Principles into practice

The interventions social care staff make into people’s lives can be far-reaching and have permanent consequences. Professionals should ensure they intervene on the basis of the best available evidence, otherwise their actions become nothing more than experiments.

Research in Practice, the largest research implementation project in England and Wales, is helping practitioners make sure their decisions and judgements are shaped by an understanding of:

• The best available research evidence about what is effective (from academic research studies, but also from local data gathered systematically – for example, through user consultations or service evaluations).
  
• Practice wisdom (built up through learning from operational experience).
  
• Feedback from service users (for example, about expectations, preferences or the impact of interventions).

As social care staff increasingly find themselves in multi-disciplinary teams, they will have to ask fundamental questions about their traditional role such as “what makes my contribution distinctive?” and “on what do I base my judgements and decisions?”.

Having confidence in their professional knowledge base, and extending this through learning from research and reflection, will be crucial in maintaining the distinctive contribution and identity of each professional discipline.

So “evidence-informed practitioners” think critically, reflect on their experiences, keep themselves up-to-date with research and consider how research knowledge might influence assessments or proposals they make. The challenges of working in this way are immense – including conflicting or competing demands and workload pressures.

But is it reasonable to expect staff to take on this challenge alone? Our experience suggests that there is only so much even the most committed practitioner can do to continue to develop and apply their research-based knowledge in the absence of their agency’s support. Indeed, the Social Care Institute for Excellence concludes: “There is little point in simply turning up the rate at which research flows to the social care workforce – little research in fact has direct applicability, many practitioners are not equipped to digest research, and support systems are lacking.” (1)

The Research in Practice network has been working intensively with agencies over the past six years to explore how to embed evidence-informed practice into the lifeblood of an organisation.

What is clear is that the right culture and practical facilities must be in place to enable staff to have the evidence to inform their practice. The sort of “organisational support” that our work suggests needs to be in place – which is beyond the capacity of individual practitioners and teams to provide – falls into five broad categories.

1. Providing strategic leadership. A committed and enthusiastic senior leader is important to spearhead the drive for greater use of research in policy and practice. This gives the initiative profile and priority, and provides a champion to drive it forward as a crucial element of practice development. Agencies that have been most successful in embedding a culture of using evidence to inform practice have a figurehead who unites staff around a clear vision about research use in professional practice. Having a broad-based strategy that publicly sets out what the agency will do to promote access to research and encourage its use has also proved important.  Auditing the agency’s strengths and weaknesses can be helpful and provides a base-line against which to measure progress.
   
2. Setting expectations that policy and practice decisions will be evidence-informed. The social care workforce reforms and the national occupational standards for social work set out general requirements for social workers on continuing their professional development and drawing on research to guide the way they work. They are rather lighter on the specifics. So agencies must clarify what is expected of individual staff: what evidence should be used, where, how, and by whom. For example, how should front-line practitioners keep abreast of new research, integrating it into their practice and using it to guide individual cases. Job descriptions, person specifications and competency frameworks need to record reasonable and feasible expectations of qualified and unqualified staff. It is also crucial to set out how processes such as strategy development, business planning, performance improvement and supervision, should be using research.
   
3. Encouraging learning from research. These expectations need to be supported by protected time and space at work.  As one senior leader we have worked with put it: “Nobody gives time to us – we organise our own time. For practitioners and their managers there is an issue about how they build time into a very punishing schedule to make sure they keep abreast of what’s going on.”  Making use of team meetings, development days and supervision sessions to discuss new research, user feedback and learning from individual cases is important. Tying into initiatives such as post-qualifying awards and re-registration can also generate capacity to develop research-based knowledge. But agencies must also initiate new opportunities to learn including messages from research events, practice development groups or journal clubs. This must be accompanied by efforts to create a fertile environment in which evidence seeds will grow.  Managers are influential in shaping culture, for example, by valuing constructive questions and debate, encouraging a genuine attempt to learn from mistakes and being receptive to new ideas and innovations. Some staff may see the use of research as threatening, because it implies a re-examination of ways of working and certainties. Leadership development to ensure managers focus on outcomes and create a learning climate is therefore crucial.
   
4. Improving access to research. It’s important to provide physical facilities such as quiet rooms, library resources (in-house or purchased), journal subscriptions and internet access. Targeted dissemination of evidence that makes sure new material gets to relevant people is key. The availability of practical help for staff in searching for, reading or applying research messages has also proved important.  This can sometimes be delivered through strategic partnerships (for example with local universities).
   
5. Providing support to staff research. Specialist support for local studies, evaluations and service user consultations and funding even for a modest study of gap-filling, exploratory research are important elements for agencies to have in place.  Being evidence-informed is the professional responsibility of practitioners. But this responsibility must be supported and encouraged by an organisational culture that values continuing professional development and learning, and an infrastructure that ensures easy access to high-quality, relevant research evidence and the resources to support its use.  The development of this culture and infrastructure needs to be actively planned and led as a key element of any organisation’s strategy to develop the professional practice of  its staff. 

Training and Learning

The author has provided questions about this article to guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl  and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.
Abstract

Delivering practice that is truly evidence-informed is a shared responsibility between individual practitioners and the organisations they work for. This article discusses how agencies can support the full use of evidence to inform work with service users. Five key foundations that organisations need to have in place to promote the use of research in policy-making and practice decisions are described.

References

1. I Walter, S Nutley, J Percy-Smith, D McNeish and S Frost, “Improving the use of research in social care practice”, Knowledge Review 7, Social Care Institute for Excellence, 2004 www.scie.org.uk/publications/index.asp

Further information

Research in Practice has produced a handbook called Firm Foundations: A Practical Guide to Organisational Support for the Use of Research Evidence. It contains guidance, practical tools and filmed case studies, and is supported by extensive web-based materials. It can be purchased at www.rip.org.uk/foundations or by calling 01803 867692.

Contact the Author

E-mail: rhiannon@rip.org.uk

Rhiannon Hodson is interim deputy director at Research in Practice. She has five years’ experience of supporting evidence-informed practice in social care agencies. She was formerly head of performance at Hampshire social services and also spent eight years as a consultant with the police.