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Three deaths at Cawston Park Hospital shed a bright light on Norfolk’s services for people with learning disabilities and autism, including those operated by the company that ran the hospital. The purpose of this paper is to review Norfolk County Council's current position from the unique aspect of a senior manager wihtin the system.

This paper reviews the unique perspective of a social worker from within the system.

The process of making change included engagement and action concerning such thorny challenges as the pressures on community services; the undervaluing of care-giving as a career; and the continuing admissions to specialist mental health services at a time when hospital discharges are being expedited.

Norfolk’s investment in improving its services involves the adoption of a human rights approach; a capital programme to facilitate new developments; nurturing care-giving as a career; and bringing a clearer evidence base to this work programme.

The author will describe the operational tasks of S.44’s statutory mandate: for example, commissioning the review; being responsive to the representatives of the relevant agencies concerned; securing pharmacological/medical advice; adding Ben’s death to the review; engaging with relatives; and ensuring that “lessons” were foregrounded. How the review was set up/recognising the standout features from the beginning/managing the situation when an agency is withholding information/“drip feeds” information into the review; navigating/steering the Safeguarding Adults Review (SAR) alongside other processes – police/inquest/Care Quality Commission.

This practice paper describes the experiences of coordinating a complex SAR into the deaths of three adults at Cawston Park Hospital in Norfolk.

The system insights that SARs give us prompt exploration of how to inject this learning into current discourse on how we better protect the most vulnerable in our communities.

The purpose of this paper is to explore the process and requirements of conducting a complex SAR from the perspective of a safeguarding adults board manager. It will be of interest to anyone who is involved in SARs, in particular safeguarding adult board chairs, board managers, members of SABs and SAR authors as management of SAR is one of the three statutory duties of a SAB.

The purpose of this paper is to report on an interprofessional (IPE) student training scheme recently conducted in three care homes across the Northwest of England. The intervention was designed as a feasibility study to explore the impacts such schemes have on residents, students and care home staff. Additional lessons emerged that contribute to the design and direction of future IPE initiatives in other care homes and care settings.

This case study outlines how the intervention was designed and implemented and the findings from its evaluation. This paper uses Biggs’ (1993) presage–process–product framework to evaluate the process of setting up care homes as a site of collaborative learning.

Collaborative working between stakeholders is necessary for the successful implementation of IPE in care home settings. The process is complex and requires communication and commitment across all levels of engagement. For this model to grow and have a beneficial impact on older people’s lives, there are layered factors to consider, such as the socio-political context, the characteristics of the individuals who participate and diverse approaches to learning.

This case study reports the subjective views of the research collaborators. While this raises the potential for bias, it presents an “insider” perspective of the research process and offers learning that might be beneficial in efforts to run future IPE training schemes.

To the best of the authors’ knowledge, no other research studies or published interventions have been identified that explicitly address the experiences of implementing an IPE training scheme in UK care home settings. This paper will therefore be useful to academic researchers, individuals managing student placements and to health and social care staff who wish to learn about of the value of IPE learning schemes.

This study aims to investigate the experiences of frontline managers supervising and developing staff to support autistic adults living in two types of residential housing in the community.

A qualitative approach used semi-structured interviews with 14 frontline managers. Audio-taped material was transcribed and analysed using thematic analysis.

Two main themes emerged. Theme 1 “autism in practice” illustrates commonalities observed to affect autistic adults with learning disabilities receiving staff support; whilst one sub-theme illustrated the diversity in how these commonalities may be experienced and expressed, another focused on participants’ experiences of staff concerns regarding behaviours described as challenging. Theme two, “what’s important in autism-informed support” reflected participants’ perceptions of the features of successful person-centred staff support for autistic service users.

The “rich” experiences of these managers may not be readily generalised.

Features of good staff support for autistic adults who may show behaviours of concern included attending to individuals’ specific communication and sensory needs and for predictability within their environments. Developing staff skills and confidence to implement skilled approaches in the context of often high risk behaviour of concern took time and frontline managers “on site” to observe, coach, mentor and demonstrate good practice. More intellectually (verbally) able service-users were perceived as more “difficult” to support.

Staff supporting autistic adults in ordinary housing need frontline managers to act as practice leaders rather than administrators.

This study is the first to report, to the best of the authors’ knowledge, on management for staff supporting autistic adults living in community housing.

To ensure health, social and criminal justice services are suited to the complex and dynamic needs of people with learning/intellectual disabilities (LD) at risk of offending, it is important to systematically analyse the needs and characteristics of this population. This study aimed to analyse the patterns of referrals to a single community forensic LD service before and during the COVID-19 pandemic.

A structured audit was conducted on all referrals to the service (n = 37) across a three-year period (May 2019 – end of July 2022).

