Exploring impacts of co-located anti-poverty and social care prevention services for older people: a theory-based rapid evaluation (Co-CARE)

Background Local government and social workers believe that increasing rates of poverty seen in the UK in recent years are affecting both demand for social care services and the complexity of cases (British Association of Social Workers, BASW & The Child Welfare Inequalities Project, CWIP, 2023). Poverty exacerbates many inequalities and may accelerate the onset of care needs, adding pressure to an already stretched system. While the relationship between poverty among children and families and social care has attracted much attention, the relationship between poverty and social care in working and later life has been comparatively neglected, with some noted exceptions (e.g. Montgomery et al. 2025, Bach-Mortensen et al. 2025). In addition, the role of social care services in reducing poverty is unclear, with little recognition of the potential role that more explicitly anti-poverty social work and social care practice could play as part of local authorities’ Care Act 2014 prevention functions. At the same time, there is an increasing policy attention on prevention and rising poverty is influencing public and political debate, creating opportunities to rethink the scope and purpose of adult social care prevention as part of a broader system response to poverty. In this context, the co-location of welfare and social care services has emerged as a promising anti-poverty and preventative approach. Co-located welfare and social care services take an array of forms, with different services and staff in different settings, such as income maximisation staff in social work duty teams, social workers working closely with local food banks, and welfare and debt advice in community hubs. While there are some studies of co-located welfare and health services, which suggest that co-located services with an anti-poverty focus can be effective at prevention, reducing barriers to access to welfare services and facilitating early intervention (Reece et al 2022), studies taking an explicitly social care perspective are limited. There has been little consideration of the role of social care and social work in co-located services and the consequences of these services for individuals and the social care system, from a prevention perspective. Since welfare services for adults differ depending on whether or not adults are of working age, in this work we will focus on older people. Research Questions The study will address four questions: 1. What are the different types of co-located services with respect to their focus on anti-poverty and potential as a form of social care prevention for older people? 2. Is it possible to assess the extent to which different types of co-located services are reaching the older people who need to access them? 3. How does co-location of services in a variety of settings affect how local organisations, volunteers and staff groups work together around anti-poverty and social care prevention and what are the conditions for success? 4. How does co-location of services affect how older people experience and use anti-poverty and social care services and with what consequences for their experience of poverty and social care prevention outcomes? Aims and Objectives The project aims to build evidence for policy and practice on co-located anti-poverty and social care services for older people, paying attention to who different models of co-location are for, how they operate and how they bring about improvements in poverty and preventative social care outcomes in different contexts. The project has the following objectives: 1. To develop a framework for conceptualising different co-located service models, which reflects their approaches to anti-poverty practice and potential as a preventative social care service. 2. To develop a Theory of Change (ToC) illustrating how different co-located service models work to address poverty and deliver preventative social care. 3. To develop quantitative methods to better understand and visualise levels of need for and existing provision of co-located anti-poverty and social care services within specific, but diverse, geographies. 4. To explore who is accessing and using different co-located service models and assess the reach of the models. 5. To explore how organisations and different staff groups (including volunteers) work together to deliver different co-located services models 6. To explore the experiences of older people accessing and using different co-located service models 7. To identify the critical success factors and enabling conditions for effective delivery of different co-located service models 8. To develop proposals for an impact evaluation to better understand the association or causal impact of co-located services on poverty and social care outcomes To formulate evidence-based policy and practice guidance to inform the adoption and commissioning of co-located service models, focusing on the siting, accessibility and implementation of effective co-located services Methods The evaluation will use a theory-based, mixed-methods design. The fieldwork will take place in two sites (a local area of one or two local authorities) in different regions in England. The core of the research will be case studies of co-located welfare and social care services. Sites and cases will be selected purposefully to build in variety and provide opportunities to learn about different co-located models that have an anti-poverty and preventative focus. In total we will conduct three case studies per site (six in total). The clustering of case studies by sites will facilitate exploration of interactions between co-located services, how they are affected by local strategic activities and plans around poverty and prevention, and their relationships with key local public bodies. The evaluation is structured into five work packages (WPs): 1. WP1: Preparatory phase and conceptual development (Months 1-3) will establish an initial conceptual framework and a Theory of Change (ToC) for how co-located models improve poverty and deliver preventative care. Key activities include a rapid synthesis of existing evidence, building relationships with sites and case studies. We will also conduct participatory actor mapping with the two sites to identify the further co-located services and important actors, and secure local data access agreements. This phase also involves setting up the Co-CARE Public Advisory Group (EPAG) and the Evaluation Advisory Network (EAN) to guide the research. 2. WP2: Exploring demand for and supply of co-located services (Months 1–12). In the two sites, using Geographic Information Systems (GIS) we will create ‘heat map’ visualisations to illustrate local need against co-located service locations. We will identify need using publicly-available data (e.g. Index of Multiple Deprivation) and supply by extracting potential locations of co-located services from sources such as the Charity Commission and OpenStreetMap. We will generate buffer zones around co-located services to estimate coverage and identify ‘service deserts’, i.e. areas of high need but limited access. The choice of need indicators, buffer zones and accuracy of the identification of co-located services will be tested and refined using local data and insights from the sites and case studies, and through engagement with the EPAG and EAN. 3. WP3: Case studies of co-located services (Months 4–9). A rapid ethnography involving non-participant observations, documentary analysis, and semi-structured interviews to explore how the co-located services work to improve poverty and social care outcomes focusing on staff practices and organisational structures. The team will conduct three case studies (of co-located services) per site (six case studies in total). The team will conduct a maximum of 30 staff interviews and 30 interviews with older people to gather perspectives on service impact on poverty and social care needs. Additionally, a short survey of people attending the co-located services will capture demographic characteristics, eligibility, and access to co-located services (i.e. distances travelled to the service) to understand which groups of older people are accessing co-located services and refine the WP2 spatial analysis. 4. WP4 allows for an extended data collection period (Months 10–12) to include an additional 2–4 case studies in different regions of England, ensuring greater diversity in the sample and capturing potential seasonal impacts on service usage, bolstering the validity of the findings. 5. WP5: Synthesis and Knowledge Mobilisation (Months 10–15), involves synthesising results from all work packages using methods like a tabling approach and a convergence-coding matrix to compare different service models, refine the theory of change and conceptual framework, and identify critical success factors. Working with the EPAG, EAN, and policy customers the team will develop evidence-based policy and practice guidance and a briefing paper. Participatory engagement is embedded throughout. An Evaluation Advisory Network (EAN) comprising a dedicated Co-CARE Evaluation Public Advisory Group (EPAG) and other stakeholders will inform all stages of the research, ensuring that the perspectives of older people and practitioners shape the evaluation. Members will be funded for their involvement. Timelines for Delivery The project will run for either 12 or 15 months. In the first three months, the team will focus on conceptual development, site recruitment and familiarisation, tool development and ethics approval. Months four to nine will form the core phase, encompassing data collection and analysis at all levels. An optional extension of the data collection and analysis into months ten to 12 will allow for additional case studies and analysis of seasonal variation. The final three months will involve the synthesis of findings and preparation of outputs, including academic publications, practice insights and policy and commissioner guidance. Anticipated Impact and Dissemination The study will advance conceptual and practical understanding of co-located services as an anti-poverty and preventative strategy in adult social care. It will provide new methods to identify possible mismatches or gaps between need and provision of co-located anti-poverty and preventative social care services, inform decisions on the siting and delivery of such co-located services, and generate actionable guidance for policy and practice at local, regional and national levels.