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On the 1st December 2021, the British government published the long-awaited White paper: ‘People at the Heart of Care’.

A week on, we have had opportunity to digest its contents, and to form our thoughts about it. Here is a link for you to read or download the full document. We think it’s really important that people are able to access and understand clear information about things which affect them. Below, we have included a summary of some of the key elements of the paper.

What are the headlines?

The paper is heralded as a ten year vision for adult social care, and it covers three core objectives:

1. People have choice, control, and support to live independent lives.
2. People can access outstanding quality and tailored care and support.
3. People find adult social care fair and accessible.

Person-centred care is a recurring theme throughout the paper. There is acknowledgement that…”the ambition of the Care Act has not consistently been achieved in the way we would have liked”.

Key policies

There are some key policies to be introduced over the next three years:

The proposals set out within the White paper are backed by the Health & Care Levy announced earlier this year in September, stating that £5.4 billion is being invested into adult social care over the next three
years.

Further detail

The paper then goes out to break down the three core objectives into finer detail. Under each objective, there is a set of statements, which could be used as a benchmark to demonstrate whether the objectives are being met and embedded at a local level. The statements are written in the ‘first person’ and should be able to stated by anybody drawing on care & support, anyone in an unpaid carer role, or any wider organisations or professionals involved in the delivery of care & support.

The next section of the paper refers to ‘strong foundations’ and makes reference to underpinning legislative frameworks such as:  Mental Capacity Act 2005; Health and Social Care Act 2008, 2012; Care Act 2014 and the Health & Care bill which is currently going through parliament.

In addition, there is further reference to Mental Health Act 1983 (which is currently going through reform); Autism Act 2009; Children & Families Act 2014 which add to the wider legislative framework surrounding Social care.

There is also a statement of intention to publish a further White paper on the integration of health & care services.

The paper sets out some of the current challenges such as:

The next section of the paper emphasises the concept of ‘Right care – Right place – Right time’, with an emphasis on improving the range of housing options available to people and ways to support people to live in homes and communities they choose.

There are a range of case studies throughout the paper which illustrate the themes being presented.

One of the really stand-out elements is the emphasis on unpaid carers (including young carers being recognised), and the willingness to explore models of support for carers that are working well in other countries such as Germany & Australia.

The White paper states the intention for the Department for Education to amend their schools census to clearly include ‘Young carer’ data; to raise the visibility of young carers within the school system. This will also help to build the picture of the impact of  ‘caring’ on school attendance, educational progress and attainment.

There is also a section on supporting people with autism and learning disability into employment.

The paper goes on to lay out further details about improving the Health and Social Care workforce (including support with recruitment, retention and skills/training); and finally how it is going to work with Local Authorities to stimulate new and innovative ways of providing support and a good range of choice for people at a local level.

Independent assessment of Local Authorities within the Health & Care bill

The CQC (Care Quality Commission) as a regulatory body will have a new duty to review how partners of Integrated Care Systems (ICSs) are working together and also to review how Local Authorities deliver Adult social care functions. Under the Health & Care bill (currently going through parliament) the CQC will assess how Local Authorities are meeting people’s needs.

There is an example set of assessment criteria given within this White paper:

The paper concludes by outlining next steps, which mainly cover the introduction of working groups on a number of the new policies being introduced.

Let us know your thoughts- it is helpful for us to hear from people who are interested for different reasons; so we’d love to hear from:

Has this blog been helpful? What do you think about the proposals which are being outlined? If you’re reading this via a social media post, pop a comment below; or alternatively, drop us an email: info@imagineer.org.uk

You can read some of our other blogs here.

 

We talk about being person-centred in social care, but what does this mean in the context of supporting people with learning disabilities or autistic people to leave a long-stay hospital or assessment and treatment unit?
When we talk to leaders in adult social care they openly admit “we can do better for people” with regards to community support and getting a good life.

So how can we do better?

One national project, Small Supports, is providing some answers and raising some questions about how we support people and commission services differently.
Personalisation and being person-centred is at the heart of this project, with twelve sites nationally supporting the growth of small providers. Amanda (from the Team at Imagineer) is involved in developing the Lancashire and South Cumbria Small Supports project.

What are Small Supports?

Small Supports are small, local organisations who work with people with learning disabilities and/or autism, who have experienced difficult or traumatic life events and who need a different approach to support them to leave hospital.

These new providers will focus on putting the person in the driving seat by building strong relationships with them and their family and circle of support. Fundamental to this is their willingness and ability to listen deeply to the person, their aspirations and hopes
for their future and then to help them choose and plan what a great life looks like for them. Conversations about support and risk follow that.

Why small?

The belief is that remaining small enables the leaders of the organisation to keep in touch with everyone, the people being supported, their families and those providing the support. Small is also very much about quality. Building strong relationships of trust with the individuals they support and their families, the commissioners and the community teams is vital to ensuring quality continuous support. Being able to ‘touch the sides’ of the organisation means that when challenges arise and changes are needed they can be spotted early and acted upon quickly.

