Lockdown lunches

Written by Dr Laura Johnson and Dr Zoi Toumpakari

Family life has been transformed by lockdown. Since schools closed on 23rd March many families have had to create classrooms at home and juggle home-schooling with home working. But what has happened to school food at home? Are packed lunches still the norm or are family meals now the dish of the day?

Campaigners like the Food Foundation (@Food_Foundation) have already identified the most vulnerable children and are working hard to ensure that free-school meals are maintained for 18% of families with children eligible. Under half of these families have been given vouchers to buy food, another third has had food prepared for collection or delivery by schools, so provision, to some extent, has continued. But worryingly a third have not had anything. Furthermore, out of necessity food provided is often highly processed to ensure it lasts for a week or more at a time, suggesting that compared with food served in canteens, where school food standards apply, food quality may have dropped. But what about the other 82% families? Are meals worse across the board? Or is it possible that for many children lockdown lunches are a healthier option than the norm?

According to a YouGov poll in April, over half of households haven’t noticed a change in what they eat, but 1 in 3 have reported cooking from scratch more often; 1 in 5 think their diets are healthier since lockdown but 2 in 5 think they are eating more. Straw polls of families we know have reported diverse reactions. Some are more aware of what their children eat, have more control, are providing more fruit or eating meals as a family. Others have been fending off relentless biscuit requests (not always successfully). For some kids it’s meant a switch from cooked school dinners to more packed lunch type fare at home. But is that a problem? What do we know about school food pre-COVID19?

A review of studies up to 2007 comparing the nutritional quality of packed lunches to school dinners found that more energy, sugar, saturated fat and salt was in packed lunches. Back then both school dinners and packed lunches were pretty poor. However, school food standards have been in place in England since 2006 to raise the nutritional quality of food provided by schools. Around the world, as in England, the introduction of school food standards have generally improved the quality of meals provided in schools. Although intakes of vegetables and nutrients like fibre and iron still need attention, fruit intake is up, fat intakes are lower (especially saturated fat) and less salt is being consumed from school canteens.

Improvements in school-meals is great news, a real win for public health, but now the gap in the quality between school dinners and food brought from home has widened and the spotlight is firmly on packed lunches as a key area for action. Food from home still makes up 40% of meals eaten in UK schools. Recent times have seen small changes in how often sweets and how much sugary drinks are packed in lunches, but protein is lower and vegetables remain sparse, at just half a portion a day. Multiple interventions aiming to change packed lunch quality have been tested but with little success to date.

Our work on the National Diet and Nutrition Survey has used the detailed reports of what teenagers ate over 4 days to identify the key differences between meals at home vs. school. We found that most eating (two thirds) happens at home, and only 1 in 8 meals are consumed at school. Nearly 3 out of 4 school eating occasions included foods high in fat and sugar, compared with 2 out of 3 meals at home. We found that when eating at school, foods high in fat and sugar were not only eaten more often but also in larger amounts. We estimated that teenagers ate an extra 59 calories of foods high in fat and sugar in school-based meals compared with a similar meal at home, the equivalent of half a bag of Wotsits.

The kinds of foods high in fat and sugar eaten at school are similar to those eaten at home, including crisps and savoury snacks, biscuits, sugary drinks, cakes and chocolate. But there were some key differences between eating at home and school. Predictably, eating at school occurred primarily at lunchtime (about 50% of all eating) but it was also common in the morning too (40% of eating). In contrast, meals at home happen throughout the day, with around 50% occurring after 5pm (i.e. dinner time). Eating at school is more often with friends whereas at home eating is as likely to be alone (33%) as it is with family (39%).

We also went to talk with teenagers directly about what they thought influences their eating. For most teens, food choices when away from home are a result of many different factors working together. But they told us that they enjoyed eating most when they were with their friends, one said “I tend to prefer to eat at school because I’m with my friends and it’s more sociable really than with my family.”. Social drivers are clearly important. Therefore, creating social school environments that enable and actively promote healthy choices could be an element of achieving positive change in school food future. An interesting challenge in our new socially-distant world.

Many schools are opening up more widely today, what might the lifting of lockdown mean for children’s diets? Some schools, to prevent spreading the coronavirus, have banned packed lunches. In other schools, ensuring a safe school food service is a concern so packed lunches are mandated. Social distancing may limit the kind of interactions kids used to enjoy about lunch times at school, will that affect what they eat now? Times are changing fast, new normals are being created and this may be an opportunity, in the longer-term, to reset the system for the better.

About the authors

Written by Dr Laura Johnson and Dr Zoi Toumpakari, Centre for Exercise, Nutrition and Health Sciences in the School for Policy Studies at the University of Bristol. Dr Johnson is a member of the GENIUS network, funded by the UK prevention research partnership, which aims to build a community of school staff, policymakers, food providers and researchers to generate fresh insights into the challenge of ensuring healthy food in schools and reducing inequalities. Follow us in twitter @GeniusSFN

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Combatting loneliness in a climate of self-isolation for older housing residents

By Paul Willis, Ailsa Cameron and Brian Beach.

In the current climate of self-isolation, keeping social and staying in touch with others is vital to our health and wellbeing. This is even more important in later life when people’s social networks may start to shrink in size.

