Inspired by the bravery of Age UK Bradford District - who walked away from traditional commissioner designed service contracts for a future based on what older people really wanted - we asked Stephanie Smith, Director of Services at Age UK Bradford District, to share her learning on how the organisation gained insights into what matters to older people in Bradford.
In 2017/18 Age UK Bradford District were selected to engage in a Person-Centred Leadership Programme, a piece of work to co-produce a leadership programme for future cohorts. Facilitated by NDTi and working closely with 7 other local Age UK partners we were able to share ideas, experiences and learning to reflect on how our organisations operated and could develop their person-centred approaches through co-produced service design and delivery.
As an organisation we had already begun reviewing our vision and mission, however the engagement in this programme was a catalyst which influenced wider changes to our organisational ethos and approach to supporting people.
To ensure that we were able to achieve our new vision and mission we knew that we needed to engage with our communities across the district to find out what is important to people. During October 2018, Older People’s week, we started our co-production process to engage as many people as possible. This included social media, talking to people in supermarkets, GP surgeries, the city centre, our services, public events and local shops etc. We engaged over 600 people, asking people ‘What makes a good life?’
Responses were varied with people telling us what made them happy (e.g religion, family, holidays, making a difference). Some people told us about their concerns and how these impacted on their happiness. These were predominantly linked to financial security, health worries and concerns about other people.
It’s nice to be healthy and have a good life together with your wife and family
It is very important for me to always see my 3 year old grandson and play with him
Being able to be outdoors listening to birds, being able to help someone else and my faith makes me happy
Rollo my chocolate Labrador
Always keep laughing with each other in our relationship
Being in my garden
Having someone to talk to at least one conversation per day
70’s & 80’s music
We then themed the responses and categorised them into 21 areas. From these themes we noticed a very clear distinction between relationships/connections and physical/material things. The spilt was fairly even with only a 5% disparity.
The top three areas that people told us about were
The first step was complete, but we wanted to know more.
Stage two involved hosting five large group interventions across the district, asking people to discuss the themes and tell us in more detail ‘what makes a good life?’
So much was gleaned from these sessions and what was very clear is that asking what is important and taking a few words at face value is not the answer to supporting to people to live their best lives. Context is key.
A couple of examples that really highlighted this were:
When asked what makes a good life Jack* told us ‘Chicken, chips, beans with apple pie and crumble’. At face value you could be mistaken for thinking he really liked food or enjoyed cooking or baking, but actually when we discussed this in more detail what he told us was this was his children’s favourite meal so he enjoyed making it as it reminded him of having the family together and he would cook this for them when they visited. Cooking is an activity Jack enjoys but the food is emotionally connected to his closest relationships with his family, and it is the family that is the really important element.
In another of the groups a long discussion was had about going on holiday. People felt that getting away was really important to feeling happy. Different people told us about going abroad whereas others just wanted to go to the seaside to places like Blackpool and Scarborough. Margaret* said to the group ‘take me anywhere I just want to see somewhere new no matter where that is’.
Reflecting on the information we collated was an important step, and for me, considering the implications of the wide-ranging information we were presented with on a personal level is key to offering person centred support.
Growing older is a privilege and something that not everyone has the opportunity to do. Not all experiences of ageing are positive experiences, but, getting older isn’t all negative doom and gloom either. Experiences of growing older are very much dependant on a huge number of factors, as well as how each individual prioritises certain elements of their life.
Ageing is a unique journey! Despite this older people are often categorised into a homogenous group such as ‘the elderly’ or ‘old people’, without any recognition of individuality. In response to this categorisation, community responses and services for older people are often very traditional and based on assumptions and stereotypes of what we (the professional community) believe older people enjoy, e.g knit and natter groups, bingo, afternoon tea, dominos, sit be fit classes, befriending etc.
However, I personally wouldn’t enjoy these activities and it seems unlikely that just because I become a certain age (50 upwards) that I will develop an interest in knitting, bingo or any other activities that are associated with growing older. As we get older the person we are, and the things that matter to us are unlikely to dramatically change.
What we are good at (cooking), what we enjoy (reading and chatting to friends) and what is important (family, friends, pets) aren’t any less important. I will always enjoy cooking, walking the dog, reading and spending time with loved ones, however as life circumstances change, the support we need to do the important things and the things that matter to us may increase or just be different.
The Person-Centred Leadership Programme and the coproduction process have completely changed the ethos and culture of our organisation. Some changes have been simple such as changes in language. We have moved away from terminology such as ‘service user’ or ‘client’ and now just talk about the people we work with or support. We have also reviewed our processes and removed ‘assessment forms’, replacing them with one page profiles, which are tailored to promoting a conversation rather than an interview style interaction.
We have also tried to move away from some commissioned services that are rigid and prescriptive. Our wellbeing officers are part funded by the local authorities Day Opportunities grant, but also funded by fundraising and donations. This means that the staff and their team of volunteers are able to support people with what is important to them and are not pressured to ‘tick boxes’ or meet targets and ‘outputs’. The best way we can measure outcomes and how well we support people is asking them if they feel happier as a result of our support.
Involvement in this process has been a real enabler and energiser for the staff team who have really embraced this new approach. On a weekly basis I get approached by the team telling me they have had a conversation with someone and want to try something new, I respond by telling them that we can try anything and by working closely with local communities and local businesses we are coproducing some fantastic activities in response to what people tell us they want to do. We’re now working with leisure centres, cinemas, restaurants, cafes, supermarkets, churches…… in fact anywhere in our communities that people want to go. We believe that this is true Asset Based Community Development.
For Age UK Bradford District we want to enable and empower as many people as possible to live their best life, working together to coproduce the solutions that are right for them and where support is needed offering something that is appropriate and right for individuals.
With the concept of ‘personalisation’ being high up on the national agenda & one of the key themes of the NHS long term plan, the idea of person-centred approaches and putting the individual in control of their own decisions will inevitably shift the focus of many organisations.
As individuals, whether professionally or personally we need to remember that BEING person-centred and ACTING in what we consider a person-centred way within restricted platforms is not the same thing. True personalisation is a consistent attitude and mind set and not a one-off change in systems, procedures, policies and practise.
Furthermore, coproduction isn’t a ‘one off’ process, but is something that needs to happen regularly. Not all coproduction takes the form of large-scale events but is sometimes as simple as ‘asking, listening and then together you can make the important things happen’.
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