Being small and local also means the leaders and paid supporters in the organisation are rooted and engaged in their community. They are able to build links with the person to their community based on their assets and strengths.

People are therefore able to contribute to society and build relationships outside of their family and paid support, something Small Supports strongly advocates. Focusing on individual’s aspirations and building intentional relational networks with and for the
person means that anything becomes possible, including friendships, finding love, getting a job, being a good neighbour and regaining health and happiness. Whilst these things may not seem like a great ask for most people, for many people who have lived for years in locked environments these important life experiences may feel out of reach. Small Supports is aspiring to change this by putting the person at the centre of the decision making in their life including focusing on what a good life looks like for them.

How does Support Brokerage fit in?

This is where quality Support Brokerage fits in. Being able to use a personal budget in the form of a direct payment, third party health budget or individual service fund offers a way to use creative and strengths based approaches to build a support plan directed by the person and their family. Every person has unique strengths, assets, gifts and skills and these are the starting point for building a dynamic support plan with the person in the driving seat. Looking at the person’s aspirations first, instead of a ‘one size fits all’ approach to buying support services; a personal budget enables the person to be directing their plan and how they want to spend their money so that the support wraps around them. The provider is there to support the individual and broker services as directed by the person. This will look very different for each person. Support Brokerage enables this bespoke and highly creative approach to designing a support plan which makes sense to the person; and drawing on all of the other strengths, connections and resources available to the person which can help to make their plan a reality..

Why Personal Budgets?

What Small Supports organisations learnt was that compromising on control and aspirations is when things start to go wrong. Using an individual service fund or a personal health budget enables the person to be in control, supported by their family and the provider. This type of personal budget offers flexibility like a direct payment.
Recognising that daily life is not on a schedule, is not predictable and is not the same every day. The person, their family and network supported by their provider can flex the support around the person’s choices and changing needs and if something unexpected comes up, they can adapt. This is not necessarily the case with a commissioned or managed budget (sometimes referred to as a ‘notional’ budget), where they might have to ask for a social care review to change the support plan, which may not happen immediately.

An individual service fund (ISF) is where the person and their family might like the idea of directing their support and being in control but don’t want the responsibility of managing the finances, staff and payroll. The provider or a third party helps them work out how to spend their budget and create their support plan and is accountable for it on their behalf; while the person remains in control of their support.

How can you get involved?

People who have successfully established their new Small Supports organisation tend to be people who have a background in providing or commissioning services.
Some are people with lived experience and family members, some are learning disability nurses, commissioners or social workers. However, they are bold and compassionate leaders committed to human rights, who understand the value of their community, aspire to provide high quality, local support and plan to remain small but sustainable- not supporting more than 5 people in their first year.

All Small Supports sites are actively looking for brave values-driven people who want to explore with them how to set up their own dynamic citizen-focused great Small Supports organisation. They will need to be tenacious, pro-active, flexible, good at problem-solving and passionate about making a difference and supporting people to live a great life.

Find out more

The Lancashire and South Cumbria Small Supports team are looking for passionate people to help us do this. Get involved or find out more .

Find out more about joining the Small Supports programme and other Small Supports sites in England.

 

Amanda Topps is an Associate Consultant at Imagineer. You can read her full bio here.

Say hello to the flexible shape of Self Directed Support

The majority of commissioning for Adult Health and Social Care is still focused on fixed and outdated service models which are determined and designed by profit-making service providers; squeezing individual and often complex needs into a broken system which is no longer fit for purpose. The result is that people experiencing a complex range of challenges in their lives often fall into a cycle of crisis, knee-jerk commissioning responses, placement breakdown, trauma and further crisis. Is the person being supported in the system complex? Or does the current system propagate complexities?

These linear commissioning processes are still the norm. Yet we all know the world of Health and Social Care changes quickly. Let’s say goodbye to traditional commissioning processes and embrace a more flexible and individualised approach. It’s called Self Directed Support.

A world that should no longer exist

Traditional commissioning for Adult Social Care and Health started at a time when the world of Health and Social Care was more stable and financially predictable than today. It made sense to those holding the budgets to have a model which used universal needs analysis of geographic areas (‘misery maps’) as a starting point, and then went to the Provider market place to seek solutions for meeting those needs. Provider organisations jumped to attention. Commissioning budgets quickly got tied up in framework and block contract arrangements agreed via European tendering processes and costly procurement systems which were designated by service label, and need. Lots of ‘specialist’ provider services sprung up- ranging from small Learning Disability homes to private Mental Health ‘Assessment and Treatment’ facilities and blocks of flats for people with Dementia. Lots of little ‘Care Ghettos’ were created around the UK.

There was profit to be made. It attracted the Venture Capitalists. Their cost and volume discounts stifled the small locally-based, community provider organisations, charities and social good organisations (who existed to help people to live well, learn to self-advocate and uphold their rights, enjoy citizenship in their local communities and experience a good life). The Health and Social Care market became a place for the giant corporates. The individual receiving support was forgotten- buried under the swathes of corporate governance, regulation and cost efficiency measures.

