Adult social care helps older people and those living with a disability or physical or mental illness to live independently, and stay well and safe. In England in 2023/24, around 1.59 million people worked in the adult social care sector, providing a huge range of activities, from personal care and safeguarding to end-of-life care. Inclusion needs to be at the heart of this work, ensuring all groups can access the care and support they need.
In February 2025, NIHR Evidence hosted a webinar that brought together research focusing on seldom heard groups, who are frequently most at risk. The webinar included research that could improve the care of those experiencing homelessness, people with learning disabilities, and people living with dementia.
Safeguarding for people experiencing homelessness
Adult safeguarding protects a person’s right to live in safety, free from abuse and neglect. People and organisations need to work together to stop abuse and neglect, while promoting the adult’s wellbeing and having regard to their wishes, feelings and beliefs. Safeguarding needs to recognise that adults may be unclear or unrealistic about their personal circumstances; the relationship with the provision of care and support can be complex. There are examples of good practice, but there are also barriers.
Jess Harris is a Research Fellow at the Health & Social Care Workforce Research Unit at King’s College London. She led an NIHR School for Social Care Research funded study on strengthening adult safeguarding responses to homelessness and self-neglect.
End of life planning for people with learning disabilities
Many people with learning disabilities have complex care needs and are at risk of health inequalities and premature death. Research suggests that staff may lack the necessary skills, confidence and support to engage people with learning disabilities in end-of-life planning. As a result, the deaths of people with learning disabilities are frequently unplanned for, and poorly managed.
Irene Tuffrey-Wijne is Professor of Intellectual Disability & Palliative Care at Kingston University, London. She leads a programme of research and development on learning disability, bereavement and palliative care. She presented a video about research into end-of-life planning for people with learning disabilities.
Dementia Champions in the homecare sector
People with dementia make up around 60% of all those receiving personal care at home in the UK, yet research suggests that less than half of care staff have received any kind of dementia training. Dementia Champions work across health and social care services. They are a valuable source of information, support and advice for homecare staff, but are not well established in the homecare sector.
Monica Leverton is a Research Fellow in the NIHR Policy Research Unit in Health & Social Care Workforce at King’s College London. Her work focuses on ageing, dementia, and the social care workforce. She was principal investigator of the Dementia Champions in homecare project, which explored how the role could develop.
How to cite this Collection: NIHR Evidence; Adult social care: how to improve support for people at risk through homelessness, learning disabilities or dementia; March 2025; doi: 10.3310/nihrevidence_66104
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