Determining Best Preventative Social Care Practice in the Contexts of Older People Receiving Care and Support at Home and Those Living with Dementia

Background and aims

Prevention is core to recent Welsh and UK social care policy. Regional partnership boards (RPBs) in Wales and integrated care systems (ICS) in England play a key role in outlining how prevention is interpreted and implemented. Yet the work undertaken can be variable and reliant on public health definitions (e.g. ’primary’ prevention to intervene before any health effects occur) rather than those of social care. With prevention aiming to reduce dependence on services, it is important that spending decisions are made wisely. It is false economy to invest in social care prevention without clarity on what it is and how it happens successfully. We will address these knowledge gaps by developing a theoretical toolkit for best practice, supporting decision-making on future social care prevention investment. Research will examine how prevention is interpreted and implemented across regions, and how it is regarded by service users, carers and a range of professionals enacting its agenda. The focus will be on two Welsh and UK government priority areas: i) those living with dementia, and ii) older people receiving care and support at home.

Research questions

Research questions include how those involved in delivering prevention work (e.g. local authority staff, GP teams, health board staff, third sector, private sector, carers) perceive their work to fit within existing government definitions of prevention (if at all), and how older people receiving preventative social care regard such initiatives.

Design and methods

The study adopts a case study approach with six RPBs and ICS situated across Wales and England over six phases of research:

1. Identifying existing or planned prevention activity in the two priority areas through existing databases (e.g. DEWIS), document analysis and qualitative interviews with RPB / ICS professionals.
2. Observing RPB and ICS board meetings, collaborative activities, and prevention work within ‘home’ organisations, as well as interviewing those involved, to identify how the prevention agenda is interpreted and implemented.
3. Interviewing and observing carers involved in delivering prevention initiatives, as well as the service users receiving them to explore their perspectives on preventative social care.
4. Analysing qualitative data and developing the toolkit (initial version).
5. Re-interviewing participants from Phases 2 and 3 to validate findings.
6. Analysing additional data from Phase 5 and developing a further iteration of the toolkit.

Public involvement

The project is dependent on the inclusion of service users and carers as participants, but also arbiters of data interpretation and project outcomes. As such, phases 4, 5 and 6 are structured to allow feedback from participants at the analytical stage. Additionally, Swansea University research centres such as Centre for Ageing and Dementia Research will provide access to public involvement networks for co-developing interview schedules and information sheets.

Dissemination

We will invite social and health care professionals, third sector groups, primary care representatives, paid and unpaid carers, and service users to a set of workshops. These will outline study findings and the preventative social care toolkit, offering new perspectives on best practice. We will communicate findings to academic communities through papers for academic journals, and by presenting at selected academic conferences.