Strengthening the case for prevention
Evidencing how strengths-based prevention works in Adult Social Care.
Project summary
The Challenge
Preventative approaches are increasingly important in adult social care, but conventional evidence tools often struggle to capture how strength-based support prevents crisis.
The Approach
Researchers evaluated Local Area Coordination in four places, combining life stories, system and ward-level research, qualitative comparative analysis, and economic analysis.
The Outcome
The study led to the development of the Strengths-Based Model, a practical framework for evidencing how prevention works.
Lead academics
Project Partners
A new model for evidencing prevention.
Our research provides robust evidence that Local Area Coordination improves lives, strengthens communities and helps public services intervene earlier, and establishes a model and practical tools to inform future policy and investment decisions.
The Challenge
Adult social care is under increasing pressure from rising demand, complex needs, and constrained resources. Prevention is often positioned as part of the answer, but councils face a difficult evidence problem: how do you demonstrate the value of support designed to prevent crisis before it happens?
Local Area Coordination (LAC) offered a powerful case through which to explore this problem. LAC is a clearly defined model of strengths-based prevention, built around Coordinators who work alongside people and communities to build capacity, connection and resilience. Previous evidence was promising, but fragmented, with limited comparative analysis across local authority areas.
What is strengths-based prevention? Strengths-based prevention starts with the assets, relationships and resources that already exist within people, communities and places. It focuses on creating the conditions that help people stay well, connected and independent, and on addressing challenges before they reach crisis.
In England, local authorities budgeted £26.7 billion for Adult Social Care in the 2025/2026 financial year.UK Ministry of Housing, Communities and Local Government
Estimates suggest preventative intervention could lead to a 33% reduction in ill health and GDP increase of £320bn over 20 years. However, only 29% of councils had a positive investment strategy for prevention in 2024/25 compared to 44% in 2023/24.
The Approach
Prevention is not a simple chain of problem, activity and outcome. The study used LAC to show how relational, strengths-based work creates change across people, communities and systems.
The research team set out to address this important evidence gap by examining the impact of the Local Area Coordination (LAC) model of prevention. The research compared how LAC works in four existing locations, to understand whether the model achieves consistent outcomes across different places, how those outcomes are created, and what value the model brings to individuals, communities and public service systems.
The team used mixed-methods, participatory design, combining system and ward-level research with in-depth life stories from people supported by LAC. People with lived experience helped shape the study through a Patient and Public Involvement Advisory Board, while life story interviews placed their experiences at the Centre of the analysis.
A Qualitative Comparative Analysis explored whether particular combinations of LAC activities could be linked to specific outcomes. This was important because it showed both the complexity of LAC’s work and the limits of linear evaluation models when applied to strengths-based prevention. A Nested Economic Study drew on previous LAC evidence and the qualitative findings to develop a cost-consequence framework, mapping costs and benefits across individual, community and system levels.
Together, these methods helped the team move beyond asking whether LAC works, towards understanding how it works, what it enables, and how strength-based prevention can be evidenced.
Our findings:
- The study found consistent evidence across all four sites that LAC creates value across individuals, communities and public service systems.
- A central finding was that LAC works in the “spaces between” individuals, communities and services. Coordinators helped bridge gaps where people could otherwise become stuck, missed or disconnected from support.
- For individuals, LAC helped people feel accompanied, less isolated and more confident, supporting them to cope with challenges and access the right support.
- For communities, LAC helped people connect with local groups, activities and informal networks, sometimes creating a ripple effect as people moved from receiving support to contributing to community life.
- For services, LAC extended reach into communities and helped people navigate services, rights and entitlements before problems escalated into crisis.
- The wider significance of the study was the development of the Strengths-Based Model, which provides a practical framework for evidencing how prevention works by building connections, capacity and resilience across these spaces in between.
The full research team
Professor Joe Cook, University of Hull - Project Lead
Dr Jon Burchell, University of Sheffield
Mr Simon Dalby, Leicestershire County Council
Professor Claire Hulme, University of Exeter
Mr Joe Micheli, City of York Council
Dr Silviya Nikolova, University of Leeds
Professor Adam Martin, University of Leeds
Dr Harriet Thiery, University of Hull
The Impact
The study formed the first comparative evaluation of LAC. It provides some of the strongest evidence to date that LAC delivers consistent benefits across different locations. This timely evidence has empowered ASC teams to support LAC, in the context of difficult decisions around retaining prevention investment during this time of significantly heightened public funding crisis.
Its most significant legacy was the development of the Strengths-Based Model. The model has provided a new way to evidence strengths-based prevention, moving beyond linear measures of problem, activity and outcome, that can be applied to other areas including welfare, poverty and public health. The Strengths-Based Model has since become the foundation for further funded projects and commissioned evaluations with local authority and voluntary and community sectors partners.
It has also informed the development of practical tools and training to help organisations evidence preventative work more effectively. This wider programme of work is explored in our related case studies: Commissioned Evaluations and the Strengths-Based Prevention training programme.
These include a strengths-based model and a cost-consequence framework that are now being shared with practitioners, policymakers, and the Local Area Coordination Network to support evidence-based decision-making and future service development.