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Social care assessments in England are envisaged as conversations, implying an informal and congenial encounter, in which both parties have equal roles. However, a fundamental task during an assessment is to gauge eligibility for resources. This article uses conversation analysis to consider audio recorded data of seven social care assessments in England. The article focuses on topic shifts, where the assessor introduces an ‘assessment relevant’ topic, and we examine how these shifts are managed. Sometimes assessors used what was said by the client or by the carer as a ‘pivot’, which could produce a feeling of friendly conversation, but simultaneously lead to an intrusion into the client’s personal knowledge domain. Assessors also had other strategies for framing a ‘next question’, such as noticing something in the environment, referring to previous notes or to previous conversations. The conversation might feel ‘friendly’, but these tactics could lead to the personal life domain of the client being inadvertently revealed and used as relevant for their assessment.

Reflective supervision is widely recommended as an effective way to support social workers to think about their practice and to make better decisions. Although previous research has proposed methods of pursuing reflective supervision, little is known about how supervisors attempt this in actual supervision meetings. One proposed method for supervisors is to elicit third person perspectives so that social workers can consider a situation from different points of view. In this article, we examine this method by analysing audio recordings of 12 supervision meetings from one local authority Children and Families Social Work team. Using Conversation Analysis (CA), we explore supervisors’ attempts to elicit other people’s perspectives, focusing on how such requests were formed and how the social worker responded. We found 35 instances of supervisors attempting to elicit third person perspectives and identified four different ways that supervisors designed these enquiries. Supervisors oriented to two concerns, based on whether they enquired about a perspective that was currently established or projected into the future, and whether the information was verifiable through speech or actions, or imagined based on the other person’s thoughts or understanding. We draw on CA work on epistemics and stance to show how these different approaches have implications for what the social worker is expected to know and how both speakers orient to the accountability of the social worker. We conclude by considering the epistemic friction between the design of these enquiries, the relevance of professional accountability and the possibilities for pursuing reflective supervision in practice.

Parenting programmes are recommended as an effective means to support parents in promoting positive relationships with, and managing the behaviour of, their children. One barrier that impedes their successful implementation is that partners, especially fathers, are less frequently recruited by child welfare services. This article reports on a study that investigated how both parents were engaged with parenting services. Direct recordings were made of initial telephone conversations between six practitioners and 28 parents referred to those services and investigated for evidence of how the other parent was recruited. Conversation analysis was used to identify how participants introduced the possibility of both parents being included in the service; how these possibilities were negotiated and what eventual agreements were made for both parents to be included in future arrangements. Implications for practice, training and future research are considered.

Summary The social care assessment is a ‘key interaction’ between a person and the local authority with ‘critical’ importance for determining a person’s needs for care and support. In order to achieve this, the guidance requires that assessments must be ‘person-centred throughout’. The concept of person-centred practice is now routinely invoked, but there remains little empirical evidence on how it gets put into practice. Findings This paper draws on interview data from 30 practitioners about their experiences of conducting social care assessments in England. While there was widespread support for the principles of a person-centred approach, tensions emerged for practitioners in three ways: the way in which ‘chat’ was used to build a relationship or conduct the assessment, whether to conduct the assessment via a conversation or by following the sections on the agency form and the extent to which the assessor should involve and negotiate the contributions of family members. Applications We argue that each of these dilemmas represents an occasion when a commitment to person-centred practice is negotiated between professionals and service users and sometimes compromised as a result. We consider the possibilities for and constraints on achieving person-centred assessments in a post-Care Act environment and discuss the implications for social work practice and research.

Accessible summary When people with learning disabilities have children and become parents, they sometimes need good support to help them.Research about parents with learning disabilities and the support they get is usually about mothers and not fathers. There is not very much written about dads with learning disabilities.This paper is about interviews with eight dads with learning disabilities who told us about what it was like to be a dad and about the kind of support they had got.We think more support needs to be given to parents with learning disabilities and that dads should be included in this. Abstract Background This article reports on the perspectives of fathers with a learning disability in England about being fathers and the support they have received. Although there is an established literature that considers parenting with a learning disability, few studies have focused on the perspectives of fathers. Method We adopted a qualitative approach for this study, using semi‐structured interviews with eight fathers with learning disabilities, recruited through learning disability organisations and social media. The data were analysed using thematic analysis. Results Being a father was important to participants and the findings are presented in three themes: descriptions of fatherhood; challenges of fatherhood; and support with fatherhood. Conclusion We discuss how fathers' perspectives on fatherhood relate to wider transformations of fatherhood in society, the impact of these on fathering with a learning disability and the implications for services.

