What are you going to do differently?
Interview with Christine Denovan talking about how the Community Led Support programme is helping Somerset to meet the changing needs of people who need support in our communities.
We’d got into a system over the last 10 years where we were looking at a placement or a care package as the only thing to offer. So we were looking at domiciliary care or a sitting service, or day care and I don’t know how we’d got there?
My team were lucky enough to be chosen to trial the new way of working. Without the drive and passion from our commissioner, we wouldn’t have gotten as far as we have. Despite doubters at the beginning, they empowered us and drove that change in our staff and systems.
Community Led Support meant we got out into the community to find out what else there was for people to widen the choices we were able to offer rather than a very limited menu of support. Rather than waiting for decisions to be made by a manager or a panel, we now use the peer forum with community agents involved in that, which has helped us to widen our awareness of what’s out in the community and share the responsibility as a team.
This also acts as a peer challenge. One of the things that was most notable with the peer forum model was that when decisions had been sent up to a manager, staff could be very defensive when decisions hadn’t worked out the way they thought they would – with the peer forum its not like that, your colleagues are making suggestions “Have you thought of doing this”, “what about trying this”. We’re able to work together and often make recommendations that are much better for the individual that we wouldn’t have known about before. I wouldn’t say that we’ve always been able to put a community solution in place, but just by having the community agents involved in helping us find solutions has been priceless. It leads to better outcomes for people, which is what it’s all about.
The community led support model has allowed us to do so many things differently. The different conversations, and the triage system of calling people back ourselves as soon as they are referred by Somerset Direct (our contact centre), means that we have far less people on waiting lists and the people that need us most are getting the help they need much quicker.
The challenges in the beginning felt fine – we were in a bubble, and it felt controllable as it was only in one area. But the roll out was difficult. We were challenged by people that just didn’t believe it would work. I’d never looked at data evidence beforehand in my role, it wasn’t our way of working, but having built up evidence, we were able to convince people that we had already been making a difference in our test area. It didn’t matter what the doubters said, it couldn’t dampen our enthusiasm or lessen the evidence. It gave us the confidence to know we were doing the right thing.
We knew that we were at the beginning of a journey and it was exciting to be able to show that we were on the right track for sustained change. Having large waiting lists is horrible for everyone but seeing them lower dramatically whilst also giving better outcomes for people is so rewarding. Having a conversation instead of an assessment really gets to the bottom of an issue, which inevitably means people get something that is more likely to meet their needs. For people with long-term support, instead of saying in a review “how’s your support, good, great, we’ll see you next time”, instead we’re able to ask “what do you want in your life, what would you like to be doing and how can we support that?”. As a director I’d want to know ‘are you improving outcomes for people, are you within budget and are you seeing people in a more timely way?’ – and we absolutely are. That’s quite a big change and we need to remind ourselves how far we’ve come.
In the beginning, we started off thinking that we’d need places in the community for drop-ins with our own staff, but we quickly learnt that they would be better staffed by people in the communities, because that’s what communities wanted, plus they’re the ones who have the connections and knowledge. We just needed to work out how to best work with our communities and support that to happen. Afterall, that’s real community led support.
Commissioning support within Somerset (and wider) is now much more about building community capacity and enabling people to stay at home as long as possible. So we also have very different conversations with our providers, asking them “what are you going to do differently”. We all need to start thinking differently about how we support people to live a good life in their communities rather than offering a limited range of traditional support.
For me personally, I feel excited by what we’re doing to create real support in our communities. It used to be that, when asked outside of work “what do you do?”, you wouldn’t necessarily tell people that you were a social worker because people had negative perceptions of what that meant. But this model gives you pride in your work and I truly think this next year will be as exciting as when we started. We’re still on a journey to change Adult Social Care in Somerset, but we’re heading in the right direction.