; recommendations using AEBCD in social care; and a catalyst film for use across LA settings. Dissemination via social media, conference presentations, third sector organisations and end of project event. Outputs will be relevant to service users,families, health and social care professionals and students, commissioners and service providers. Social care research is somewhat in its infancy in terms of funding beyond NIHR School for Social Care Research. We know that engagement with NIHR agendas in practice has been limited therefore we feel the project will provide valuable learning over and above the immediate project outcomes in terms of a wider engagement strategy with social care partners.

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