users, residential care is the only solution, even if this means challenging the overriding ethos of the profession to allow older people to live in their own homes independently. But this is where the social worker’s input is crucial. In these cases, the role of the social
worker may focus on relocation and agreeing funding. But they may also continue to be involved in the lives of care home residents by maintaining contact with them over support plans, in reviews or monitoring, or they may be consulted if circumstances change. For some people living in care homes the social worker or care manager may be the one professional who has known them before the move. The small number of studies into dementia
in care homes refl ects a systematic failure to include people with complex and multi-faceted conditions or needs in health and social care research. This has excluded a large proportion of people who are very old, have considerable disabilities, or are at the end of life. One result particularly relevant to social
workers is that non-drug interventions are under-investigated. If care home residents continue to be generally excluded from dementia research this risks bias in the fi ndings. Equally important, research questions may overlook the matters that are crucial to residents and their families. Social workers may be cautious or
protective of their clients or even sceptical that research will make a positive diff erence. However, in the context of researchers wanting to include care home residents and more research funding being available for this, four main calls on social workers may be made: In the absence of a family member, social workers may be asked to be the ‘consultee’ for a person with dementia who cannot consent to take part in a research study (under the Mental Capacity Act 2005, applicable in England and Wales). Social workers can off er their opinion about whether they think that this would be something that the person might have wanted to take part in.
Social workers as key professionals may be asked to take part themselves in studies that seek their views. They may also be asked
PRACTICE
POLICY
to provide case-related data or talk about aspects of their practice. If they do not talk about their practice no-one else will.
Protecting and empowering
residents – the social work role
The opinion of a social worker may be sought by a relative or care home manager on whether they should agree to take part in a study. They may see social workers as neutral or independent. In giving their opinion, a social worker can suggest that the relative or care home manager asks for a meeting with the research team member before making any commitments; they can suggest that the proposal is in plain English if necessary, and they might suggest that the research team be invited to explain matters of concern (see Knowledge Button 1).
The small number of studies into dementia in care homes refl ects a
systematic failure to include people with complex and multi-faceted conditions
Social workers may be asked – or perhaps should suggest – ideas for what needs to be researched. This is an area where The College of Social Work may be able to off er support. Other colleges are engaged with “condition- or disease-specifi c” research communities and research groupings. Its contribution could enhance the research agenda because it will be able to synthesise and report what matters in frontline practice and what practitioners would like to know.
The National Institute for Health Research School for Social Care Research has been consulting on research priorities and has provided a toolkit, called ENRICH (see reference), which could provide the key to unlocking the knowledge potential. Other areas where social workers can take the lead in research include choosing care homes as the subject of their own studies, at post- graduate and doctoral levels. SWM The ENRICH Toolkit
Jill Manthorpe is a member of the ENRICH project board, Associate Director of the NIHR School for Social Care Research, and is Director of the Social Care Workforce Research Unit, King’s College London. Email jill.manthorpe@kcl.ac.uk