Older adults can experience feelings of loneliness due to the loss of intimate connections, such as the death of a spouse or relationship separation, and the transitions associated with later life, such as retirement, the onset of chronic illness, or changes in living environments. We also know that social isolation (being separated from the company of and contact with others who are important to us) over a protracted period of time can trigger feelings of loneliness and have an adverse impact on older adults’ emotional and mental wellbeing.

The current government policy response requiring older housing residents aged 70+ to self-isolate during the COVID-19 pandemic can potentially exacerbate feelings of loneliness. Below are some key messages for those providing support to older residents in housing with care schemes [1]. These messages have been distilled from research projects led at the University of Bristol over the last four years on extra-care housing, loneliness in later life, and social inclusion in housing schemes for older adults.

1) Supporting residents to maintain daily contact with significant others, such as through telephone calls or online messaging, is essential. Many older residents in housing schemes will live alone in their homes. While living alone does not mean every resident will experience loneliness, residents may be missing regular face-to-face contact with family (e.g. adult children and grandchildren) and good friends within the same scheme and the wider community.

Housing staff need a good understanding of each resident’s social networks – who is important to them and who do they call on for practical and emotional support when needed. For example, we know from previous research that older LGBT+ people may regard friends as close family members and hold close friends in equal esteem as biological kin. Supporting residents to maintain the connections that matter to them is really important during this time of self-isolation.

2) We know that some older adults may equate loneliness with thoughts of being socially discarded, not having a purpose, and being no longer valued by others. Now more than ever, residents may value having a clear role they can play to contribute to the lives of others and the scheme where they live. While volunteering outside the scheme is not a viable option, residents could be supported to help other residents, such as keeping in daily telephone contact with those who lack social contact or experience illness or poor health. Other ways of contributing could be through gardening or maintenance activities around the scheme where tasks can be completed solo.

3) While some older residents may already use social media on a regular basis and be confident to extend their use into new media such as community-based WhatsApp or Facebook groups, we should remember that many will have no access to the internet and as a result may become more isolated over the coming weeks and months. For example, preliminary findings from our DICE project suggest that around a third of housing with care residents never use the internet, in contrast to over half using the internet at least once a week.

Our recent research into older men’s experiences of loneliness with Age UK highlighted how much older men who were single or living alone valued social connections with other people through groups, whether that be through clubs, societies, sports groups, or learning with others. While some men were online, it was routine, face-to-face contact outside of the home that was valued and helped keep loneliness at bay. Where feasible within public health guidelines, staff may explore ways in which residents within schemes can meet together each day for a short period of time while maintaining social distancing, for example in open courtyard spaces or gardens.

4) Our previous work with older people living in housing with care settings illustrates how the impact of austerity had already exacerbated older people’s experiences of isolation and loneliness because of a lack of public funding to support social engagement. For these older people, calls to self-isolate may reinforce their sense of isolation and marginalisation from wider society; regular resident contact with housing and care staff is critical more than ever.

In addition, as a result of the new Coronavirus Bill 2020, many local authority obligations bestowed under the Care Act 2014 (for example, in relation to assessing an individual’s needs, determining an individual’s eligibility for services, and care planning duties) have been suspended. As a result, care and support staff will need to be attentive to the additional care and wellbeing needs that residents may have, and housing with care providers may have to provide additional care and support to those older people in need without local authority involvement.

Concluding messages: Other groups have recently commented on the many problems of adopting blanket policy approaches based on chronological age (e.g. see the British Society of Gerontology’s recent statement). We echo these concerns about the ageist assumptions within this policy approach, while recognising that the mortality risk from COVID-19 is associated with age. More than ever, older adults need support to keep in regular social contact with others. If that must be in their homes, they will need assistance to access online technology to facilitate this, and it should not be assumed that digital resources and broadband access are automatically available to them. At the same time, maintaining face-to-face contact, at the recommended physical distance, is equally important and should not be underestimated or forgotten.

[1] By ‘housing with care’ we mean housing schemes that support older adults with independent living while providing care and support if needed, for example extra-care housing, sheltered housing and supported living schemes.


About the authors:

Paul Willis and Ailsa Cameron are Senior Lecturers at the University of Bristol and Senior Research Fellows of the NIHR School for Social Care, England. Brian Beach is a Senior Research Fellow at the International Longevity Centre UK. For more information contact: paul.willis@bristol.ac.uk

Related research:

The Provision of Social Care in Extra Care Housing, 2015-17, University of Bristol, funded by NIHR School for Social Care Research. More information: https://www.housinglin.org.uk/_assets/Resources/Housing/OtherOrganisation/ECHO-summary.pdf

Older Men at the Margins: Addressing older men’s experiences of loneliness and social isolation in later life, 2016-2019, University of Bristol with Age UK, funded by NIHR School for Social Care Research. More information: https://www.ageuk.org.uk/our-impact/policy-research/older-men-at-the-margins-how-men-combat-loneliness-in-later-life/

Promoting social inclusion in housing with care and support for older people in England and Wales (the DICE study), 2019-2021, University of Bristol with ILC-UK and Housing LIN, funded by the Economic and Social Research Council. More information: https://www.bristol.ac.uk/sps/research/projects/promoting-social-inclusion-in-housing-schemes/

Isolation: The emerging crisis for older men. A report published by the International Longevity Centre UK in 2014. https://ilcuk.org.uk/isolation-the-emerging-crisis-for-older-men/

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Secondary Trauma and Researchers

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Drawing on new research based on the experiences of a research team working on a project exploring gender based violence, Dr Emma Williamson discusses the negative emotional impact that can arise for researchers working on traumatic issues, their coping mechanisms and calls on funders and Universities to look at positive ways to address this.