The majority of the overall sample were male (36, 97%) and Caucasian (24, 65%) with a mean age of 32.9 years and mild LD. The most prevalent current offending type was sexual offending (17, 44%), whereas the most prevalent historical offending type was violence (17, 35%). The most common service/function offered by the service was advice and consultation to other professionals and agencies (10, 19%). The service user and forensic/legal characteristics measured did not differ significantly before and during COVID-19.

To the best of the authors’ knowledge, the project is the first to systematically analyse and compare community forensic LD service referral patterns before and during the COVID-19 pandemic. This study also provides an example of how a structured audit tool can be used to benefit individual services and the wider literature on assessing the needs and characteristics of adults with LD who live in the community and are at risk of [re]offending.

This paper examined the significance of the built environment for shaping inclusion and social connections in housing with care (HwC) schemes for older people (50+ years) in England and Wales. The purpose of this study was to develop a better understanding of how the availability, absence and use of communal spaces impacts social connections with other residents within HwC schemes.

Longitudinal and cross-sectional qualitative interviews were conducted with 72 residents across three HwC providers in England and Wales. Data were analysed using a thematic framework approach to examine how residents experienced their living environments.

Whilst the presence of communal shared spaces helps facilitate social connections and the development of friendships, full and equal access to these spaces remains challenging for residents with minority characteristics, and/or physical impairments. Building designers need to ensure they are complying with building regulations and the Equalities Act. The presence of on-site staff may also help to manage the impact of discriminatory attitudes.

A key strength of this study is its design, both in using longitudinal and cross-sectional interviews and in recruiting respondents with marginalised characteristics, whose voices have often been excluded in gerontological research. Another strength, albeit unexpected, is that this study was able to capture perspectives across the onset of the COVID-19 pandemic. The pandemic, however, may also have generated some limitations in this study. COVID-19 restrictions limited the ability to engage face-to-face within housing schemes whose residents were predominantly from different ethnic minoritised groups, and it therefore limits the inclusion of the voices and experiences of these groups. Responses in later interviews may also have been influenced by the changes in social engagement stimulated by lockdowns and may only be specific to the context of the pandemic. However, the findings reported here focus on the role and use of the built environment, and much of the interview content would feasibly apply regardless of the pandemic.

This research offers some key insights and implications for housing providers and policy. Housing providers and architects must ensure that the design of HwC schemes affords all residents access to every area of the built environment to maintain independence, autonomy and to adopt the ethos of the ageing in place agenda. If communal areas are to function as “third” or social spaces – if they are to remain equally accessible to all members of the community – then building providers must ensure that all areas are accessible to all residents in line with building regulations and the Equality Act (2010).

Housing staff need to balance the natural development of friendship groups with the potential of the formation of exclusionary “cliques” within HwC schemes. Such cliques threaten the accomplishment of communal areas as “third” or social spaces and, as such, impact the quality of life for residents.

This study offers insights into how built environments support the development of social connections and friendships in HwC schemes. It also identifies ways that housing managers can ensure that all residents feel equally valued and included.

The purpose of this paper is to share learning about practical steps that can be taken to eliminate persistent racism from the workplace, including racism by people who have cognitive impairments who do not understand the impact of their behaviours.

This paper is informed by qualitative research. An independent researcher was commissioned to recruit 45 black British, black African and black Caribbean women living in Norfolk and working for a range of employers. Parameters were agreed in advance (aims, consent, data protection). A list of questions was provided to the researcher. The questions covered experiences of prejudice and discrimination. Data collection included face to face/online/telephone interviews, focus groups and questionnaires. The researcher recorded the women’s views and compiled them in a findings report. The report was shared with the women to confirm that their views had been recorded accurately. The author has also convened conversations with over 100 professionals representing providers of public services, including social and domiciliary care.

The author identified that it will be impossible for employers to eliminate persistent racism from their workplaces until all managers consistently and diligently address every report of racism effectively, in line with the steps set out in this paper. The purpose is to establish, over time, a workplace culture where racism is never tolerated or allowed to persist, and workers and managers learn – and become more confident – to recognise, address and eliminate racism at work. Until this is embedded, racism affecting workers will continue to go unchecked and unacknowledged in the workplace.

The data gathered to inform this paper (specifically the research commissioned and described in this abstract, in addition to other data, such as conversations convened with professionals) is qualitative data. It cannot be assumed that the experiences of the people interviewed reflect the experiences of all people. However, the voices of participants have highlighted issues to inform future planning.

The author must be clear that, so far there has been no definitive solution to persistent racism in the workplace. The learning so far is being shared with the hope that this assists others with developing strategies to eliminate persistent racism.

