Strengths-based practice in adult social care: Understanding implementation.

NIHR open research Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI:10.3310/nihropenres.13532.2
Sharanya Mahesh, Ila Bharatan, Robin Miller
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Abstract

Background: There has been increasing emphasis towards adopting strengths-based practice (SBP) within adult social care in England. Whilst there is agreement that SBP is the right approach to discharge adult social care duties, there is limited evidence regarding the implementation of SBP. This paper presents findings from the evaluation of the implementation of SBP in fourteen local authorities in one region in England.

Methods: We employed a mixed methods research design, drawing on data from a scoping review, 36 interviews with practice leaders and two surveys, one with wider adult social care staff and the other, with external organisations like independent care providers and community and voluntary organisations. Our data collection and analysis were guided by two well established implementation theories: the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). Interviews were analysed deductively, and surveys were analysed descriptively.

Results: Local authorities are at different stages in their implementation journey. The Care Act 2014 and support for SBP demonstrated by key professional groups were seen as major drivers for implementing SBP. Whilst SBP resonated with the professional principles of social workers and occupational therapists, staff did not always have the confidence and skills to adapt to SBP. Changing paperwork and recording systems, providing training opportunities to develop staff competencies, establishing new care pathways, genuine co-production, and senior management buy-in were key enablers supporting implementation.

Conclusions: To successfully implement SBP, a whole system approach that meaningfully collaborates with key professionals across sectors is essential. When implemented well, SBP has the potential to empower individuals by focusing on what matters to them.

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基于优势的成人社会护理实践:了解实施情况。
背景:英格兰越来越重视在成人社会护理中采用基于优势的实践(SBP)。尽管人们一致认为 SBP 是履行成人社会护理职责的正确方法,但有关 SBP 实施情况的证据却很有限。本文介绍了对英格兰一个地区 14 个地方当局实施 SBP 的评估结果:我们采用了混合方法的研究设计,利用了来自范围审查、36 次与实践领导者的访谈以及两次调查的数据,其中一次调查的对象是更广泛的成人社会护理人员,另一次调查的对象是独立护理提供者、社区和志愿组织等外部机构。我们的数据收集和分析以两个成熟的实施理论为指导:实施研究综合框架(CFIR)和规范化过程理论(NPT)。我们对访谈进行了演绎分析,对调查进行了描述性分析:地方政府在实施过程中处于不同阶段。2014 年护理法案》和主要专业团体对 SBP 的支持被视为实施 SBP 的主要推动力。虽然 SBP 与社会工作者和职业治疗师的专业原则产生了共鸣,但工作人员并不总是具备适应 SBP 的信心和技能。改变文书工作和记录系统、提供培训机会以提高工作人员的能力、建立新的护理路径、真正的共同生产以及高级管理层的支持是支持实施工作的关键因素:要成功实施校本课程,必须采取全系统方法,与各部门的主要专业人员开展有意义的合作。如果实施得当,SBP 有可能通过关注对个人重要的事情来增强个人能力。
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