The Centre for Gender and Violence Research has been conducting research on gender based violence (gbv) for 30 years.  Over that time researchers have collectively interviewed hundreds of victims-survivors of different types of abuse: domestic violence (dv), sexual abuse, rape, FGM, (so-called) honor based violence, bride price, dowry related abuse, family violence, child abuse, and child exploitation. We have also read, and written, thousands of articles on this subject and analysed thousands of case files in social care, child protection, police, criminal justice, health, housing, welfare, and third sector support agencies.

We have learnt many things over the years and contributed to knowledge and understanding globally about gbv. We also know, first hand, the difficulties faced by researchers themselves when trying to work in this emotionally difficult and draining environment.

Many of us have worked in other sectors, as advocates or professionals. We have, in those arenas, had access to clinical supervision.  As researchers we routinely do not. This is in spite of the obvious impact that working in this field has. In response to these issues we recently published an article1 which looks at the impact of working in potentially traumatic areas on researchers. That article, in the Journal of Academic Ethics, looks at the wider context of secondary trauma; the impact on researchers in the gbv field; considers both individual and collective coping mechanisms; and makes recommendations for policy in this area.

The researchers highlight the different ways that interviews, case file analysis, and literature reviews on difficult topics can have a profound impact, as one researcher stated:

Reading through police case files could be just as depressing and upsetting in some of the worst cases and especially the cases involving child victims of rape and family abuse. The police files /child sex abuse cases were particularly hard because of the language and detail of information I was reading – very matter of fact descriptions of the physical sexual acts/ abuse (which I didn’t hear generally during the interviews with victims-survivors). There was also a time when I was collecting data on a DV case and there was a warning attached to the victim’s file which said *DEAD* so I had read all about her history of domestic violence, family abuse, drug and alcohol abuse and then found out that she had actually been found dead 2 weeks after the latest incident and her partner had [previously] been arrested on suspicion of her murder but no further action had been taken (when you could see the pattern of abuse she had suffered and was obviously extremely vulnerable) – that made me gasp out loud in the open plan (and quiet) office I was in (embarrassing) and made me incredibly sad. I cried on my drive home that day.

As well as many incidents of negative impacts of this work, the paper also highlights why researchers continue to work in these traumatic fields and the many healthy and unhealthy coping strategies they adopt when conducting fieldwork. These strategies included:

Definitely mindfulness, meditation, and running (not at the same time!). Spending time with family. Counting my blessings. Also wine, chocolate and binge TV watching.

One of the main conclusions of the paper is a call for funders and Universities to look at whether a form of academic clinical supervision should be automatically funded and made available to successful research projects dealing with traumatic issues. We believe that current provision is generally reactive, rather than proactive, and the minimal additional cost would allow researchers to make choices about whether the negative impacts of such research is sustainable for them, outside of the normal line management structure. With researchers struggling to fit their existing costs within the parameters of funding calls (particularly in some disciplines where funding is lower) we believe ring fenced additionally provided resource for clinical supervision also ensures that researchers who recognize this as an important issue are not penalized in the application process.

As such, we call on funders to address this issue.  At a time when health and well-being are clear objectives in research council priorities, it is surprising that this is not being discussed in terms of the research community already.

Having 30 years experience of working in this area, the Centre for Gender and Violence Research is well aware of the support researchers need to conduct this type of work, we call on others to join us to address this issue and look at positive ways to minimize the negative impacts of working in this area.  As one researcher said:

You think it would get easier over the years, but it doesn’t. The fact that we keep having to have these conversations is in itself depressing on top of the nature of the issues we are dealing with.

If we want to continue to develop researcher’s skills in difficult areas then addressing the ways in which traumatic research can negatively impact on them is, in our view, essential.

1Secondary Trauma: Emotional Safety in Sensitive Research in the Journal for Academic Ethics.
Williamson, E., Gregory, A., Abrahams, H. et al. J Acad Ethics (2020). https://doi.org/10.1007/s10805-019-09348-y

See also: Call to fund counselling for researchers in traumatic subjects in the THE.

 

CGVR 30th Anniversary
The Centre for Gender and Violence Research will be holding a day conference event and wine reception on 13th May 2020 to celebrate it’s 30 year anniversary. For more details please keep an eye on the School for Policy Studies event page.

 

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Baby box: child welfare experts say use of sleep boxes could potentially put infants’ lives at risk

Baby box: child welfare experts say use of sleep boxes could potentially put infants’ lives at risk

The baby box in Finland is embedded as part of the maternity system.
Kela

Debbie Watson, University of Bristol; Helen Ball, Durham University; Jim Reid, University of Huddersfield, and Pete Blair, University of Bristol

Having a baby can be expensive. So it’s maybe not surprising that many retailers around the world have cottoned on to the success of Finland’s baby boxes – a package aimed to set up new parents and their bundle of joy. The Finnish boxes include baby clothing, sleep items, hygiene products and a parenting guide –- as well as a “sleep space” for the baby.

