Innovation in Social Care: This about embedding a system based on values
An interview, following last night's Panorama Part 2 Crisis in Care, with Adult Social Care Commissioner Pip Cannons on the changes that are liberating the care and support now being offered in Somerset communities.
Before, our service was based on managing the demand as it arrived and focused on completing assessments. People worked on their own and a lot of work required sign off by managers. We’ve changed that, with a greater focus on proactive demand management, working together with community partners and finding solutions as quickly as possible through strength based conversations wherever, and as soon as, someone gets in touch with us. Before, the majority of people had to wait a long time to be assessed, new figures show that we’re now able to solve around 80% of queries within 24 hours of somebody contacting us.
This transformation has happened over the last 3 years after initially developing and testing new ways of working in one area for 6 months. We’re now using our combined skills and working closely with community partners to really explore what matters to people and looking at solutions that meet their individual needs. Obviously, we were trying to do this before, but the way we worked hampered our ability to do this as well as we wanted. We were spending too much time on administering the process and were only using a limited range of well-known solutions to meet care needs. So effectively we were following a traditional approach. By cutting free of a process and assessment driven system and enabling our staff to come up with ideas to enable them to spend more time having a conversation with people instead, we now take the time to look at a wider and broader range of solutions to meet needs and help people to choose the ones that are right for them. This has meant that we are now supporting more people to stay at home and to live a more fulfilling, independent and active life in their local communities.
This doesn’t stop – there is no project end. It’s a movement, a way of working, it’s about constantly changing and adapting to new needs within our communities. So, we’re always looking at how can we change and improve that for people. Particularly for the 20% who need complex support. For example, we’re looking at better use of assistive tech (including off the shelf generic technology as well as specialised solutions) to enhance people’s ability to stay independent and feel more confident in their own homes and communities.
We have to stop seeing adult social care as a separate thing to other community services – so many things are all linked together in communities. Take away the role description and you start to see the possibilities.
As well as looking at the impact of the changes for people in our communities, we’ve monitored how staff feel throughout the change process – Staff morale was extremely low before we started. They were busy, overwhelmed and felt they were spending a lot of time doing non value adding activities. They’re still busy, but this approach is better because the team are empowered to make change. They believe this is the right thing to do, so it becomes the right thing to do. That’s exciting for all involved and staff morale has improved as a result. And the message is spreading, other departments hear the way our staff talk about how we work and want a bit of that. So we are starting to look at how we can apply the Community Led Support (CLS) approach to transport services, children’s services, library services - they’re really keen.
We didn’t do any big messaging before we started to announce a new way of working – we communicated our change in support on a person by person basis – because this whole approach is about taking the time to listen to people and have a conversation. As a result, a lot of people don’t even realise they’re receiving adult social care because they’re being supported by one of our community agents. But that’s fine as long as they’re getting the support they need.
This is about embedding a set of core values. You have to do this from the heart – adapting the core principles so they are right for your community.
We’ve been on this journey for three years – this is not a quick fix – this is a continuous thing.
The traditional way to create change is to define and map out all of the deliverables, and then plot out milestones for getting there and to be honest that can be quite dull and controlling. By relaxing the structure and using rapid improvement techniques we’ve been able to explore things we hadn’t even thought of in the beginning. This is really rewarding for me because my role is about supporting people to explore new ideas and providing support to overcome any blockages or challenges that stand in their way. It’s been so liberating to work in an environment where we are genuinely making changes that are better for the people in our communities.