Expert Perspective: Why HWL is a different type of research programme

Our aims and objectives differ from those of most projects. We have worked with care workers to co-develop practical innovations in ways of working in residential care homes.

This has produced a different type of research trajectory, as we explain in part 4 below.

1. ‘Normal’ social science research

Many social science research projects use methods like surveys, interviews and ethnographic observations to find out about people’s behaviour, their interpretations of why and how they act, and their feelings about their everyday experiences.

Researchers analyse these data and come up with conclusions about the everyday world of the people and groups they study. Then they write academic papers about what they have found and summarise the results for policy makers and pressure groups.

In the first stage of HWL researchers spent time in 6 residential care homes interviewing care workers and managers and understanding what went on in the homes – a normal pattern of research activity. But although we have analysed these data in the usual way (and several academic papers are being written) we have also used them as a crucial input to the next stage - co-design.

2. Co-design workshops

Our co-design workshops brought care workers and researchers together to identify what changes might improve these workers’ everyday working experiences in their care home and improve the delivery of residential care. Researchers did 3 co-design workshops with care workers in each of the 6 homes. The earlier interviews and observation in the care homes helped us shape this co-design stage.

Over the past few decades there has been an increasingly rapid growth in participatory research - where rather than doing research on people we do it with them. Co-design is one of the recently popular ways of doing this. It uses structured creative and game-like activities to engage people to reflect on their experiences and expertise.

HWL’s co-design activities are structured to help care workers in each care home work together to:

• discover their existing (but often tacit) knowledges and feelings about care work
• identify what sort of changes they might wish to make in the working of the care home

3. Networks, information and advice

It matters to understand the context within which a specific research problem is set. So, throughout the research process, we have networked not only with those concerned specifically with social care but also with organisations and individuals working in the broader health and ageing field. This has been vital to help us understand changes in the field and to enable us to share our project with other: this page is one aspect of that networking.

Many research projects have an external Advisory Group to provide valuable criticism and advice. We established a Knowledge Network – a diverse group of people working within, or with deep knowledge of, the social care sector and an interest in innovations within it. They have pointed out weaknesses in our plans, challenged our ideas, made creative suggestions and helped us identify and contact significant individuals.

Crucially, from early on, we set about finding and interviewing ‘trailblazing’ entrepreneurs who were developing innovations in technology or principles of organisation in the field of health and care. From the experiences of these Trailblazers, we’ve learned about the do’s and don’ts, barriers to and enablers of innovation and change.

4. Co-designing ‘problem statements’ for new interventions

The next and final stage of our programme distinguishes HWL’s research from other social science research projects.

We have set up 4 Innovation Teams to turn residential care workers’ identification of a particular aspect of their working lives as something that needs changing, into a more concrete and transferable innovation. These teams have brought together the employees from our 6 residential homes with selected Trailblazer entrepreneurs.

CodeBase (an HWL partner) - a technology incubator skilled in helping start-ups - have mentored two of the teams; the co-design team mentored the other two. Already, the process of co-design and team working has empowered care workers to suggest and develop local changes that will enhance their working lives.

The teams are also specifying the features of some clear and practicable interventions, be they digital tools or new protocols, that can be used across many care homes. For example, to use data already collected by care homes about residents, to personalise their care or to spread identified good practice in recruitment and training.

Although HWL was not funded to invest in the development and commercialisation of these interventions, we are investigating appropriate follow-on funding to enable them to be taken to market.

The benefits of our approach

The research approach in this context has been very effective in particular:

• The interviews, ethnographic observations and co-design proved effective processes to build trust between care workers and team members.
• The co-design process helped care workers crystallise what needed to change. And it empowered them to make small, but significant changes, there and then, in ways of working beneficial to carers and their residents.
• The teams helped innovators develop deeper understandings of the working lives of care workers and the difficulties and rewards of their work.
• This deep understanding is vital if scalable, appropriate innovations, both high-tech and low-tech, are to benefit everyone working and living in residential care homes.

It’s vital to commission and leverage multi-disciplinary research to make real change stick.