Jill Manthorpe

Purpose: The purpose of this study is to reflect on significant research contributions to the development of adult safeguarding, past, present and future. Design/methodology/approach: This paper takes the form of a 1:1 interview between the author and Professor Jill Manthorpe. Findings: This paper reflects on the emerging research themes in the early days of UK adult safeguarding through to the present. During the interview, the authors examine the relationship between policymakers and researchers, the perspectives and experiences of research contributors, the importance of accessible research to evolving practice and how practice and research influence each other. Finally, they consider the potentially useful future themes and methodologies of adult safeguarding research. Originality/value: This is an original interview, as commissioned by Dr Jeremy Dixon (Series Editor).

Summary : We report on the evaluation phase of a study which developed questions to identify people who were affected by gambling harms for use in adult social care services and piloted them in three English local authorities. The questions were designed to identify those affected by gambling harms, including family or friends of those who gamble. The evaluation involved interviews with staff and service users ( n = 28) assessing the acceptability, feasibility and appropriateness of asking about gambling harms in adult social care. Transcripts were analyzed using thematic analysis. We also assessed the feasibility of collecting question response data, and whether it was possible to determine if one of our two candidate questions could be recommended. Findings : Social work practitioners agreed that identifying and supporting people being harmed by gambling was an acceptable area of practice. They found it more feasible and appropriate to ask about gambling harms in welfare advice and debt support, integrated learning disability and multiagency safeguarding hub, rather than adult social care, single-point-of-access “front-door” services. Applications : Facilitators to embedding enquiry about gambling harms in adult social care were: funded staff training, ongoing support, and management capacity. Barriers were: staff perceptions about relevance to service users, staff discomfort with the topic, and competing demands. Based on our findings, two questions for identifying gambling harms to individuals/affected others are recommended: Is your gambling or that of someone else causing you any worries? Do you feel you are affected by any gambling, either your own or someone else's?

Context: Cleaning, catering, housekeeping and laundry workers (ancillary staff) play a crucial role in care homes through promoting infection control, food preparation, hygiene, and contributing to care home environments, relationships and culture. Their contributions were highlighted during the COVID-19 pandemic in the media in England and internationally. However, this workforce is overlooked in much care home research. Objective: The aim of this study was to understand the experiences of ancillary staff working in English care homes to identify elements of promising practice. Findings: From in-depth qualitative interviews with 63 participants, consisting of 38 ancillary workers (9 cleaners, 14 catering staff, 12 housekeeping staff, 3 ancillary staff supervisors), 8 care home managers, 5 human resources (HR) managers, 5 care home residents and 7 family members, we identified themes that related to promising practice to support ancillary staff wellbeing. Themes were discussed and finalised into principles in five stakeholder workshops with 13 stakeholders. These principles of promising practice were to: (1) promote fair reward and recognition, (2) enhance clear communication through leadership, (3) create effective support systems, (4) provide person-centred staff development opportunities, (5) ensure inclusive and respectful treatment and (6) recognise relationships with residents and relatives. Implications: Consideration should be given to ancillary staff being better recognised as essential workers in care homes through the creation of national training accreditation for this group, attention to their wages in addition to those of other care home staff, and more support for their occupational health.

Research investigating the experiences of women experiencing homelessness often highlights the prevalence of (sexual/domestic) violence and abuse in their trajectories. Drawing on observations across a sample of English statutory and voluntary sector homelessness services and 60 semi-structured interviews with practitioners and with women with homelessness experiences, this study explores these experiences of gender-based violence and the relational impact these may have had on women's help-seeking. Findings suggest that experiences of violence are often normalized, leading some of the women to develop informal, often risky, strategies to protect themselves from violence, using precarious social capital to find ways out of homelessness.