Many retailers around the world are now offering similar boxes for expectant parents. Indeed, research conducted at the University of Tampere in Finland suggests there are variants in over 60 countries. This includes Scotland’s baby box scheme – with all newborn babies getting a free baby box from the Scottish government.

But as a group of child welfare experts, we believe imitations of the Finnish boxes could be placing babies at risk. This is because it has become common to believe that if babies sleep in these boxes, it will help protect them from sudden infant death syndrome (SIDS). Unfortunately, the research does not back this up.

Mother and fathers in Finland are given a baby box from the state that functions a bit like a starter kit. The box includes 64 items and is estimated to cost around €140 (£119). It comes as part of a wider maternity package in Finland, in which parents are also required to register for a health check before the fifth month of pregnancy.

They can opt for a cash alternative of €170 instead of the baby box, although most choose the box. The maternity package has been offered by the Finnish government for over 50 years, and initially arose as a response to poverty and high infant mortality rates.

The Finland baby box for 2019.
Kela

What’s the problem?

To some extent, retailers in other countries have tried to copy the Finnish model. In the UK, new parents can choose between paying for bigger baby boxes or a free box with some basic items if they engage in an online course. The course doesn’t have much professional oversight, however, and these boxes certainly don’t contain as much as the Finnish version.

But there is a danger that parents might view the boxes as a safe sleep space that will help reduce the risk of SIDS. This sort of belief appears to be based on the fact that the SIDS rate in Finland has fallen over the years – but this does not appear to be because of the boxes.

The same reduction has been found in neighbouring countries such as Norway and Sweden, where baby boxes are not used. The handful of observational SIDS studies conducted in Finland do not mention the box and largely attribute the lower mortality rates to “a reasonably high standard of living, good educational level of mothers, well organised primary maternal and child health services, and the rapid advances in obstetric and neonatal care equally available and regionalised”. All three Scandinavian countries have in place a well supported welfare system that looks after vulnerable families.

As far as we can see, there is no evidence to support a belief that the box can be used as a safe space to reduce infant death. There are also already safe sleep spaces for babies, with cots and Moses baskets that have a safety kite mark readily available.

And with baby boxes being sold by private companies – and public health messaging moving into private hands as a result, the risk is that the impact of government risk reduction campaigns that have saved thousands of young lives in recent decades are forgotten.

What new parents should do

All the evidence-based guidance that has emerged over recent decades delivers clear messages about safe sleeping practices, while also acknowledging that parenting practices can be culturally diverse – in many cultures, for example, co-sleeping is the norm until children are weaned.

The importance of robust evidence must be a key priority. This is why we believe governments and health providers should consider these factors before assuming that baby boxes are the solution to ongoing tragic unexplained deaths of infants.

Look for the kitemark when buying a sleeping space as it confirms that the British Standards Institution has tested a product and found it meets a particular standard.
Monkey Business Images/Shutterstock

Crucially, research is needed on the ways in which parents use existing baby boxes, in what circumstances and contexts they might be beneficial, and whether it is the box, or the programmes around them that benefits families.

As a response to this need, we are starting to work with vulnerable parental groups and health providers in Scotland, Finland, Zambia, Vietnam and Kenya to find out whether baby boxes or alternative devices that can be brought into the parental bed can improve infant safety and survival.

The hope is that our combined research should enable low cost, appropriate solutions to be designed with the people who will benefit – and to improve the health and wellbeing of infants and mothers.The Conversation

Debbie Watson, Professor In Child and Family Welfare, University of Bristol; Helen Ball, Professor of Anthropology and Director of the Parent-Infant Sleep Lab, Durham University; Jim Reid, Senior Lecturer, Department of Education and Community Studies, University of Huddersfield, and Pete Blair, Professor of Epidemiology and Statistics, University of Bristol

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Professor Ray Forrest, 1951-2020

Ray Forrest, Emeritus Professor of Urban Studies and former Head of the School for Policy Studies, died on 16 January, at the age of 68. Alex Marsh leads the remembrance of an inspirational scholar whose research and academic leadership profoundly shaped the fields of housing and urban studies globally.

Ray’s early programme of work on the privatisation and commodification of public housing under the Right to Buy is the paradigmatic example of sustained, critical engagement with an evolving policy agenda; one that also drew out broader questions about social divisions and spatial dynamics that presented challenges back to the disciplines of sociology and geography. He continued to be committed to the belief that work done in the field of housing studies has important things to contribute to core disciplinary debates in the social sciences. His work intentionally spoke directly to these broader audiences. 

Ray had a knack for identifying the issue of the moment and his interventions were therefore often hugely influential. Following his work on the Right to Buy he pursued a succession of pressing and timely topics: struggling home owners, ageing and negative equity in the 1990s; neighbourhoods and social cohesion in the early 2000s; the impact of the global financial crisis on housing in the late 2000s; housing and the super-rich in the 2010s; an ongoing research programme on housing assets and intergenerational relations. His recent work included revitalising the topic of urban managerialism; exposing the contradictions of the neoliberal project in housing; and exploring the commodification of the city. Over time the geographical focus of his work expanded and his interest in global housing – and East Asia in particular – strengthened. 

