Title: Equitable access to social care for Black and Asian communities
Funder: Department of Health and Social Care

Abstract: BackgroundPeople from minority ethnic groups are under-represented among those using social care services. A key reason for this is the lack of culturally appropriate services. Research into how to improve provision is limited to small scale evaluations of local providers. There is almost no research into the upstream (national) process of commissioning social care services, how ethnic minority needs are assessed and how this feeds through into what services are provided.Research question(s) How are ethnic minority needs currently assessed and how can we develop better information and strategies to ensure that adult social care commissioners commission more culturally appropriate high-quality services for members of different ethnic minorities? Aims & Objectives Study 1: To investigate current and best practice methods for assessing the social care needs of ethnic minority populations. Study 2: To examine current practice regarding the assessment of ethnic minority needs during a social care commissioning process. Study 3: To investigate the views and experiences of Black and Asian people eligible for adult social care services. Study 4: Co-produce recommendations for how to improve commissioning of social care services for Black and Asian populations Methods Study 1: Qualitative semi-structured interviews will be conducted with a purposive sample of up to 30 social care commissioners from councils across England. Participants will be selected to capture a maximum diversity sample with respect to ethnic diversity of the population they serve and levels of deprivation. Interviews will be analysed thematically. Study 2: A retrospective case study analysis of current commissioning and procurement processes will be conducted to identify how the needs of Black and Asian populations are assessed and how future demand is modelled. These will be compared to alternative information on social care needs of Black and Asian populations and differences identified. Study 3: Qualitative semi-structured interviews will be conducted with a purposive sample of up to 40 Black and Asian people eligible for adult social care services. Participants will include people who are currently using services and those who have never accessed services. Interviews will be analysed thematically. Study 4: A co-design approach will be used to develop recommendations based on the findings of studies 1-3. Stakeholder groups of Black and Asian service users and carers, social care commissioners and providers will take part in five workshops to discuss findings and develop recommendations. Timeline for delivery This research will be conducted over three years. Early findings from Study 1 and 2 will be available in year 2 and findings from study 3 in year 3. Study 4 will pull together all the findings and co-produce recommendations for services by the end of year 3. Likely impact and dissemination This research will produce actionable recommendations. These will be put into practice locally and disseminated nationally through central Government policy making bodies, local government networks, and national organisations for supporting improvement in social care (SCIE) and improving wellbeing of Black and Asian populations. These changes will improve the quality of social care services for ethnic minority populations.

Lay abstract: Background Local councils struggle to provide social care services which are suitable for people with different ethinicies. This is partly because they do not have access to good information about the needs of ethnic minority people in their areas. It is also because they do not understand in what ways the people with different ethnicities have different needs in relation to the ways their care is provided. Without this information, services cannot be designed to support those needs and local councils are unable to buy ('commission') them. As a result, the services provided are not able to support people from ethnic minority groups as well as they should, which can lead to poor health and wellbeing. Research AimTo understand how social care service development, including the commissioning process, can be improved to better support the needs of people from ethnic minority groups. Design and Methods I will interview 30 commissioners working in councils with different ethnic groups. I will find out how they decide which social care services to commission and whether any are specifically aimed at ethnic minorities. I will find out what challenges they face, how they make key decisions, and find examples of good practice. This will be supported by an review of previous commissioning exercises to understand what was done and what decisions were made, including how the needs of different ethnic groups were included. This will involve looking over the paperwork linked to these decisions and will provide a clear understanding of how a council decides what social care services to buy for the local population. I will then compare this information with academic and other evidence on how to best support the needs of different ethnic minority populations. This will help identify gaps in current commissioning methods and ways to improve this. I will also interview 40 people from different ethnic minority groups with social care needs. I will talk to people who are accessing social care services and others who are not, and include carers. I will ask them about their experiences of social care, how they came into contact with services and what problems they faced. I will ask them how their quality of life is affected and how services could be improved to better support them in the future. Finally, I will use the information from these different activities to find ways to improve social care commissioning so that it can better support people with different ethnicities. I will do this in partnership with service users and their families, people from the local authority and from other social care providers . We will produce specific guidance which we will share with policymakers and others who can make the changes needed. How the public and service users and carers have been and will be involved in the research A group of six service users and their carers (of African, Indian, Caribbean and Black British ethnicities) helped plan this research. They identified key topics to explore in the qualitative interview studies and helped inform the plan to ensure good involvement of servicer users and carers in this research. A group of ten service users and their carers (the orginal six plus four additional volunteers) will support the research project. We will meet four times a year and this group will take pare in the five stakeholder workshops that will develop recommendations for services. What you hope it will change/improve This research will help develop better methods for identifying social care population need and improve the quality of social care services for ethnic minority populations.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: DISPUTED AETIOLOGY AND OTHER