Objectives: To explore accounts of the interactions between ancillary workers and care home residents during COVID‐19 pandemic lockdowns. Design: Qualitative interview study, following appropriate ethical approvals and procedures. Setting: Participants were recruited from care homes in England and through known networks. Interviews were conducted online or face‐to‐face when pandemic‐related contact restrictions were lifted, according to participants' convenience and comfort. Participants: Sixty‐three participants were interviewed: 38 ancillary workers (9 cleaners, 14 catering staff, 12 housekeeping staff and 3 ancillary staff supervisors), 8 care home managers, 5 human resource managers, 5 care home residents and 7 family members. Results: The meaningful nature of interactions between ancillary staff and care home residents was evident in participant interviews, acknowledged by family relatives, residents, care home managers and ancillary workers. Interactions with ancillary workers contributed to care practices, and many relationships were enhanced during COVID‐19. Participants felt these interactions contributed to the ‘jigsaw’ of the care home environment, and often positively impacted on staff well‐being. Management support to enable these interactions was important and could make relationship‐based care more meaningful. Conclusions: Interactions between ancillary workers and care home residents are important, can contribute to staff well‐being and resident quality of life by fostering relationship‐based care and promote the sharing of health and care information. Implication for Practice: Manager and supervisor recognition of this workforces 2019 contribution to relationship‐based care and to improve overall care home environments is needed, as well as staff development opportunities to enhance these relationships too.

This paper reports the findings of an updated systematic review on the evidence for the effectiveness of mindfulness-based interventions (MBIs) on social workers’ mental health. We addressed two research questions: (RQ1): What are the effects of MBI on social workers’ stress, burnout, mental wellbeing, coping, and resilience? (RQ2): What is the effective structure of MBIs in relation to these outcomes? The review searched seven databases for peer-reviewed papers published from 2014 to 2022. Most of the nine studies meeting inclusion criteria had used non-randomized control methods. All reported positive effects of one type of MBI in at least one of the outcomes. However, not all the improvements were statistically significant. The strongest effects reported were for stress and burnout. Several of the studies had very few social worker participants, and few studies reported long-term impacts or cost-effectiveness. Mindfulness may have positive effects on social workers’ state of mind, health, and professional outcomes. However, studies that enable us to draw conclusions about causality and evaluate the impact of a MBI on social workers are scarce; long-term impacts and cost-effectiveness are also under-studied.

Aim: To synthesise current evidence on the effectiveness of dyadic (pair-based) interventions in improving outcomes for adults with multiple long-term conditions (MLTC) and/or frailty (aged ≥55 years) and their informal carers. Methods: The review protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, with the protocol registered with PROSPERO (CRD420251144604). MEDLINE, Embase, PsycINFO, CINAHL Plus, CENTRAL, ClinicalTrials.gov will be searched for experimental and quasi-experimental studies examining the effectiveness of community-based dyadic interventions for adults with MLTC (≥2 long-term conditions within an individual) and/or frailty (aged ≥55 years) and their informal carers (spouses/partners, other family members or relatives) published since 2010 and up to September 2025. Dyadic interventions will be defined as pair-based interventions that directly involve informal carers and care recipient adults with MLTC and/or frailty using various techniques targeted at carers, care recipients, or both to change outcomes for at least one member of the carer/care recipient pair (or dyad). Database searches will be followed by a manual search of the reference lists of included studies and lists of papers citing included studies in order to identify additional studies. Two reviewers will independently screen titles and abstracts against the selection criteria and independently screen full texts using Covidence software. Methodological quality will be assessed using the Cochrane Risk of Bias (RoB) 2.0 tool for experimental studies and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool for quasi-experimental studies. Synthesis of evidence will be quantitative. If meta-analysis is not possible, we will follow Cochrane recommendations for quantitative Synthesis Without Meta-Analysis (SWiM) guidance. Conclusion: The findings will address the evidence gap in dyadic implementation research in later life and help inform clinical decision-making, policy development and program planning for adults with MLTC and/or frailty and their carers, particularly in primary care and other community health settings.