Loneliness is framed as an enduring problem for carers of all ages, including older carers; however, there is little examination of older men’s experiences of caring, loneliness and social isolation. Based on interviews with 25 men (aged 68–92 years), we discuss findings from a study of older male carers’ experiences of loneliness in England. Within their accounts, loneliness is framed as a future, rather than present, problem as caring provides a time-limited buffer to loneliness while concurrently increasing social isolation. Further, the findings shed light on how male carers seek and benefit from carers’ support groups while also maintaining autonomy.

This article examines how practitioners engage with parents who have been referred to parenting programmes. Engaging parents is an important component of child welfare work so that parents can benefit from interventions and outcomes for children can be improved. However, our knowledge of engagement is still developing and research in the field is frequently based on self-reported data. This study used Conversation Analysis to examine direct recordings of initial telephone conversations between parenting practitioners and parents following their referral to the service. Results revealed that in the majority of calls, practitioners focused on the primary task of making arrangements for the service, but in a minority of calls, practitioners departed from the usual progress of the call to ask parents about the difficulties they were facing. When they did so, practitioners committed themselves to substantial additional work listening to the parent and extending the length of the call. However, they also pursued different actions to engage the parent with the service that were built up incrementally in the talk. By examining three particular features of practitioners’ talk during these sequences, the article considers how a practice phenomenon such as engagement may be purposefully worked up moment by moment.

Background: Acute respiratory tract infections (RTI) in children are a common reason for antibiotic prescribing. Clinicians’ prescribing decisions are influenced by perceived parental expectations for antibiotics, however there is evidence that parents actually prefer to avoid antibiotics. This study aimed to investigate the influence of parentclinician communication on antibiotic prescribing for RTI in children in England.Methods: A mixed methods analysis of videoed primary care consultations for children (under 12 years) with acute cough and RTI. Consultations were video-recorded in six general practices in southern England, selected for socio-economic diversity. 56 recordings were transcribed in detail and a subset of recordings and transcripts used to develop a comprehensive interaction-based coding scheme. The scheme was used to examine communication practices between parents and clinicians and how these related to antibiotic or non-antibiotic treatment strategies.Results: Parents’ communication rarely implied an expectation for antibiotics, some explicitly offering a possible viral diagnosis. Clinicians mostly gave, or implied, a viral diagnosis and mainly recommended non-antibiotic treatment strategies. In the minority of cases where parents’ communication behaviours implied they may be seeking antibiotic treatment, antibiotics were not usually prescribed. Where clinicians did prescribe antibiotics, they voiced concern about symptoms or signs, including chest pain, discoloured phlegm, prolonged fever, abnormal chest sounds, or pink /bulging ear drums.Conclusions: We found little evidence of a relationship between parents’ communication behaviours and antibiotic prescribing. Rather, where antibiotics were prescribed, this was associated with clinicians’ expressed concerns regarding symptoms and signs.

This chapter considers how conversation analysis can be used to understand professional practice as it happens and the circumstances in which fathers are made more or less visible in the interaction. On the one hand, social work is predicated on the basis that parents, including fathers, have the capacity for growth and to improve their own and their children's lives. On the other hand, social workers are required to identify when a parent presents a risk to the child and should no longer be caring for them. Given that most social work continues to be with mothers, the chapter shows that fathers represent a practical dilemma for social workers in terms of their presence or absence in a child's life, the quality of that involvement, and the potential for them to be positively engaged with change.

Background Good communication is central to the effectiveness of GP service provision, as well as to patient satisfaction with surgeries, but very little is known about the actual communication that occurs between patients and surgeries. Aim This study was carried out to examine, for the first time, how receptionists interact with patients on the telephone, to identify features of communication associated with efficacy and patient satisfaction. Design and setting A qualitative conversation analysis of incoming patient telephone calls, recorded ‘for training purposes’, in three English GP surgeries. Method Data were analysed qualitatively to identify effective communication, then coded to establish the relative prevalence of communication types across each surgery. Results Analysis identified a burden on patients to drive calls forward and achieve service. ‘Patient burden’ occurred when receptionists failed to offer alternatives to patients whose initial requests could not be met, or to summarise relevant next actions (for example, appointment, call-back, or other query) at the end of calls. Coding revealed that ‘patient burden’ frequency differed across the services. Increased ‘patient burden’ was associated with decreased satisfaction on published satisfaction survey scores. Conclusion Patients in some practices have to push for effective service when calling GP surgeries. Conversation analysis specifies what constitutes (in)effective communication. Findings can then underpin receptionist training and improve patient experience and satisfaction.