Collaboration was central to Ray’s research philosophy. He collaborated with colleagues from many institutions and across continents. This included collaborating with several of his former doctoral students who had gone on to forge their own successful academic careers. My experience of collaborating with Ray, both on research and writing, was that he was always engaged, unfailingly energetic, and driven by insatiable curiosity.

Not only did Ray make an enormous contribution to housing and urban research but also to the institutional architecture of our field. He was one of the small group of friends and colleagues who founded the journal Housing Studies in the mid-1980s. He subsequently acted as chair of the Management Board and, between 2005-2008, as a Managing Editor. Ray was also a founding member of, tireless champion for, the Asia Pacific Network for Housing Research. And he was a great believer in bringing people together to facilitate intellectual exchange. He was almost invariably cooking up a plan to organise a panel, workshop, symposium or international conference. His reputation, diplomatic skills and dynamism allowed him to assemble stellar events: these not only initiated conversations and built networks but as often as not yielded a special issue, edited collection or new writing collaboration. 

Ray was born in Edinburgh in April 1951 and educated at Daniel Stewart’s College and Heriot Watt University. He moved south to Birmingham in 1971: first to complete a postgraduate diploma at Aston University and then a research Masters in Urban and Regional Studies at the University of Birmingham. He spent six years as a researcher at Birmingham before moving to Bristol in 1981. At Bristol Ray hit his research stride: he delivered a remarkable series of research projects, usually in collaboration with colleagues, and a formidable portfolio of publications. He was appointed as Professor of Urban Studies, at the School for Advanced Urban Studies, in 1994. After SAUS was absorbed into the School for Policy Studies Ray acted as School Research Director before becoming Head of School, 2001-2004. This coincided with his role as Co-Director, with Ade Kearns of Glasgow University, of the ESRC Centre for Neighbourhood Research. Ray then went on to found and co/direct the University of Bristol’s Centre for East Asian Studies, 2004-2008. 

Since the 1990s Ray had developed strong connections with higher education institutions in Hong Kong and after leaving the University of Bristol in 2012 he took up the role of Chair Professor of Housing and Urban Studies and Head of the Department of Public Policy at City University of Hong Kong. This was a fruitful research period for Ray, but the role also represented a significant managerial commitment. In 2017 he decided to move to Lingnan University, Hong Kong, to the role of Research Professor in Cities and Social Change. He was the first ever Research Professor appointed by the university. 

Ray Forrest’s contribution to his academic field is incalculable. He enthused generations of students. He was an inspirational intellectual leader. He was also a pleasure to spend time with – either in work or in the pub. He was always a genial host to the many members of his extensive academic network who passed through Hong Kong. Ray was a human dynamo who seemed bulletproof. I certainly thought of him that way. But he wasn’t. And our community is in shock that he leaves us too soon. 

Ray is survived by his wife, Jacqui, and children, Robert and Hana.

If you would like to add a tribute or share a memory of Ray, please write in the comment box below.

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Another Blog on the C-Word.

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Professor David Abbott, from the Norah Fry Centre for Disability Studies, looks at collaboration and power sharing in coproduced research.

It’s #CoProWeek if you’ll excuse the twitter short-hand. And with a whiff of, ‘This is what I did in my holiday’ news, I am not long back from a summer school about co-production at the rather glorious and gloriously named, University of the Highlands and Islands.

One of the things I liked about the course was that we were comprised of researchers, activists, heads of charities, community agitators and leaders, and policy and engagement types. We shared a commitment to making things change and making things better in our respective communities. I think some of us went searching for the perfect way to do coproduction and of course in that respect we were usefully disappointed. Two main learning points for me, about which more below, were: 1. Coproduction behoves us to rethink who is ‘we’ and who is ‘them’ and ‘they’? 2. In the overall endeavour of research, who has a say, who always has a say and who rarely or never has a say?

It seems to me that lots of folks are in search of ‘true’ co-production, some holy grail of perfect collaboration and power sharing. We are awash with toolkits, guidance, good practice, courses and webinars about coproduction. It’s an industry in and of itself. I wonder if there is more of this than actual coproduction.

In my field at the intersection of social policy and disability studies, there is a long history of problematising the role and historical dominance of non-disabled people doing research on disabled people. The movement towards more inclusive research with disabled children, youth, and adults, including those with learning disabilities, is now however fairly well established.

In my first research job with a disability focus, our young disabled people’s reference group held a fairly long, no-holds barred discussion about whether or not I should be in the room as a non-disabled person. It was very uncomfortable for me but they were rightly asserting their power and asking a legitimate question. So, coproduction for me sometimes has a feeling of ‘emperor’s new clothes’ but also something co-opted for better and sometimes worse to actually mask power differentials. I can still really only whisper in lower case about being part of a so-called coproduction team evaluating a so-called coproduced government policy programme “with” (lol) disabled people. The volume on coproduction was high but the reality was draconian and grim.

What I can say, from my own experience of being part of a project team made up of user-led organisations, disabled people’s organisations and university researchers, are three things:

  1. It felt like coproduction because it was hard and mostly uncensored. We had similar goals but I think the wider team sometimes felt I was a bit slavish to the research proposal and agreement with the funder. Others sometimes wanted to ‘get on with it’ or change things. I often did too but felt a bit uptight with the burden and privilege (?) of being the budget holder (see below).
  2. It worked well as coproduction because we played to our agreed strengths and interests.
  3. When we asked participants why they had decided to take part in research interviews, several said it was because of the team. Some said they would have put the paperwork in the bin straight away if it had just come from “the University”. The nature of the team reassured people about the underlying values of the research and that there was some presumption of trust and safety.