As the global prevalence of dementia continues to rise, expanding and upskilling the health and social care workforce is a top priority. To address this need, some health and social care services have implemented Dementia Champions (DCs). DCs are typically existing staff who are recognised and developed as dementia specialists to advocate for the needs of people affected by dementia within their service. However, evidence around the DC role across health and social care is limited. In this narrative review, we aimed to understand and define the DC role by exploring who becomes a DC; where they work; what their tasks and responsibilities are; and what is needed for the role to be successful. For the latter, we aimed to develop a Theory of Change framework for implementing, embedding, and maintaining the DC role in health and social care settings. A systematic search of the literature identified DCs working predominantly in hospitals and care home settings with a notable absence of the DC role within homecare services. Tasks and responsibilities of the DC role varied between settings and services. Findings highlighted that to be successful, the role needs clear definitions and boundaries; organisational and managerial support and buy-in (including establishing protected time for the role); and ongoing professional development. While DCs are implemented in pockets of the health and social care workforce, the role is not well established. Further research is needed to assess the impact of DCs on workforce effectiveness and staff well-being, patient and family carer outcomes, and cost-effectiveness in diverse health and social care settings.

This paper explores the economic implications of different support scenarios for individuals who self‐neglect whilst experiencing multiple exclusion homelessness (MEH) or hoarding behaviour (HB). It draws on analysis of six Safeguarding Adults Reviews (SARs) of self‐neglect‐related deaths from across English localities. Focused on the last one or 2 years of an individual’s life, the SARs provide a detailed examination of resource utilisation across various sectors. The study employs economic modelling to compare the costs associated with ‘unmet needs’, the scenario that ended in death, and the potential costs and benefits derived from meeting these needs more effectively. Sensitivity analyses test the robustness of the model, exploring various budgetary adjustments. For MEH cases, the analysis suggests that shifting from uncoordinated use of urgent and emergency services to planned multidisciplinary support for individuals could free up public resources, enabling reinvestment and better outcomes. The study indicates potential cost savings, emphasising the importance of timely and coordinated interventions to improve the well‐being of individuals experiencing MEH. In HB cases, addressing gaps in responses to self‐neglect among older individuals requires increased resource investment mainly for housing and adult social care but also demonstrates a release of resources for health and a significant reduction in costs for criminal justice and fire and rescue services. The study highlights the role of local voluntary sector groups in providing support and guidance. The study evidences the importance of a multidisciplinary approach, early interventions, and ongoing collaboration among diverse professionals to ensure a holistic response to the complex needs of vulnerable populations. It emphasises the need for continuous collection of quality data, to enable service evaluation and facilitate efficient resource allocation for integrated care systems, and ultimately to contribute to better outcomes for individuals experiencing self‐neglect.

Aim: To synthesise current evidence on the effectiveness of dyadic (pair-based) interventions in improving outcomes for adults with multiple long-term conditions (MLTC) and/or frailty (aged ≥55 years) and their informal carers. Methods: The review protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, with the protocol registered with PROSPERO (CRD420251144604). MEDLINE, Embase, PsycINFO, CINAHL Plus, CENTRAL, ClinicalTrials.gov will be searched for experimental and quasi-experimental studies examining the effectiveness of community-based dyadic interventions for adults with MLTC (≥2 long-term conditions within an individual) and/or frailty (aged ≥55 years) and their informal carers (spouses/partners, other family members or relatives) published since 2010 and up to September 2025. Dyadic interventions will be defined as pair-based interventions that directly involve informal carers and care recipient adults with MLTC and/or frailty using various techniques targeted at carers, care recipients, or both to change outcomes for at least one member of the carer/care recipient pair (or dyad). Database searches will be followed by a manual search of the reference lists of included studies and lists of papers citing included studies in order to identify additional studies. Two reviewers will independently screen titles and abstracts against the selection criteria and independently screen full texts using Covidence software. Methodological quality will be assessed using the Cochrane Risk of Bias (RoB) 2.0 tool for experimental studies and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool for quasi-experimental studies. Synthesis of evidence will be quantitative where possible, following Cochrane recommendations for quantitative Synthesis Without Meta-Analysis, and narrative otherwise. Conclusion: The findings will address the evidence gap in dyadic implementation research in later life and help inform clinical decision-making, policy development and program planning for adults with MLTC and/or frailty and their carers, particularly in primary care and other community health settings.