Developing Care and Practice research

Our research considers the needs and perspectives of those who deliver care and support to people living with long-term health conditions, and practice approaches that can lead to improvements in care and support. This includes a focus on developing the support available to family/informal carers, as well the practice of paid staff and practitioners, and exploring new approaches in the provision of health and social care.

Projects
Study	Full title	Type	Area	Funder
The Experiences of Distance Carers	Caring at a Distance; the experience of people who provide help, care and support from a distance	Survey study	Informal carers (families and friends)	Unfunded scoping study
Caring From a Distance: Using New and Familiar Means of Keeping in Touch With Family and Friends in Care Homes During Covid-19	Caring from a Distance: using new and familiar means of keeping in touch with family and friends in care homes during COVID-19	Survey study	Families and friends of people in care homes	Unfunded scoping study
Social Prescribing	An evaluation of Connect Well and Social Prescribing in Hull	Evaluation study; mixed methods	Social prescribing	Hull CCG and Hull City Council
Social Work and Social Prescribing		Online survey	Social worker use and perceptions	Unfunded scoping study
Abuse in Care - Safeguarding in Care Homes	Abuse in Care? The identification of early indicators of concern in care homes	Interview studies	Abuse of people in care homes/staffed settings	Birmingham Safeguarding Adults Board Scottish Government
GPs' Roles in Safeguarding Residents of Care Homes - What Do They See and What Do They Do		National online survey Qualitative interviews	Adult safeguarding Care Homes	East Riding of Yorkshire Clinical Commissioning Group (CCG)
Evaluation of seven day working for social work staff		Mixed methods study; analysis of patient discharge data; Qualitative interviews and focus groups	Hospital social work Hospital discharge	Hull City Council
Together	Together Suicide Bereavement Service Evaluation	Survey Qualitative interviews	Death, Dying Bereavement/ Suicide Prevention	Humber Coast and Vale Health and Care Partnership
An Ethnography of Community Nursing

The experiences of Distance carers

Distance carers are an important group who provide significant amounts of support and which may be growing in number as family demographics change. However, consideration of their experiences and needs has been neglected within health and social care policy, practice and research. This study explored the specific challenges for carers who have to navigate distance (involving travel time of at least one hour each way when visiting), as well as the satisfactions and rewards experienced, and identified strategies used by distance carers to ‘bridge the distance gap’.

More information

This study explored the experiences of a neglected group of carers – those who provide help, care and support from a distance, and worked to identify the distinct challenges which arise from caring from a distance, as well as satisfactions experienced by carers. It highlighted the multitude of tasks carried out by distance carers, and the costs and challenges encountered in seeking to ‘bridge the distance gap’.

AIMS

To explore the experiences of a carer group which has been neglected within research, policy and practice, and to identify the distinct challenges which result from caring from a distance.

FUNDED BY

This was an unfunded study

Outputs

White, C., Whitfield, C. and Wray, J. (2019) Providing help, support and care from a distance: summary of findings from an exploratory study of ‘distance carers’ in the UK.

White, C., Wray, J. and Whitfield, C. (2020) 'A fifty mile round trip to change a lightbulb’: An exploratory study of carers’ experiences of providing help, care and support to families and friends from a distance. Health and Social Care in the Community

Project team

Caroline White

Jane Wray

Clare Whitfield

CONTACT

Caroline White c.white@hull.ac.uk.

Twitter - @dist_care

Caring from a Distance: using new and familiar means of keeping in touch with family and friends in care homes during COVID-19

Keeping in touch with people in care homes can be important both for family carers/friends and care home residents. However, our distance carer research demonstrated that maintaining contact between visits can be challenging. This project is exploring how carers have responded to the challenges of the care home closures during the COVID-19 pandemic, the approaches they have adopted to stay in touch, and how care homes have worked to support this. We hope that this study can help identify good practice in maintaining contact between visits or when visits are not possible (for example due to infections in care homes, geographic distance, carer illness).

More information

Caring by family members and friends does not cease when individuals enter care homes. This study explored the experiences of families and friends of care home residents during the closure of care homes during the COVID-19 pandemic, with a specific focus on how they worked to maintain contact with their relative/friend, the approaches which worked well as well as those which were unsuccessful.

Funder

This is an unfunded study

Project team

CONTACT

c.white@hull.ac.uk

TWITTER

@dist_care

Social Prescribing

Social prescribing is a new and emerging way of addressing health inequalities, increasing mental and physical health and wellbeing, reducing isolation and loneliness, as well as reducing pressures on primary care; this forms an important element of the NHS Long Term Plan and current health policy. This research project is evaluating the social prescribing support currently provided in Hull. It is collecting data from multiple perspectives, including quantitative data on referral patterns, and qualitative data on experiences of social prescribing from potential referrers, social prescribing clients and their families, and community agencies and support groups.

