We’re listening…

The
Social Care Institute for Excellence was set up to evaluate research and
provide best practice guidelines for social workers. Frances Rickford last week attended one of its "listening
exercise" meetings to find out what progress it is making.

Knowledge
is power, as the Elizabethan philosopher Francis Bacon pointed out. And
knowledge is what the Social Care Institute for Excellence (Scie) is charged
with producing – knowledge about what makes good social care. Scie was set up
by the government and Welsh assembly to collate evidence about good social care
practice and translate it into a "knowledge base" from which best
practice guidelines will eventually be written and disseminated.

But although its remit is to pass on
knowledge, Scie is doing its very best not to be a "listen to me"
organisation. At this early stage in its development – before it has even been
formally launched – it is asking people involved in social care what they think
it should be doing. Through a series of regional meetings, and through its own
and Community Care‘s website Scie is conducting what it calls a
"listening exercise". Last week at the third of its five scheduled
regional meetings, about 60 people got together in London to find out about
Scie and to feed in from their own experiences as users, carers, practitioners,
managers and researchers where they believed was the most urgent need for
service improvements, and how Scie could most effectively help improve practice
where they worked, or in the services they used. Participants had been
nominated by a wide range of agencies and organisations, and Scie expects the
current listening exercise to lead to the establishment of five regional
consultation groups, enabling those with an interest in social care to have a continuing
input into the organisation’s work.

The question of what areas of practice most
needed improving produced a remarkable consensus, at least in the group
attended by this author. The group identified as its priorities the far from
seamless boundary between children’s and adult services, and between disabled
adult and "elderly" services; the arbitrary differences between
available services across geographical boundaries; failure to follow through
long-standing best practice guidance such as the importance of placing children
within their own family or friendship circle wherever possible; and problems
with consultations including the practical challenges of meaningfully
consulting some client groups such as "users" of child protection
services, and very frail elderly users of home and residential care.

This last point is not lost on Scie itself.
There were no children, or anyone over 80 at the meeting – although there
apparently had been young people at previous meetings in Bristol and
Birmingham, according to Scie officers. Perhaps it is asking too much to expect
the full range of social care users to be fully represented at this stage, but
there is also a question mark over how these important but difficult-to-reach
groups can be involved in the next stage of the process – building Scie’s
so-called knowledge base.

So what is knowledge and where is it to be
found? This is not an abstract question but a hugely practical challenge for
the institute. Social care is still in its babyhood as a discipline, and
there’s relatively little empirical research evidence robust enough to prove
that this – or that – is necessarily the best way to do something. Another
drawback with relying solely on research evidence is that, as service users
have pointed out, those who fund research usually also determine the questions
researchers ask which are not always the same ones people who are using, or
working in the services are most interested in.

Scie’s chief executive Ray Jones has the
difficult job of balancing the demands and interests of all its stakeholders.
It has settled on a very inclusive definition of knowledge, including as well
as research the expertise and experience of service users and carers; the
expertise and experience of practitioners and managers; and reports from audit
and inspection bodies. But Mike Fisher, director of analysis and reviews,
insists that will not mean any old thing will do. "Our job is to make sure
people can trust what they get from our website." And he emphasises that
they won’t be proposing simple solutions – "it’s not ‘what works’ but
‘what works for whom and under what circumstances’." This week it awarded
a commission worth £80,000 to the Economic and Social Research Council’s UK
Centre for Evidence-based Policy and Practice to devise a system for both
classifying input from the four different knowledge sources, and for weighing
its reliability and authenticity. The project is expected to be complete by
early next year.

Scie stresses that it is an additional
resource, and not an alternative to any of the existing organisations which
have traditionally been seen as generators of knowledge – research institutes
and universities for example. But there is concern among eminent social work
academics. Ian Sinclair, a professor at the social work research and
development unit at the University of York, argues that Scie has been set a
very difficult task. Not only is the research base not very strong, but even
where research findings have suggested changes which might make things better,
there is no tradition, or funds, for testing those ideas to the point where you
know whether or not they are right.

He points out that what is known is often
both obvious, and also difficult to ensure. "For example, we know from
research that good foster carers are people who are kind and firm and they love
kids."

Sinclair also is concerned that its broad
approach makes Scie more likely to be asked by the government to answer
questions which concern values more than evidence. But Ray Jones believes he
can defend Scie’s independence from government, including its ability to
determine what jobs it does and doesn’t take on. Unlike the National Institute
for Clinical Excellence (Nice), Scie is not a government body but a company limited
by guarantee, and plans to register as a charity. It has already resisted
pressure to publish guidance from the adoption task force on its website on the
grounds that it wasn’t appropriate for Scie to publish material it hasn’t
evaluated.

Scie has already published its first best
practice guide, on managing practice. It is available on Scie’s website in the
Electronic Library of Social Care, which also contains Caredata, more than
50,000 abstracts of reports, articles and books on social care. Caredata was
developed by the National Institute for Social Work, but until last autumn was
accessible by subscription only.

Jones believes Scie’s role will enhance the
status of social care, not only by improving practice and policy but also by
profiling its successes. It’s own success – in terms of being able to survive
as an independent and credible source of expert knowledge through the storms of
change in social care – may well depend on its capacity to secure loyalty among
its stakeholders. As Jones said last week: "We depend on you telling us
what we should be interested in. Otherwise other people are going to be telling
us what we should be interested in."

– You can take part in Scie’s listening
exercise via Community Care’s website at www.community-care.co.uk  Scie’s own website is www.scie.org.uk. The
Caredata database of abstracts on social care is at www.elsc.org.uk/bases_floor/caredata.htm