Evidence Informed Change Model for Adult Social Care

Summary

The Improving Adult Care Together Centre (IMPACT) is a cross-university and practice network, supporting change and improvement in adult social services across the UK. Through IMPACT's work with local, regional, and national partners, they have developed a model which sets out the key principles, informing change based on research evidence, practice knowledge, and lived experience. The model is illustrated through social service examples with a range of resources to support its implementation in practice.

Organisation

University of Birmingham, United Kingdom

Context/ Social issues addressed 

Whilst there are numerous change and improvement models available, these have generally been developed within other sectors, in particular business and health care. Whilst they do have relevance to social services, the language, concepts and values which underpin them can seem unfamiliar, and the examples to support them are often from other practice areas. This change model responds to this gap through a developing a set of principles which would help social service systems to undertake and sustain change effectively, ethically and in collaboration with people and wider partners.

Objectives

1.  To facilitate positive change and improvement in adult social services through insights from research, practice knowledge, and lived experience
2.  To understand how to put co-production with people with lived experience and communities at the heart of change
3.  To develop examples, tools and resources which could support change and improvement in adult social services.

Activities

The IMPACT Centre has worked with over 80 adult social services projects since 2023 which vary from improvement projects with a voluntary and community sector organisation within a local neighbourhood to strategic change within local authorities and/or at a regional and national level. The projects are structured around three approaches: Demonstrators employ a pair of Strategic Improvement Coaches to work in a local system for 12 months to lead a large, system-wide, change; Facilitators lead smaller, more bounded, bottom-up projects in a single agency setting; and Networks focus on complex but everyday practice issues, with local groups all over the UK working on the same practical issue and meeting to share challenges and potential solutions. All projects start with a review of available research evidence and then combine this with lived experience and practice knowledge to provide an accessible overview of what is know about the topic and how outcomes can be improved. There is also a strong emphasis on co-production with people and communities, both in how the overall IMPACT Centre is governed, and how local projects are designed and implemented. The individual projects are evaluated through the creation of a local theory of change with the overall IMPACT approach to change being evaluated through a central team.

Through these projects and our collaboration with local sites, we have learnt that whilst each situation and opportunity is different, there are common challenges and obstacles which prevent improvements from being made and sustained in the long term. We have also found that whilst more general change and improvement tools can be useful, these do not always reflect the values, language and realities of social services. We have therefore used the learning from our projects to develop a set of core principles for evidence-informed change in social care. The core principles within the change model are as follows:

• Agreeing on the issues
• Mobilising the evidence
• Engaging with people
• Taking informed action
• Making co-production central
• Trying out in practice
• Sustaining for the long-term
• Click on the stages to learn more.

The model is supported with examples from practice within social services, useful resources and tools, prompt sheets and a virtual community of practice.

Outcomes

Each project has its own evaluation alongside an internal and external evaluation of the IMPACT centre as a whole – this is deploying mixed methodologies involving internal and external stakeholders and secondary project data to provide a summative report in 2028. There are already numerous examples of the benefits of the overall approach from the individual project which are detailed in the annual reports (see below for link).

Learning to date includes:

• Adopting a process of co-creation that draws together evidence from research, practice and lived experience allows the creation of rich contextualised evidence that is applicable in the local context. This helps to ensure that implementation strategies and innovation reflect and are responsive to the social care systems they are working within.
• Relational approaches are crucial in social services where many diverse organisations are working together and relationships between individuals and organisations provide the glue that makes the system work. Successful change is supported by recognising the value of and adopting a relational approach and building trust and psychological safety through shared values and purpose.
• Introducing an independent informed voice free from organisational cultural norms and power dynamics provides external credibility, introduces new ideas and organisations into the conversation and supports innovation.
• There are many collaborative techniques and approaches that can be used to support evidence implementation and change in ASC through building relationships and improving capacity to engage with, collect and utilise evidence. These include training, mentoring, mediation, asset-mapping, ‘framing’ techniques, and project planning through visual maps and theory of change approaches.

Funding Source

Grant from National Research Body and Charitable Trust

Comments and tips

• There is often a pressure to move quickly into making practical changes, but to avoid changing the wrong things, it’s important everyone understands the current situation, opportunities and challenges.
• Evidence does not always provide a clear ‘answer’ – but often it gives you a sense of what might be fruitful, a starting point for dialogue and further questions to help you make progress together.
• There are often tensions between what is ideally hoped for in a change and what is feasible within the time and resources available – being realistic from the start helps to prevent people becoming disillusioned later.
• Being involved should not only help the process of change but also be beneficial for the person with lived experience through, for example, growing their networks and skills.
• It is important to be clear about which aspects of the process and/or impact are being explored when trying out in practice, and how these will be measured and understood.

Links to supporting documents:

• For more information on the IMPACT Centre: Improving Adult Care Together Centre
• For more information on the IMPACT Change Model: IMPACT Evidence Informed Change Model for Social Care
• For more information on emerging insights: Lessons from Impact 2026