Money matters and I mentioned above that I had been the budget holder in our work together even though in fact the collaboration was well established and the need for research established before I was ever invited in as a researcher. (I liked this. To me it turned on its head the usual idea that coproduced research is about the researcher inviting the non-academics, the non-researchers into the tent. Plus, note the ‘non’ rather than what people actually are – experts in all kinds of domains.) But the reality is that many funders require the budget holder or principal investigator to be based in a University or the NHS or some other statutory service. This doesn’t rule out coproduced collaborations but the power is already and instantly a bit unequal.

This is why the Disability Research on Independent Living & Learning (DRILL) programme was so neat as the world’s first major research programme led by disabled people. Not to my credit, but I can recall feeling irked that such a big funding opportunity excluded me from applying missing, initially, the point that this was entirely right and massively exciting and important. My initial annoyance presumably mirrored by groups routinely excluded from or hampered by the set-up of research funding streams.

If I can end by directing you to elsewhere it’d be to this brilliant podcast which discusses what to my mind is a wonderful, authentic piece of coproduced research with young disabled women living shorter lives but exerting the value, joy and expertise that their lives engender. “Coproduction is not about having all the answers, but about learning together,” say the researchteam. Amen sisters.

David Abbott is a Professor of Social Policy in the School for Policy Studies at the University of Bristol and an Associate Director of NIHR School for Social Care Research. He tweets things about research, cake and the countryside at @davidabbottbris 

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Working with volunteers in social care for older people

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Dr Ailsa Cameron, Senior Lecturer in the Centre for Research in Health and Social Care and a Fellow of the NIHR School for Social Care Research, discusses findings from a recent project looking at how we can best support volunteers in social care settings.

Encouraging people to volunteer in social care for older people has been a key part of practice in the sector for many years, but in recent times the significance of volunteering has grown, particularly in light of the funding cuts faced by the sector.

We know volunteers can do a huge amount to enhance the care and support that older people receive. They can bring a new energy to settings and give older people an opportunity to develop meaningful relationships with people other than paid care workers. Volunteers can also do a lot to reduce the loneliness and isolation that many older people experience.

There are also benefits for those who volunteer in social care themselves – opportunities to develop new skills, gain experience of different work contexts and enhance their own wellbeing, or just an opportunity to give something back.

During our research on Exploring the Role of Volunteers in Social Care Settings (ERVIC), we heard about many settings where volunteers were making an important contribution to older people’s care and support. We learnt about volunteer-run exercise programmes and befriending services in residential care, organising and running lunch clubs, and volunteers giving extra support at day centres and visiting people recently discharged from hospital.

However, reliance on volunteers to deliver care and support for older people brings new challenges to the sector. Volunteers are not a ‘free service’ – to be effective, they need training as well as ongoing support. This is particularly important given the vulnerability of many older people who receive social care services. Volunteers have much to offer, but they also need to be clear of the boundaries and limits of their role, and they need to know what to do if they have concerns about an older person.

Several of the settings we visited told us they were struggling to recruit and retain volunteers. Changes to retirement law, as well as growing numbers of older people looking after grandchildren or caring for their partners or friends, means that fewer people have the time or flexibility needed to volunteer. On top of that, delays in DBS processes and burdensome training programmes were thought by volunteer coordinators and managers to put some people off of volunteering in the sector.

On Thursday 21 March 2019, in partnership with Voscur, we will host a workshop at the Southville Centre to present our findings from the ERVIC project and exchange ideas about the challenges and opportunities associated with working with volunteers in social care settings for older people.

This event is aimed at volunteer coordinators, commissioners of adult social care and providers and managers of social care organisations and will involve a Voscur-led workshop called Measuring the Value of Volunteering, plus discussions about how volunteers are contributing to social care, the challenges of involving volunteers and how best to work with volunteers.

If you’re connected to social care, volunteering or services for older people, or you’re just curious and would like to find out more, we hope to see you at the Southville Centre next month. Book your place for the workshop.

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Winter months, loneliness and isolation amongst older men.

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Dr Paul Willis and Alex Vickery from the Centre for Research in Health and Social Care introduce findings from their recent project looking at older men at the margins.  

Watching the early February snow fall outside my office window is a beautiful sight but it can also be a stark reminder that snowfall in the UK means many things to different people – for some a frustrating barrier to their daily routine or journey, for others a (hopefully) opportune moment to enjoy time off from work or school. For some people who struggle with feelings of loneliness day-to-day and experience social isolation daily, adverse weather conditions in winter can be another reminder of their solitude and disconnection from others and present a further obstacle to leaving the home, both mentally and physically.

Loneliness is a natural and widely experienced emotional response to our desire for increased social contact with others and it’s something we all experience across our lifetime. Feeling lonely is an important social cue that tells us we need to reach out and connect with friends, family members or other people in our neighbourhood or local community. In a lot of cases these feelings are temporary and serve a short-term purpose in getting us socially mobilised. For some people however, loneliness can become an ongoing and persistent ache for other people’s company that is not easily alleviated. It is increasingly defined as a social problem requiring a healthcare and social policy response and, in the UK, this has recently accumulated in the appointment of a Minister for Loneliness and the release of a cross-departmental strategy on tackling loneliness by the UK Government.

