A realist review examining the effects of regular contact with an adult social worker on wellbeing and quality of life and key outcomes for people using services

Background: Adults may face complex health and social care challenges that require intervention through the adult social care system. The adult social care system provides a wide range of services to help individuals aged 18 years and above using and requiring social care services maintain independence, well-being, and safety. Adult social workers play a critical role in safeguarding and facilitating the health and well-being of people requiring and/or using social care services. Social workers can be referred to as the wheel that promotes the development and delivery of care that enhances outcomes for social care service users. The contact that occurs between adult social workers and individuals who use and require social care services is a key component of social care service delivery. However, the extent to which their involvement, particularly in collaboration with other social care professionals, influences service user outcomes remains insufficiently understood. We propose a realist review to explore how, why, for whom, and under what circumstances contact with an adult social worker impacts service users' well-being, quality of life, and other key outcomes in the United Kingdom. Methods: We will include studies that explore the perspectives of adult social care users who request and use social care services in the United Kingdom. We will systematically search the following sources: Medline, Social Policy and Practice, CINAHL, PsycINFO, Sociological Abstracts, Social Science Citation Index, ASSIA, Social Work Abstracts and IBSS to identify relevant peer-reviewed literature. Grey literature will be identified through searches of organisational websites, Overton, Dimensions, and advanced Google searching. Evidence will be extracted to address the review objectives, with particular attention to identifying recurring patterns of context, mechanism, and outcome (CMO) and developing CMO configurations (CMOCs). An interpretative, cross-case comparative approach will guide the synthesis, helping us to explain how, why, and under what circumstances particular outcomes occur. Included studies will be assessed using the criteria typically applied in realist reviews: relevance to theory development or testing, methodological rigour, and the richness of the data. To strengthen the depth, applicability, and support broader understanding of the topic, interpretation and contextualisation of review findings, we will seek insights from a diverse range of stakeholders, including social care service users. throughout the review. The review will be conducted using a systematic, transparent, and iterative approach, in line with the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES I) guidance for realist reviews. The review will be performed iteratively over five stages: (1) clarification of review scope, (2) initial programme theory development using the CMOCs, (3) evidence search, (4) evidence selection, quality appraisal, data extraction and analysis and (5) drawing conclusions, recommendations and dissemination. Expected result: Findings will include the identification of CMOCs to describe the impact of social workers' contact with adult social care services on service users. Through evidence synthesis and engagement with stakeholders, we will develop and present a programme theory that explains whether and how contact with social workers impacts the health and well-being outcomes of social care service users. Conclusion: This review employs a realist approach to provide policymakers, social workers, and the social care system with practical, in-depth insights to enhance service delivery and improve outcomes for service users. Our goal is to produce robust findings that inform evidence-based practice in adult social care. PROSPERO Registration - CRD42025652026