Make the evidence count

Will the Social Care Institute for Excellence deliver the sort
of research that social work needs to improve practice, asks
Frances Rickford .

Back in 1971, young Mike Leadbetter started his first job as an
unqualified social worker. In his first week he received six
children into care and placed them in a church-run children’s home.
Now director of social services at Essex, Leadbetter looks back on
his early career with some discomfort. “There was no evidence base
for what we did. Nothing had been tested in terms of alternative
strategies, and we made all kinds of interventions in families
without really having enough knowledge about their likely
impact.”

The idea of evidence-based practice in social care has been
gaining support over the past 10 years, and several agencies have
taken on the job of trying to disseminate to frontline staff some
of the fruits of the past 30 years’ academic research.

Now the government is establishing a Social Care Institute for
Excellence, a national resource for England and Wales that will
eventually issue evidence-based good practice guidelines to social
care professionals.

The institute will be set up over this summer at a cost of
£2 million, and will start recruiting about 30 staff in the
autumn. The National Institute for Social Work has been closely
involved in the project, and “key staff and functions” of NISW are
expected to be transferred to Scie in the next few months.

One of them will be the Electronic Library for Social Care, set
up by NISW’s director of information Mark Watson. It will
eventually house all Scie’s research reviews and good practice
guidelines.

Watson explains: “Scie is going to look at what research there
is, then talk to users and carers to get their perspective on what
the research says. Scie will work in partnership with users and
practitioners and will incorporate user and practitioner evidence
and experience in the best practice guidance which will be aimed at
the practitioner.”

Watson is emphatic that Scie’s work will avoid duplicating what
other people are doing, but he also believes the research world has
largely failed to impact on social work practice. “There has been a
huge amount of money spent on research in social care but a lot of
it hasn’t delivered advice to practitioners. Even if you look, for
example, at Barnardo’s What Works? series of research
reviews, they are good but not very practitioner friendly.”

But even if they haven’t published “how to” guides to social
work, many leading social work academics have spent much of their
careers trying to illuminate the professional practice of frontline
staff. And many are now directly involved in working with social
services departments and other provider agencies. David Berridge,
professor of child and family welfare at Luton University and
author of many studies of foster and residential care for children,
is a member of Making Research Count – a network of seven
university departments providing tailor-made research support to
social care agencies in their own regions. Subscribing social
services departments specify an area where they want research-based
input – for example, if they are reviewing a particular service and
academics will work with staff, digging out and disseminating the
most relevant research evidence for their purpose. The
participating universities exchange time and expertise, so a social
services department can access the most appropriate relevant
expert, even if he or she is based at a university at the other end
of the country.

Berridge is concerned that Scie should also draw on the
knowledge and expertise of the widest possible range of
researchers, and should also avoid any prescriptive advice to
frontline staff. “We are all working towards helping practitioners
to use research evidence to develop best practice. The importance
will be in the detail of how Scie works. I would be concerned if
the organisation thought it could undertake all these research
reviews itself, because putting these things together is quite a
complicated process. It should draw on people’s expertise.

“It’s also important that it avoids a simplistic approach to
‘what works’. The nature of the evidence in social research is more
complicated than it is in scientific research. For example, you
could not say adoption, or family therapy, is good or bad. It
depends how it is applied and who experiences these things. No two
children and no two families are the same. The skill is in the
interpretation and application of what we do know.

“Also we’ve only really been building up a solid base of
research in the last 25 years. We don’t know enough to be telling
people what they should and should not do.”

Berridge’s views are echoed by June Thoburn, dean of the school
of social work at University of East Anglia. Thoburn welcomes the
Scie’s commitment to work in partnership with users and carers, but
points out that it may be easier said than done.

“It’s always difficult to find people who represent other
people. How do you go about finding a representative abusive parent
for example?”

She is also enthusiastic about Scie’s plan to issue best
practice guidelines rather than do’s and don’ts. “It will be very
useful to have best practice guidelines based on research evidence.
After all, we have had plenty of practice guidance based on nothing
at all.”

Thoburn hopes that Scie will be as open and transparent as
possible, as well providing itself with a very strong academic
base. “Our world is so huge, and it won’t make sense for Scie to
have a huge permanent staff to deal with the range of social care.
It would be more sensible to work on a collegiate model. A small,
central Scie could do the literature reviews.”

Thoburn emphasises that research is not simply a process of
revealing an objective truth. Researchers often disagree strongly
about the interpretation and implications of research evidence, and
Scie should develop a process that allows for such disagreements.
“They could set up short-life working groups including people of
different views – researchers from voluntary agencies as well as
universities – who could argue over the evidence and emerge with
areas of agreement, areas of disagreement, and areas where we flag
up the need for more research to clarify things. It would be less
satisfactory if Scie sends out for comments and then comes out with
its own answers.”

Thoburn is also concerned that the guidelines should recognise
the complexity of the work. “We must not pretend there are easy
answers. The nature of our evidence currently – perhaps inevitably
– is that when you are dealing with individuals working with other
individuals it is going to be very difficult to say what should
happen. The thing that has the biggest impact on outcome is the
quality of the relationship between the client and the worker, and
how do you reduce that down to simple formulae?”

Helen Roberts, formerly head of research at Barnardo’s,
commissioned the charity’s What Works series. She is
enthusiastic about Scie because she hopes that its existence will
increase the chances of the many gaps in research being filled by
new work.

“Research evidence is only one kind of evidence but it is
important, and it should be made available to local politicians as
well as practitioners and managers. If I were a user of social
services I would want there to be much better research evidence
about what is likely to be effective, but the user voice in social
care is not strong compared with the voice of users in the NHS.
Scie’s existence makes it more likely the research will be
commissioned. It is a push from the user end.”

Leadbetter is equally enthusiastic about Scie, and suggests the
challenge will be in linking Scie to the forthcoming national care
standards, and to the training agency TOPSS. His own department
subscribes to Research in Practice (see panel) and includes a
dissemination group to make sure research evidence reaches
frontline staff. But Essex also carries out its own small-scale
action research in conjunction with Nottingham Trent
University.

“It all helps to focus practitioners on what works. We can’t use
control groups in social care. We can’t do blind studies. But we
can as departments and councils make a contribution to extending
knowledge, and we have a responsibility to do that.”

Organisations disseminating social care research
evidence to practitioners, managers, users and carers

Centre for Evidence Based Social Services. Partly funded by the
Department of Health, it works with 16 local authorities in south
west England, running conferences and workshops on research
evidence relating to a wide range of services. Also carries out its
own research in partnership with member agencies. www.ex.ac.uk/cebss/

Research in Practice

Funded by its 56 member agencies across England and Wales, it
disseminates key research evidence on child care via written
summaries and briefings, audio tapes, symposia and its own web
site. Commissioned by the Department of Health to publish a series
of Quality Protects research briefings. Emphasises that research
evidence is most useful when harnessed to the professional
experience and expertise of staff. www.rip.org.uk

Making Research Count

Network of university-based academics providing tailor-made
research support to social care agencies at the request of the
agencies. Able to provide researchers with very high level of
expertise to work directly with staff and users. Contact david.berridge@luton.ac.uk

Electronic Library of Social Care

Impressive web-based resource, including NISW’s Caredata
abstracts, updated monthly. Includes a section for users and carers
and another on research skills. www.elsc.org.uk

Research Matters

A twice-yearly digest of research in social services, published
by Community Care. It provides selective reviews of research, by a
team of academic commentators across the social care field