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

Fiona Verity, Jonathan Richards, Simon Read, Sarah Wallace

Health & Social Care in the Community, Volume: 30, Issue: 1

Swansea University Authors: Fiona Verity, Simon Read

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DOI (Published version): 10.1111/hsc.13429

Abstract

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&#...

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Published in: Health & Social Care in the Community
ISSN: 0966-0410 1365-2524
Published: Wiley 2021
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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. 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spelling v2 56888 2021-05-18 Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review e8ab076d041ca74c58d6b9cda8289db7 Fiona Verity Fiona Verity true false a5fdd0f9bc9dd4b6716fc42cb1ee8a30 Simon Read Simon Read true false 2021-05-18 ASSD 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. Journal Article Health & Social Care in the Community 30 1 Wiley 0966-0410 1365-2524 ageing; caregiving; complexity theory; prevention; social and health services; social determinants of health 15 5 2021 2021-05-15 10.1111/hsc.13429 COLLEGE NANME Social Work COLLEGE CODE ASSD Swansea University SU Library paid the OA fee (TA Institutional Deal) Welsh Government C410/2017/2018 2023-06-28T15:59:50.0827108 2021-05-18T09:42:34.6614144 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Social Work Fiona Verity 1 Jonathan Richards 2 Simon Read 3 Sarah Wallace 4 56888__19996__6e1c200a4ba943b7b1058663c975bebc.pdf 56888.pdf 2021-05-25T10:55:30.1917543 Output 673536 application/pdf Version of Record true © 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/
title Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
spellingShingle Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
Fiona Verity
Simon Read
title_short Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
title_full Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
title_fullStr Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
title_full_unstemmed Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
title_sort Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review
author_id_str_mv e8ab076d041ca74c58d6b9cda8289db7
a5fdd0f9bc9dd4b6716fc42cb1ee8a30
author_id_fullname_str_mv e8ab076d041ca74c58d6b9cda8289db7_***_Fiona Verity
a5fdd0f9bc9dd4b6716fc42cb1ee8a30_***_Simon Read
author Fiona Verity
Simon Read
author2 Fiona Verity
Jonathan Richards
Simon Read
Sarah Wallace
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container_title Health & Social Care in the Community
container_volume 30
container_issue 1
publishDate 2021
institution Swansea University
issn 0966-0410
1365-2524
doi_str_mv 10.1111/hsc.13429
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Social Work{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Social Work
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description 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.
published_date 2021-05-15T15:59:46Z
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