More information

This study evaluated the provision of social prescribing in Hull using mixed methods, and collecting data from multiple perspectives. Analysis of referral data was undertaken, and qualitative data was collected from social prescribing workers; referrers (GPs and social workers), social prescribing clients, staff from VCS agencies. It explored the impact of social prescribing both for clients and practitioners, and the nature of the support provided by social prescribing workers.

FUNDERS

Hull CCG and Hull City Council.

Outputs

White, C., Bell, J., Reid, M. and Dyson, J. (2022) More than signposting: Findings from an evaluation of a social prescribing service. Health and Social Care in the Community.

Project team

Jo Bell

Marie Reid

Judith Dyson

Caroline White

CONTACT

Dr Jo Bell – J.Bell@hull.ac.uk

Social Work and Social Prescribing

There is an increasing focus within primary care on social prescribing as an approach to address health inequalities and non-medical issues through linking patients with community based forms of support. However, our recent evaluation of social prescribing in Hull found that more referrals for social prescribing support were made by social workers than by GPs. Yet, to date, there is little information about the role of social prescribing within social work and the extent to which social workers access this as part of their practice. This exploratory study seeks to build on the findings of the previous research, through using an online survey to explore the perceptions and experiences of social workers throughout the UK of social prescribing.

More information

Our survey sought social workers' views and experiences of social prescribing and whether linking to social prescribing is a useful element of their work with those they support. The research explicitly sought a range of perspectives - aiming to include social workers across the career trajectory, working in different geographic and professional areas, and with diverse perspectives on the role and value of social prescribing.

We received responses from over 100 UK social workers and are currently analysing the data.

We are sharing information about the research on Twitter at @SWSPstudy

Project team

Abuse in Care - Safeguarding in care homes

Abuse and neglect have been widely reported within care homes, and the need for approaches which prevent the onset of abuse have been widely called for. This area of research aimed to enable health and social care practitioners who visit care homes as part of their professional roles, to recognise service environments and cultures in which residents are at high risk of abuse and preventative responses are required. This was undertaken through the identification of ‘early indicators’ of abuse and harm, which can act as early warning signs of significant risk to residents. Guidance for visiting practitioners to enable them to identify, record and evidence early indicators, and to take action, have been developed, both for care homes for people with learning disabilities and for older people.

More information

This research sought to identify early warning signs. or ‘early indicators’, that people living in care homes are at risk of abuse, through conducting research with health and social care practitioners. Practical resources were developed to enable visiting practitioners to recognise, document and report services in which there are significant concerns that residents are at risk of abuse or neglect. These can be accessed below for use by practitioners who visit care homes as part of their professional roles.

Aims

To understand and identify early warning signs ‘early indicators’ that people living in care homes are at risk of abuse, and to produce practical resources to enable visiting practitioners to recognise, document and report services in which there are significant concerns that residents are at risk of abuse or neglect.

Funder

Birmingham Safeguarding Adults Board

Scottish Government

Outputs

Marsland, D., Oakes, P. and White, C. (2012) Early Indicators of Concern in Residential Support Services for People with Learning Disabilities - report | guide

Marsland, D., Oakes, P. and White, C. (2012) Early Indicators of Concern in Residential Support Services for Older People - report | guide

Marsland, D., Oakes, P. and White, C. (2007), "Abuse in care? The identification of early indicators of the abuse of people with learning disabilities in residential settings", The Journal of Adult Protection

Marsland, D., Oakes, P. and White, C. (2015) Abuse in care? A research project to identify early indicators of concern in residential and nursing homes for older people. Journal of Adult Protection DOI 10.1108/JAP-08-2014-0027

Project team

David Marsland

Peter Oakes

Caroline White

Contact: D.Marsland@hull.ac.uk

GPS' ROLES IN SAFEGUARDING RESIDENTS OF CARE HOMES - WHAT DO THEY SEE AND WHAT DO THEY DO?

GPs (General Practitioners) are among the most frequent visitors to care homes for older people, providing healthcare support to residents unable to visit the surgery. They therefore can play important roles in observing care home practices and resident wellbeing. This includes noticing signs of abuse, and that residents are experiencing poor care or are at risk of abuse and neglect. This research project consists of two interlinked studies. The first is an exploration of GPs’ experiences of working in care homes, which represent a distinct environment in contrast to the surgery or domestic home visits, and in which there are unique barriers and facilitators to the delivery of healthcare and support. The second study is exploring GPs’ experiences of safeguarding in the care home environment, and the specific difficulties and dilemmas encountered.