Workplaces across the UK are committed to eradicating racism. However, the rate of change is glacial. This research paper shares learning about how to address this, to increase the pace of change, to begin to genuinely eliminate persistent racism from the workplace.

To the author’s knowledge, the learning from this research is original and not replicated elsewhere.

This research explored the impact that the relatively new role of the Health and Wellbeing Lead upon the health and wellbeing of children and their families at this school.

This case study took place in a primary school (children aged 4–11) in the South-West of England. Data was collected through activities with children, semi-structured interviews with senior staff and parents and a “learning walk”.

Our data suggested that this role provided compassion, unconditional positive regard and respect for parents, factors that are frequently absent from research into parent partnerships in education. The role presented as invaluable in tackling the many mental and physical challenges that parents faced in rearing their children, and in providing their children with the best possible chance of success.

This is a single Case Study and, as such, may or may not be representative of similar schools. We also question to what extent the findings demonstrated the strength of this role per se, or whether the impact could simply be the result of a uniquely caring and passionate individual.

We concluded that this was a role needed in all schools, recognising the key role that parents play in their child’s wellbeing, and the indirect impact that parent mental health can have upon their child’s success.

It is vital that this role is not used as an excuse by the government to further reduce the already denuded Social Services landscape within communities. It is also important that this responsibility does not become yet another burden added to already overstretched teaching staff.

This research presents a fresh perspective on the multiple pressures that parents face and how these can impact upon their child's education.

The lack of a proper register to store, match and display information on the adapted property has led to a waste of resources and prolonged delays in matching the disabled and elderly people with appropriate properties. This paper presents the development of a Housing Adaptations Register with user-matching functionalities for different mobility categories. The developed system accurately captures and documents adapted home information to facilitate the automated matching of disabled/aged applicants needing an adapted home with suitable property using banding, mobility and suitability index.

A theoretical review was conducted to identify parameters and develop adaptations register construct. A survey questionnaire approach to rate the 111 parameters in the register as either moderate, desirable or essential before system development and application. The system development relied on DSS modelling to support data-driven decision-making based on the decision table method to represent property information for implementing the decision process. The system is validated through a workshop, four brainstorming sessions and three focus group exercises.

Development of a choice-based system that enables the housing officers or the Housing Adaptations Register coordinators to know the level of adaptation to properties and match properties quickly with the applicants based on their mobility status. The merits of the automated system include the development of a register to capture in real-time adapted home information to facilitate the automated matching of disabled/aged applicants. A “choice-based” system that can map and suggest a property that can easily be adapted and upgraded from one mobility band to the other.

The development of a housing adaptation register helps social housing landlords to have a real-time register to match, map and upgrade properties for the most vulnerable people in our society. It saves time and money for the housing associations and the local authorities through stable tenancy for adapted homes. Potentially, it will promote the independence of aged and disabled people and can reduce their dependence on social and healthcare services.

This system provides the local authorities with objective and practical tools that may be used to assess, score, prioritise and select qualified people for appropriate accommodation based on their needs and mobility status. It will provide a record of properties adapted with their features and ensure that matching and eligibility decisions are consistent and uniform.

Delay in housing adaptation is a major problem, especially in assessing if homes are suitable for the occupants and in determining if the occupants are qualified for the Disabled Facilities Grant (DFG). This paper describes the development of two self-administered intelligent integrated assessment tools from the DFG Adapt-ABLE system: (1) The Home Suitability Assessment Platform, which is a preventive mechanism that allows assessment of the suitability of homes based on occupants’ mobility status and (2) an indicative assessment platform that determines if the applicants are qualified for the DFG to prevent lengthy delays.

The adopted method aligned with a development study approach: a grounded literature review, a severity measurement approach, two stakeholder engagement workshops, four brainstorming sessions and four focus group exercises. The system development relied on Entity–Relationship Diagram (ERD) technique for data structures and database systems design. It uses DFG context sensitivity with alignment with DFG guidance, interlinkages and interoperability between the assessment tools and other platforms of the integrated Adapt-ABLE system.

The assessment tools are client-level outcomes related to accessibility, usability and activity based on the assessment process. The home suitability platform shows the percentage of the suitability of a home with assessment results that suggest appropriate action plans based on individual mobility status. The indicative assessment combines the function of referral, allocation, assessment and test of resources into an integrated platform. This enables timely assessment, decision-making and case-escalation by Occupational Therapists based on needs criteria and the eligibility threshold.

These assessment tools are useful for understanding occupants’ perception of their physical housing environment in terms of accessibility, suitability and usability based on basic activities of daily living and their mobility status. The indicative self-assessment tool will substantially cut down the application journey. The developed tools have been recommended for use in the CSJ Disability Commission report and the UK government Guidance on DFGs for local authorities in England.