In our recent conversations with other experienced and esteemed practitioners in the field of health and social care, a regular topic keeps coming up. Why aren’t we seeing real progress in Adult Social Care transformation?
Why now is it still seen as ‘progress’ when a student Social Worker talks about a person they are supporting on the basis of their skills and strengths? This is not new, and it is not innovative. In fact, if a social worker is describing this type of practice, they are merely demonstrating their compliance with the Care Act and Care & Support statutory guidance. We are not seeing change, because those who are the gatekeepers of the change are still seeing ‘new innovation’ as practice which is aligned with what the innovators were discussing and doing 30 plus years ago.
Innovative work is often observed from an external position, where the work of the innovators is recognised, admired, heralded and celebrated but still seen as separate to ‘what we can do’; therefore those that are in a position to make a difference do not recognise the role they have to play in making it happen. They don’t recognise how they can be part of making the difference themselves – always seen as something the the people on the other side of the statutory fence do. It is common practice to attend conferences and online events which are presented as ‘an audience with the innovators’. The problem with this is that innovation continues to be seen external to the audience and the very gatekeepers of change.
So what would it take for people not only to see and admire the ‘innovative’ work but to embed it into their practice, for them to model this approach and build it into what they do, rather than celebrating it as ‘best practice’ and ‘something to aspire to’?
Is this about providing support and guidance; and to be alongside people, building it into their practice as they stretch their comfort zones until it becomes part of their comfort but preventing them from going into the place of panic? Is it about bringing in what is covered in the Be Humankind practitioner experience around recognising your circles of influence, concern and curiosity; functioning from a position of influence and courage whilst being in high states of self care?
Organisations need to focus on building an organisational culture that has psychological safety as a foundation, so that those with the passions, skills and understanding can dare to do things differently and to feel safe and supported in the pursuit of this. We need a health and social care system that is not defined by users and providers but by people being alongside each other in the pursuit of a better life experience.
Wherever the answer lies, it is this dynamic shift in culture and practice we need to see before we can expect to observe any dynamic shift in the way care and support is organised, sourced and experienced.
Independent Support Brokerage creates the shift by working with one person at a time. It does not start with standardisation of processes, forms and templates (which often squeezes out creativity and innovation). Instead it focuses on some key principles:
Listen: to what is happening for the person. Use discovery conversations to understand what the person wants to change or achieve. Start with the strong stuff. Relationships, skills, interests, passions, connections, hobbies. Learn from listening about what a good life looks like for the person. From this foundational information, exploration and planning can happen.
Explore: From the basis of what has been learned from the person, support the exploration of possibilities, opportunities and resources which are available to support the person in what they want to change and achieve. From this stage of the listening, learning and thinking, the person can begin to form some clear ideas of how they want their life to look, and how they would like to be supported with it.
Connect: From the exploration which has taken place, create some ‘maps’ of assets, relationships and opportunities which the person wants to include in their planning. Make connections. Facilitate conversations. Access resources (which could include statutory funding such as a Direct Payment of Personal Health Budget) and secure assets which will support the implementation of the person’s ‘good life’ plan.
Action: Support the bringing together of the final plan. This may need to be signed off by statutory decision-makers, so it is important that the plan meets eligibility and requirements for sign-off. The plan should include costings for any paid-for elements of support, but could also include non-paid elements which still contribute towards the person’s overarching wellbeing outcomes. Once the plan is agreed, an action plan to support the implementation of supports and resources is helpful to ensure that support is put in place for the person. Ongoing support around review and update of the plan may also be helpful.
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