More information

Aims

These linked research projects are exploring GP experiences of working in care homes for older people, and of working to safeguard residents in these unique practice environments.

Funder

East Riding of Yorkshire Clinical Commissioning Group (CCG).

Outputs

COVID-19 Bulletin (June 2020) Supporting Care Home Residents and Staff

White, C. and Alton, E. (2022) The interface between primary care and care homes:General practitioner experiences of working in care homes for older people. Health and Social Care in the Community.

Project team

Caroline White

Elisabeth Alton, East Riding of Yorkshire CCG

CONTACT

Caroline White – C.White@hull.ac.uk

Evaluation of seven day working for social work stafF

Seven day working has been introduced for the hospital social work/social care workforce. This research project will explore the impact of these working arrangements on staff, their working practices and hospital discharge.

More information

Local Authority social workers currently provide a 7 day service designed to facilitate hospital discharge. The aims of this evaluation are to explore the extent to which this working pattern supports effective and timely patient discharge, and the impact of this working arrangement on staff (both in respect of their work and their home/life balance).

Qualitative data collection will be undertaken with hospital social workers, and discharge patterns before and after the introduction of seven day working will be compared.

Project team

Dr Jane Wray, Director of Research, Senior Lecturer in Nursing

Ms Caroline White, Research Associate

Professor Liz Walker, Professor of Health and Social Work Research

Funded by Hull City Council

Together Suicide Bereavement Service Evaluation

This project is evaluating a new support service: Together for those bereaved by suicide, launched in May 2020, and delivered by local mental health charities Hull and East Yorkshire Mind and North East Lincolnshire Mind to support those bereaved and affected by suicide across Hull, East Riding of Yorkshire, North East Lincolnshire and North Lincolnshire. Offering free emotional and practical support to individuals who have lost someone to suicide, or been affected by suicide, the service aims to improve the resilience, functioning and wellbeing of people bereaved by suicide, enabling them to understand their grief, develop coping strategies, and feel safe to explore their thoughts and feelings.

More information

Aims

This project will explore the experiences of users of the service as well as staff and volunteers working within the service to identify how service aims are best met and inform future recommendations and guidance for best practice in postvention.

Funded by

Humber Coast and Vale Health and Care Partnership

Project team

Dr Jo Bell

Dr Fiona Earle

CONTACT

Dr Jo Bell – j.bell@hull.ac.uk

An Ethnography of Community Nursing

This study explored the staff and older patient experiences of dignity and human rights in community nursing care practices. Previous empirical considerations of dignity in healthcare focused primarily on hospital-based care, and only a paucity of literature explored dignity and human rights in community healthcare settings. This study assumed a sociological approach, applying a human rights lens to the subject matter which offered an original contribution, as, to date, much of the work in this context has been written from a health or bioethical perspective.

More information

The ethnography on which the thesis reports was conducted over a period of fourteen weeks in which the chief investigator was located within an urban district nursing team in the north of England. Two methods of data collection were used – observations and interviews. Observations of clinical interactions (n=62) were undertaken between older adult patients aged over 60 (n=40) and members of the nursing team (n=15). Semi-structured interviews were undertaken with staff (n=11) and patients (n=11), which covered some standardised questions about dignity and human rights, plus individualised questions from the observations.

Thematic analysis resulted in three overarching themes: dignity in relationships, dignity in caring for the body, and dignity in the home. Dignity is fluid and there are some nursing tasks in which dignity is highly fragile, which includes care of the leaky body. Dignity does not exist absolutely, but findings indicate dignity is socially (de)constructed through social interactions. Within the caring relationship, nurses and patients can create a ‘dignity encounter’, and if care within the home is managed successfully, an ‘environment of dignity’ ensues.

The study concluded that although dignity is desirable, it is highly complex and has multiple meanings, yet dignity remains core to community nursing practice. Through investigating routine and ‘mundane’ aspects of community nursing, this study showed how micro-articulations in caring relationships have macro applications in terms of dignity.

Project team

Dr Emma Stevens

Dr Liz Price

Professor Liz Walker

Outputs

Stevens E, Price, E, Walker, L “Just because people are old, just because they're ill…” Dignity matters in district nursing”, Journal of Adult Protection, 24(1), 3-14.

Stevens E, Price E, Walker L (2021) Dressings and dignity in community nursing. British Journal of Community Nursing, Vol 26 (11), pp 526-531.

Stevens E, Price E, Walker E (2021). Making the mundane remarkable: an ethnography of the ‘dignity encounter’ in community district nursing. Ageing & Society 1–23. S0144686X21000738

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