The aim of this blog isn’t to offer any definitive answers but to raise a number of brief observations that we hope will contribute to the emerging discussion about partnerships between people using services, communities, providers and strategists.
As a bit of background ….
The Community Led Support programme, incorporating community-led social work, was developed from learning in Shropshire and their willingness to share experiences with others embarking on similar change. Shropshire (and People2People, their delivery partner) do not claim to have solved the challenges in adult social care but there are some ingredients in their developing model that appear to be key to success.
How these can be applied and developed in different areas is the learning at the heart of this programme. Councils and Health and Social Care Partnerships are supported to develop and build partnerships between people using social care services, local communities, social workers and other professionals to deliver community based, responsive and person centred support.
Our experience shows this way of working, rooted in person centred approaches and minimal bureaucracy, makes it possible to redesign processes and change the culture, and most importantly the outcomes, of practice. The emphasis is on preventative and proportionate support through information, advice and face to face discussions where needed, which mostly take place in familiar community settings.
Initially four local authorities (Denbighshire, Wakefield, Calderdale and Somerset) joined the NDTi, People2People and Shropshire in the partnership. Recently we identified ten outcomes of the work so far that we will be exploring over the next year. New authorities and health and social care partnerships will join us after March (more on the new sites in the next few months).
1) Change needs to start with some key principles:
Coproduction between people and services, person centred processes and empowered staff. It’s not enough to just talk about these. Old fashioned command and control approaches to planning and provision are deeply embedded and we need to continually challenge ourselves and be challenged.
2) Solutions rooted in the community are more sustainable and deliver better outcomes. We all need to be better at demonstrating this.
3) Conversations with local people and communities have been time consuming and delivered different levels of engagement but have provided real value for each site. People have worked together successfully to:
4) The most important conversations are not those about the form of the new service (community interest companies, mutuals or being 'arms length’) but focus on function - how to build partnerships between local people, communities and social care practitioners. Once we understand local needs and aspirations, we can think about leadership plans and design different ways of supporting people.
5) Assessment procedures tend to be too long, not person centred and don’t easily lead to creative outcomes. Redesigning away from procedures and towards conversations isn’t complicated (there is lots of great person centred practice out there) but it needs bravery to strip out what is unnecessary, uncreative and unhelpful.
6) There are many staff who want to work differently and they need to lead the process with local people, supported by strong leaders – both officers and elected members.
7) Decisions about how to spend money need to be proportionate and are best led by the person, without layers of management and additional bureaucracy. This is achieving better supports and real savings. Savings come from being genuinely person centred and creative - reducing costs cannot be the sole or main focus for change.
8) Each area has a different plan but all have ownership at a senior level, political understanding and a structured plan of support.
9) Community Led Support is about systemic and cultural change. Existing service inefficiencies create waiting lists and unnecessary bureaucracy which stifle creative thinking and proactive working. Addressing these problems is essential for sustainable change.
10) Getting this right requires a flexible, responsive approach based on genuine collaboration, trust and partnership. Letting go may be the hardest part.
Bill Love is the Director of Delivery and Impact at the National Development Team for Inclusion (NDTi)
NDTi is an organisation that promotes equal and inclusive lives for people in their communities, particularly where ageing or disability are issues
Bill Love's blog is a personal opinion and does not necessarily reflect the views of the NDTi.