Positive risk taking: debating the research agenda in the context of adult

The purpose of this paper is to present the case for examining the concept of Positive Risk Taking (PRT) in the context of adult protection. The paper argues there is a need for empirical research to understand the application of and attitudes to PRT to explore whether the concept has moved beyond a principle to make an identifiable difference to service users. By investigating evidence from policy, literature, and professional opinion, this paper presents the ethical tensions for professional practice in adult protection between respecting a service user’s freedom to make choices to enhance their independence whilst preserving safety for service users and society. This is considered in the context of risk in health and social care and the recent changes in society resulting from Covid-19. Inherent tensions are apparent in the evidence in health and social care between attitudes propounding safety first and those arguing for the benefits of risk taking. This indicates not only a need for a paradigm shift in attitudes but also a research agenda that promotes empirical studies of the implications of PRT from service user and professional perspectives. This paper draws attention to the relatively limited research into both professionals' and service user perspectives and experiences of PRT in practice

Applying a new concept of embedding qualitative research: An example from a quantitative study of carers of people in later stage dementia

BACKGROUND: Qualitative methods are increasingly included in larger studies to provide a richer understanding of people's experience. This paper explores the potential of using a novel approach to embedded qualitative design as part of an observational study examining the effectiveness of home support for people in later stage dementia in England. The method involved collecting and analysing unsolicited conversational comments made by participants as they completed standardised measures. An evaluation of the method is presented using the voices of participants to illustrate its potential. METHODS: The conversations of 17 carers recruited to an observational study were audio recorded to gather commentary made while completing a structured interview. Data were interrogated using thematic analysis to investigate the feasibility of conducting an embedded qualitative study, the potential richness of the material and participants' reactions to formal questioning and participating in research. RESULTS: The findings revealed that qualitative data were available from this approach. Analysis generated three themes from carers: conflicting carer emotions; the importance of maintaining normality and agency within day-to-day life; and tensions between these desires and making use of formal services. Important issues for carers were revealed establishing the benefit of using the method. The advantages of exploiting unsolicited conversation included enhancing understanding of people's lived experience, reducing participant burden in research and easing the process of data collection. In addition, it provided an opportunity to evaluate individuals' experience of the research process. CONCLUSIONS: The findings demonstrate how unsolicited comments during structured interviews may appear incidental but can reveal important aspects of living with dementia. The method also emphasised methodological challenges for research in dementia, including the influence and impact of the research context. Further research is required to evaluate the method with other groups including people with dementia themselves

Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review

Prevention has become increasingly central in social care policy and commissioning strategies within the United Kingdom (UK). Commonly there is reliance on understandings borrowed from the sphere of public health, leaning on a prevention discourse characterised by the 'upstream and downstream' metaphor. Whilst framing both structural factors and responses to individual circumstances, the public health approach nonetheless suggests linearity in a cause and effect relationship. Social care and illness follow many trajectories and this conceptualisation of prevention may limit its effectiveness and scope in social care. Undertaken as part of a commissioned evaluation of the Social Services and Wellbeing Act (2014) Wales, a systematic integrative review was conducted to establish the key current debates within prevention work, and how prevention is conceptually framed, implemented and evaluated within the social care context. The databases Scopus, ASSIA, CINAHL and Social Care Online were initially searched in September 2019 resulting in 52 documents being incorporated for analysis. A further re-run of searches was run in March 2021, identifying a further 14 documents, thereby creating a total of 66. Predominantly, these were journal articles or research reports (n = 53), with the remainder guidance or strategy documents, briefings or process evaluations (n = 13). These were categorised by their primary theme and focus, as well as document format and research method before undergoing thematic analysis. This highlighted the continued prominence of three-tiered, linear public health narratives in the framing of prevention for social care, with prevention work often categorised and enacted with inconsistency. Common drivers for prevention activity continue to be cost reduction and reduced dependence on the care system in the future. Through exploring prevention for older people and caregivers, we argue for an approach to prevention aligning with the complexities of the social world surrounding it. Building on developments in complexity theory in social science and healthcare, we offer an alternative view of social care prevention guided by principles rooted in the everyday realities of communities, service users and caregivers

A History of the University of Manchester, 1973-90

This is the second volume of a history of the University of Manchester since 1951. It spans seventeen critical years in which public funding was contracting, student grants were diminishing, instructions from the government and the University Grants Commission were multiplying, and universities feared for their reputation in the public eye. It provides a frank account of the University's struggle against these difficulties and its efforts to prove the value of university education to society and the economy. This volume describes and analyses not only academic developments and changes in the structure and finances of the University, but the opinions and social and political lives of the staff and their students as well. It also examines the controversies of the 1970s and 1980s over such issues as feminism, free speech, ethical investment, academic freedom and the quest for efficient management. The author draws on official records, staff and student newspapers, and personal interviews with people who experienced the University in very different ways. With its wide range of academic interests and large student population, the University of Manchester was the biggest unitary university in the country, and its history illustrates the problems faced by almost all British universities. The books will appeal to past and present staff of the University and its alumni, and to anyone interested in the debates surrounding higher education in the late twentieth century. A history of the University of Manchester, 1951-73 by Brian Pullan is also available from Manchester University Press

Positive risk taking: debating the research agenda in the context of adult protection and COVID

YouTube video recorded for Emerald Publishing's Social Care Research Campaign March 2022