Winter is often associated as a difficult time for people living with long-term loneliness and experiencing social isolation, with shorter days and longer nights and adverse weather conditions that undermine attempts to meet and connect with other individuals in person. National campaigning organisation Age UK runs an annual campaign, ‘No one should have no one’, to bring attention to seasons such as a winter and festivities like Christmas as particularly difficult times for older adults who may be socially isolated. Age UK estimates that currently around 1.4 million older people (50+) living in England are ‘often lonely’. We know that a greater percentage of older women report loneliness in comparison to older men in the UK but that men can also struggle with discussing and disclosing emotionally sensitive topics such as loneliness.

As part of a two-year research study on older men, social isolation and loneliness, we’ve been speaking to 111 men from different social groups and circumstances about the ways in which they experience loneliness and how they alleviate these feelings and keep it at bay. We’ve interviewed men (65-95 years) about their experiences from five different groups: older men who are single or living alone in rural and urban areas; older gay men who are single or living alone; older men with hearing loss; and, older men who are carers for significant others (such as family members, partners). The project is funded by the NIHR School for Social Care Research to April 2019 and in collaboration with Age UK.

Across our interviews with different groups of older men, a common thread has been the challenges of combating loneliness during colder months, and winter and night times as being tough times to manage, particularly when on one’s own. The older men in our study talked of ‘winter blues’ that can make them feel particularly isolated and how with the dark nights and winter illnesses they can have trouble socialising and engaging in activities. Over half the men we interviewed lived alone which also complicated efforts to connect with others daily.

I suppose it’s the what, regrettably, is the long nights. We change the clock, the night comes in that much quicker, and daylight hours are shorter.
It gives the general feeling of claustrophobia, then.
[M83, 75, single/ living alone]

Sitting here, probably not feeling very well, which is when it hits, in the depths of the winter, when it’s dark. I’m doddering on my legs, and I have to be careful not to go out when it’s icy these days, because you don’t want to fall over and break your hip. That can be very serious. [M7, 72, single, gay]

For men who are caring for significant others such as partners or adult children, night times were difficult not because of the season but more as the first moment of the day they were alone and not in the company of the person they were routinely caring for. This could be experienced as a moment of necessary solitude but also a reminder of their isolation from others within the caring relationship.

Despite experiencing periods of loneliness, this does not mean these men were socially isolated from others. This is where it is important to recognise the difference between loneliness and social isolation. Most men we spoke to had regular contact with friends and family members in their social networks and all were connected to and participated in groups in their local community. Many men told us about how they valued contributing to and being actively involved in running groups and the importance of having a role and purpose which made them feel valued and regarded by others. With Age UK, we are currently in the process of developing good practice guidance for service providers on what men value about groups and some of the considerations that need to be given to running groups.

Tackling loneliness at any time of the year is the focus of many voluntary and third sector organisations. Bristol Ageing Better is one locally-based programme that is commissioning groups and interventions aimed to reducing loneliness and isolation for older people. The UK Men’s Shed Association is another initiative targeting the interests and needs of older men, with Sheds running across the UK. While the UK Government’s Strategy on Loneliness is a welcome policy response on this important issue, there remains further scope for tackling the wider, more complicated problem of social disconnection and the social distances older people, amongst other groups, experience between themselves and the wider communities in which they live.

Further information: Findings from the study, along with the practice guidance, will be launched on Monday 29th April 2019 at Age UK, Tavis House, London WC1H 9NA. To find out more about the launch event please contact alex.vickery@bristol.ac.uk

Funding disclaimer: ‘This blog summarises independent research funded by the National Institute for Health Research School for Social Care Research. The views expressed in this blog are those of the author(s) and not necessarily those of the NIHR SSCR, the National Institute for Health Research or the Department of Health and Social Care.’

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How transformed is care?

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Dr Sandra Dowling, a lecturer in Disability Studies at the Norah Fry Centre for Disability Studies discusses deinstitutionalisation in the context of the Transforming Care Policy programme.

People with learning disabilities are still, in some circumstances, leading institutionalised lives – the Transforming Care programme has a long way to go, and we must not forget those people with learning disabilities with the highest levels of ‘need’ who are experiencing the highest level of separation from an ordinary life. Recent decades have seen significant changes in the lives of people with learning disabilities in the UK. Once routinely institutionalised, distanced from home communities or their Right to a life like any other, people with learning disabilities were relegated to the shadows of the everyday and had limited opportunity to effect change. This article suggests these issues might still be affecting too many people with learning disabilities in 2018.

Advocacy and activism amongst people with learning disabilities and their allies has been a powerful force in altering the opportunities available to some people. To be respected, to be heard, to have choice and to really have the chance of a life like any other have been common demands. For many people these demands, these requests, have to some extent been realised. In the UK today some people with learning disabilities live in a home they have chosen, some have a job, some have regular contact with family and friends and some feel part of their community. Too many do not.

