Title: Family Group Conferencing in adult social care and mental health: exploring how it works and what difference it can make in people’s lives
Funder: Department of Health and Social Care

Abstract: While a lot of care and support for adults is provided by family, friends and neighbours, care services may not be very good at involving them in planning and decision making alongside the person with care needs. This can lead to stress or breakdown in caring arrangements. _x000D_ _x000D_ Originating in children’s services, Family Group Conferencing (FGC) is now being offered in adult social care and mental health services. It offers an opportunity for family, friends and neighbours to come together with a person to devise their own plan for how best to arrange their care, support and safety. An independent person is appointed to coordinate the process, including helping those involved to prepare for their meeting (called a Conference). The conference usually comprises a discussion with the professionals involved, and ‘private time’ in which those involved can come up with their own ideas and proposals. Plans made in this way can be both more acceptable to the person and those involved in their support, and can enable a better life in the community rather than simply receiving social care services. Such plans can also reduce the likelihood that all the responsibility for care and support will fall onto one person. _x000D_ _x000D_ We will start by finding out about the approaches to FGC that are currently being developed nationally. We will consult with people who deliver FGC services and those who have used them. _x000D_ _x000D_ We will then look at more depth what is going on in some local FGC services. As well as interviewing people involved in delivering the service, we will track what happens for around 25-30 individuals, together with members of their family and/or social networks, who choose to go through with a Conference. This will involve a combination of interviews and survey questions – and also direct observations of Conferences where people are comfortable with this. We will also track the progress of some of those who do not go through to have a Conference, and we will seek to find out the reasons for this. We will follow everyone up 9-12 months later and compare their progress with a group of people in similar situations who have had no involvement with FGC. From this, we hope to find out what sorts of difference FGC can make in people’s lives, and whether any improvements are sustainable. We will explore what factors may influence whether there are positive outcomes, and what parts of the FGC process people find most useful. We will also look at what FGC costs, what benefits may be achieved, and how FGC may impact on people’s use of care services. _x000D_ _x000D_ Working with an Expert Panel of people who have used or are involved in providing FGC services, we will use our findings to inform standards and guidance as to what a good FGC service should look like. We will develop a range of practical learning resources for those seeking to set up or deliver FGC services, and for members of the public who might be interested in making use of them. _x000D_ _x000D_ Alongside the research, we will set up an adults’ FGC Research and Practice Network to build our links with those involved with FGC and social care or mental health services. This will be hosted by Community Catalysts - an organisation that supports innovation in adult social care. Through a series of events and an active Website, this will connect the research with a wider audience of practitioners, policy makers and member of the public.

Lay abstract: Research question_x000D_ How and where is Family Group Conferencing (FGC) for adults and mental health being delivered, how may practice model(s) be characterised in terms of contexts, mechanisms and outcomes, and what is its effectiveness in terms of costs and consequences?_x000D_ _x000D_ Background_x000D_ FGC is a relatively new approach in adult social care and mental health services. It offers an inclusive approach in which people can plan for their care and support on their terms – and which can mobilise the strengths and resources that may potentially exist within people’s family and social networks. It can also be used where there are safeguarding concerns or where people may require support for their decision making. Apart from some local evaluations, there has so far been no larger scale UK study of FGC in adults and mental health contexts._x000D_ _x000D_ Aim_x000D_ To examine how FGC is being offered in adult social care and mental health services, what are its key processes and mechanisms, and what difference this can make in people’s lives._x000D_ _x000D_ Methods_x000D_ Following an initial scoping of FGC activity in adults’ and mental health services, a realist synthesis approach will be used to derive a preliminary programme theory as to how FGC is seen to work, what sorts of outcomes may be achievable, and for whom and in what circumstances/contexts. Evidence will be drawn from the relevant literature; online surveys and targeted interviews with key informants including those with lived experience; and a deliberative process with a full range of stakeholders to check out and refine the emergent theory._x000D_ _x000D_ This theory will then be tested and refined in a realist evaluation of practice using a sample of 25-30 case studies of individuals and family/networks from 3 different services in England, alongside a matched comparator group receiving service as usual, and a sample of 12-15 which did not proceed to a Conference. We will track process and assess outcomes at 4-6 weeks and at 9-12 months. Interview data on people’s experience of contexts, processes and outcomes will be triangulated against measures of capability (ICECAP), individuals' perceived quality of network relationships (5 item Social Provisions Scale) and family/network members' experience (Carers Experience Scale). Effectiveness will be evaluated using a cost-consequence approach, with ICECAP values linked to data on service use and associated costs._x000D_ _x000D_ Findings will be used to inform a Delphi exercise (including experts by experience), to achieve a consensus determination of the key elements of underpinning programme theory for FGC - and hence to translate these into fidelity criteria and practice standards for the ongoing development of FGC practice in adult social care and mental health._x000D_ _x000D_ Timeline for delivery_x000D_ The overall research will take place over 33 months, with the preliminary work taking place over the first 6 months and the case study fieldwork taking place between months 6-24._x000D_ _x000D_ Anticipated impact and dissemination_x000D_ Emergent findings, fidelity criteria and practice standards will be disseminated through a Research and Practice Network that will be hosted by Community Catalysts CIC and will build on an existing Practice Network for adults FGC that already has had active participation from around 30 local authority areas from across Great Britain. Practice development will also be supported by the production of a package of e-learning resources in collaboration with Research in Practice.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH