A rapid review of what organisational level factors support or inhibit the scale and spread of innovations in children’s social care

Innovation may provide a means for tackling challenges facing childrens social care, some of them deep-rooted and many exacerbated by COVID-19. Welsh Government has recently committed to a significant 3-year investment to support innovation in adults and childrens social care. The delivery of social care in Wales has a complex and multi-faceted approach, involving collaborative working between a range of organisations, which will likely affect decisions around implementation and scale-up of new and/or existing interventions. The aim of the review was to identify any factors (barriers and enablers) that affect the implementation and scale up of an innovation in childrens social care organisations. Ten studies were identified, comprising three secondary studies (reviews) and seven primary studies. Factors potentially influencing scale and spread of innovation were extracted and categorised. The domains (and sub-domains) covered by included studies were; adopters (staff role/identity; carer input), organisation (capacity to innovate; readiness for change; nature of adoption/funding; extent of change needed; work needed to implement), and wider system (political/policy; regulatory/legal; professional; socio-cultural). Enablers for which a clear consensus seems to be emerging across the literature included: specific training and support for professional staff, support and mutual respect within inter-professional and professional-carer relationships, senior management/leadership buy-in and support, multi-disciplinary communication and joint working, and developing compatible data systems to support joint working/collaboration. Barriers for which a clear consensus seems to be emerging across the literature were: short term or lack of funding (the need for funding was presented as an enabler in some studies), and implementation difficulties (e.g. multiple priorities and changing structures). Policy Implications: This review highlights the complexity of the social care models but provides some clear pointers for policy and practice. The findings indicate the need for: senior management buy-in and support, short and longer term funding, multi-disciplinary communication and joint working, good professional (and professional-carer) relationships with support and mutual respect, and specific training and support for professional staff. The confidence in the evidence is uncertain as the study designs included non-systematic reviews and service evaluations; most studies did not use a formal methodology and all had some quality limitations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Specialist Unit for Review Evidence was funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * CASA : Cognitive and Affective Supervisory Approach CSCIP : Children’s Social Care Innovation Programme FDAC : Family Drug and Alcohol Courts ICF : Integrated Care Fund LA : Local authority LSE : London School of Economics MFM : Mockingbird Family Model NASSS : Non-adoption, abandonment, scale-up, spread, sustainability framework NEST : Nurturing, Empowering, Safe, Trusted RCT : Randomised controlled trial RE-AIM : Reach, effectiveness, adoption, implementation, maintenance RPBs : Regional partnership boards SASCI : Supporting Adult Social Care Innovation Project SCW : Social Care Wales SCIE : Social Care Institute for Excellence SoS : Signs of Safety PIP : Partners in Practice VIPP-FC : Positive Parenting and Sensitive Discipline, Foster Care