Research project
Scottish Government Social Care ESRC Policy Fellowship
Respectful, responsive and relational: a mixed methods qualitative study on how to define, evidence and improve social care in Scotland
Completed
February 2022
November 2023
Funding
Funders
Economic and Social Research Council
This research project explored how evidence-informed understandings of ‘good’ social care are embedded into the design, implementation and continued improvement of social care in Scotland. Social care in Scotland is undergoing a period of review and transformation, following on from the Feeley Review of Adult Social Care in Scotland in 2021 and the ongoing design and development of a National Care Service. For the most up-to-date information on social care reform in Scotland, see the Scottish Government Social Care website.
This page summarises the research carried out by Dr Jenna Breckenridge for her ESRC Policy Fellowship. This involved Jenna being seconded into the Scottish Government Social Care Analytical Unit part time for 21 months. This meant that Jenna could bring her academic expertise into Scottish Government and could learn more effectively from policy makers and analytical colleagues to ensure the research would be useful, timely and relevant. It also helped her to build relationships between policy and academia to maximise research impact.
Study summary
The aim of this research was to explore and critically examine how evidence-informed understandings of ‘good’ social care can be embedded into the design, implementation and continued improvement of the National Care Service.
Twenty stakeholders participated in individual interviews to share their experiences of, and opinions about, using evidence to inform policy, using the ‘My Health, My Care, My Home - Healthcare Framework for Adults Living in Care Homes’ as a case study.
Sixty-four stakeholders participated in two creative research workshops to define ‘good’ social care, discuss how it can be evidenced, and to co-create a distinctly social care vision for improvement.
Study participants comprised people with lived experience of social care, people working in frontline and managerial social care roles, people working in healthcare, people working for professional, regulatory and improvement bodies, academic researchers and policymakers.
Analysis of the interview and workshop data were combined to generate the “3Rs” model which identifies three core characteristics that define ‘good’ social care:
- Respectful – we recognise that care, evidence and improvement are all founded on an unwavering respect for humanity and the personhood of people using and providing social care.
- Responsive – we recognise that care, evidence and improvement all require flexibility and responsiveness to complexity, individuality and change.
- Relational – we recognise that care, evidence and improvement all take place within multi-directional relationships between people using, providing, overseeing and evaluating social care.
The “3Rs” model demonstrates how these defining characteristics of ‘good’ social care can be operationalised in how we design and deliver good social care, how we evidence it, and how it is improved.
The “3Rs” model is a research-informed visual tool that can be used practically to support conversations and decisions about how to design, evidence and improve social care in Scotland.
For both users and providers, respectful social care:
- Fosters self-identify, self-worth and enables people to feel like their “true self”
- Stimulates people’s minds and creates opportunities for them to gain, regain and maintain skills, regardless of their stage in life or level of impairment
- Encourages creativity and risk taking
- Enables people to experience purpose and meaning in life
A respectful approach to evidencing social care:
- Focuses on knowledge equity, where everyone’s knowledge is heard and valued
- Values social care knowledge as credible and trustworthy
- Seeks out good practice and experiences as well as negative
A respectful approach to improvement in social care:
- Involves social care users and providers as trusted experts
- Encourages creative solutions
- Invests in staff development because of their intrinsic value and worth
For both users and providers, responsive social care:
- Creates genuine options, respects freedom of choice and enables people to make decisions about their lives
- Respects that people change over time and situates care within the broad context of people’s past, present and future lives
- Listens deeply to individuals, not based on stereotypes, preconceptions or rigidly standardised approaches
- Enables access to satisfying, enjoyable and nutritious meals
- Is provided at the time and place it is needed, as opposed to being determined by systems, rotas and available resources
A responsive approach to evidencing social care:
- Embraces messiness and values qualitative evidence
- Brings together different types and combinations of evidence at different times, in different ways
- Works to a flexible evidence plan rather than fixed benchmarks
- Invests dedicated resource into developing and implementing a flexible evidence plan, with a clear process for reflecting regularly on the continued usefulness and sensitivity of the evidence approach
A responsive approach to improvement in social care:
- Designs, implements, evaluates and refines change in response to what is meaningful and useful to social care users and providers
- Uses and adapts methods flexibly to include social care staff and users as active agents in improvement
For both users and providers, relational social care:
- Takes place in the context of trusting, empathic, personal, respectful and familiar relationships
- Connects people with other human beings and creates a sense of belonging, where people are valued for who they are and what they bring to communities
- Harnesses technology in flexible and strategic ways so that it supports and enables human connection, rather than replaces it
- Involves being with people and facing difficult situations and emotions together
- Means having accountability and repairing relationships when they go wrong
- Is holistic, focussed not only on the individual in isolation but their interconnected relationships with family, communities and systems
A relational approach to evidencing social care:
- Recognises that evidence is not singular or static, but in continual negotiation
- Does not singularly privilege one perspective of evidence over another e.g. what counts as evidence for regulatory bodies might be different to what matters to users and providers
- Uses inclusive and creative ways of generating data
- Is based on transparent and accountable sharing of data for everyone’s benefit
A relational approach to improvement in social care:
- Embeds improvement in daily practices and conversations as a ‘way of life’
- Builds and sustains a network of improvers with established mechanisms for sharing and learning
- Fosters care literacy in society to encourage everyone to support and contribute to social care improvement
The research also provides insight into the process of evidence-informed policy making and supporting effective communication between policymakers and people using and working in social care.
The research is continuing to support and inform the Scottish Government’s co-design and development of an improvement approach for social care in Scotland.
Get involved
The research part of this project is now completed. You can help spread the word about this study by sharing it with colleagues and thinking about how the 3Rs model could support your work in social care and beyond.
If you would like to chat to Jenna about this research or invite her to do a talk or a presentation, then get in touch with her at [email protected]
Outputs
Breckenridge JP (2024) Respectful, responsive and relational: a mixed-methods qualitative study on how to define, evidence and improve social care in Scotland. Scottish Government Social Research Report: Edinburgh. ISBN: 978-1-83601-496-6