The challenge to realise the fundamental human rights of this section of the population is ongoing. The urgency of the challenge is very much determined by personal position. If you are a person with learning disabilities or indeed an ally, these challenges are of course urgent. Although recent policy does commit to a transformation in social care for people with learning disabilities, urgency to transform this to practice is not consistently apparent.
Major policy initiatives and legislation in recent years have produced a convincing rhetoric to support ideas of individual autonomy, inclusion and a role in decision making about important life matters. The Care Act 2014, for instance, details guidance for adult social care which, importantly, includes the principle of individual wellbeing. In practice wellbeing involves people having control of their day to day life, living in suitable accommodation and being able to contribute to society. It is a requirement of The Act that local authorities take people’s views, wishes and beliefs into consideration, and that their efforts support what people themselves want to achieve in their own lives.

The Transforming Care Policy Programme produced a raft of reports, guidance and policy following the shocking abuse of people with learning disabilities residing in Winterbourne View Assessment and Treatment Unit. The overall aim of Transforming Care has been about improving health and social care services to enable people to live in the community, to have good support and to be close to home. It aimed to address the high numbers of people with learning disabilities living for too long in Assessment and Treatment Units (ATU), often at a long distance from their families and without adequate discharge planning. However, since the scandal broke in 2011, and following a robust policy response, little has changed. The numbers of people in ATU settings has remained stubbornly high, provision of sufficient support in the community has not met need and discharge remains an elongated process for many.

Narratives of Home, a study funded by the NIHR School for Social Care Research, conducted within the Norah Fry Centre for Disability Studies (NFCDS), has interviewed 18 people with learning disabilities and three parents of people discharged from Assessment and Treatment Units (ATU) during the lifetime of Transforming Care. This narrative study has collected people’s stories of resettlement in the community following their hospital stay. Of those interviewed, 12 were male and 6 were female. Time spent in ATU settings ranged from 4 – 20 years. The legacy of institutional living clearly impacted on their resettlement experiences.

The factors which are identified as important to individuals are just what you would expect. Security, choice, a valued social role, friendships, fun and the opportunity to take pleasure in things which are important to you. But what is different is that the people that we interviewed, even though living in the community, still often live within parameters defined by others. Some described their attempts to ‘get out’ of the ATU by ‘doing what the doctors said’ or ‘just do what you are told, keep your head down, get through all the programmes and hope for the best’. These experiences travelled beyond the walls of the ATU into their now ’independent’ lives in the community. In interview people checked with present support workers whether they were saying the ‘right thing’, or whether it was ‘ok to say this’. Some were so heavily medicated that they could not remain awake throughout the interview.

Choice and autonomy was found in things such as choosing how to decorate your home, or what to have for a meal. A deeper sense of independence of thought and action though, remained elusive for some. Institutionalisation, just as a hundred, or fifty or twenty years ago produces the same results. It dis-empowers individuals, depleting independence of thought and sense of self. A good life happens at a deeper level than what can be seen on the surface of community living. The need to address issues of identity and equality remain pertinent. Deinstitutionalisation remains a goal.

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The Social Disinvestment State Unleashed

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Dr Noemi Lendvai-Bainton, Senior Lecturer in Comparative Urban and Public Policy at the School for Policy Studies, discusses the recent Hungarian election and how it reflects the trend towards political populism & the rise of illiberal democracies.

After a very long and rather Kafkaesque election night in Hungary, FIDESZ secured a victory for a third term of governing with a two-thirds majority. After eight years in government, the vote for the radical right in fact increased, with both Fidesz (49% of votes) and Jobbik (a far–right party with 19% of the votes) gaining more votes than four years ago. Tellingly, Orban in his victory speech thanked ethnic Hungarians living abroad (largely dual citizens of Romania, Ukraine and Serbia with voting rights) who ‘defended Hungary’, he thanked his Polish friends and Kaczyński, and he gave thanks for all the prayers (with no end to religious references).

The campaign was a single-issue, emotively hostile and negative campaign, focusing on the migration issue and financier/philanthropist George Soros, that erased public policy as a matter for debate all together – the end of an era when negative campaigns can’t be electorally successful, it seems. A déjà vu of the Brexit campaign in which the migration issue captured the public discourse.

This Hungarian result talks to a lot of different issues. It reflects a deep division between the capital Budapest, where the opposition won by a two-thirds majority, and the ‘country’ (countryside) where Fidesz won almost outright. It reflects on the widespread and significant institutional ‘reforms’ in the country which confidently delivered votes in small towns and in villages through channels of appointed officials, public finances, and EU funds (no need for subtle pressures here – civil servants were asked to take a photo of their ballot papers and email it to a central account; Kindergarten teachers were told to hand out Easter chocolate to parents as a ‘gift’ from Fidesz). The election result also points to the fact that corruption has become normalized – despite unprecedented levels of corruption concerning both EU funds as well as public funds, the government secured its third term.

No longer can one think that populism is a short-term political project. Orban can now thrive on the basis that his legitimacy with a high turn-out (70%) at the election makes him a stronger leader than many of his counterparts in (Western) Europe. His anti-EU rhetoric is expected to intensify in the coming months and years and he is already working hard on building a new transnational coalition against ‘liberal’ Western Europe and to evict all NGOs from the country that have political missions.

Read more…

This article was first published in Social Europe on 19 April 2018.

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