Because of this system the very need for Self-Advocacy exists, and we see an ongoing advance of legal challenges such as Judicial Reviews for people within the system who are fighting for their rights.

But this model of commissioning and market-shaping is outdated and provides a perfect breeding ground for the deprivation and abuse of human rights of the very people it should be there to protect and serve. Ultimately, it is costly, damaging and just plain wrong.


Flexible commissioning and flexible budgets

Instead of a narrow linear path to services, support by hours and tasks; we argue for flexible budgets—based on genuine person-centred and strengths-based assessment. Rooted in the intrinsic motivation and aspirations of the person and reflecting the need for flexibility which comes with the very natural and human process of changing & evolving interests, changing needs and ageing; and we argue to support the development of community connections and cohesion. Effectively the same level of connection, choice, control and flexibility which other citizens are able to access and enjoy when they are not reliant on statutory funding and provision to lead a normal life.

We argue for a recognition that Support Plans which are designed primarily around the person’s strengths, passions and motivations; rather than need, deficits and risks are more likely to achieve outcomes long-term, keep the person safe and ultimately reduce their dependency on the public purse or the repeated cycles of crisis which result in the need for high-cost emergency interventions.

We argue for more flexibility and less standardisation. For more variety and opportunity to use budgets more flexibly in order to build good personalised support which is tailored to the individual, and fewer blue-printed service models from large provider organisations. (Who wants to live in a care ghetto??) We argue for people to hold and control their own budgets, with good support to manage them if needed. We argue for ordinary homes in ordinary neighbourhoods. Good support. More courage, kindness and respect for human rights. More value for people as citizens and fellow humans. More focus on the strength and opportunity of connected communities, neighbourhoods and localities as the starting place for finding solutions. We argue for local democracy and decision-making power for communities to develop and build what makes sense for them on a local level, rather than what is determined by decision-makers who live far away, hold the purse strings and don’t have any understanding or experience of what it is like to live in those communities.

We’re thinking of the brave ones out there who challenge the current system and embrace new ways of working and stewarding the public purse. We’re thinking about a world where everyone matters and everyone has a voice.

The future of commissioning

(Based on an image concept by @waitbutwhy)

We have a way forward

It’s called Self Directed Support. It’s actually been around for years. It’s embedded within current Health and Social Care legislation. It’s a right in law (Care Act 2014) for people to have it. Self Directed Support is where the person entitled to receive support is given clear information about their options, and a choice to use the financial resource allocated for their support (by their Local Authority and/or CCG) in a flexible way which makes most sense for them. Effectively, the person can design their own support plan. So why is it not the obvious first option?

It’s because we are still stuck with the old traditional systems for commissioning and contracting for support. We have very expensive Local Authority & Health departments and systems which are inefficient and not fit for purpose. We spend a lot of time and money on trouble-shooting poor commissioning and support arrangements which have not met people’s needs and have triggered the cycle of crisis. We have a pool of social workers entrenched in a focus on crisis intervention and budget cuts. There is no room for proactive or preventative approaches. Everybody is fire-fighting.

Let’s stop trying to re-invent a buckled wheel, calling it by a different name and expecting it to change things. Let’s be radically different.

Where are the some of the good solutions happening already?

Self Directed Support makes absolute sense- it connects naturally to all of these Strengths-based approaches. Let’s learn how to make life work well for everyone.

For more information about Self Directed Support, visit our website: www.imagineer.org.uk

To keep up to date with Imagineer & Support Brokerage Network, sign up for our mailing list.

At Imagineer, our day-to-day team consists of the three of us: Liz, Mollie & Sarah.

Imagineer team image- Mollie-Liz-Sarah

Although we didn’t deliberately set out to be a female-only team (as we do have male board members, and have had male staff working in the organisation previously); we have landed here for now, and we are a formidable trio!

We wanted to take the opportunity to celebrate our little team on International Women’s Day 2021, and also to recognise and honour some wonderful women who have influenced us and continue having an impact on our work.

Imagineer started 12 years ago with Liz, who was heavily impacted by the work of many other female visionaries working for a better world- one where everyone could be equal, recognised first and foremost as citizens with gifts and skills, rights and responsibilities. Liz’s early work in person-centred planning shaped the future direction and vision of Imagineer.

Mollie and Sarah joined the team at later points (both inspired by Liz’s work)- Mollie bringing her wonderful graphic skills, and Sarah bringing her writing skills as well as many years of collective experience in the Health and Social Care sector.

Much of the work which influenced the development of Imagineer and Independent Support Brokerage in the UK came from women such as Beth Mount, who wrote many wonderful books and developed beautiful person-centred planning approaches using creative and visual techniques. One of the approaches she is well known for is the creation of beautiful quilts which help to tell a person’s story. You can read more about Beth Mount’s work and the different resources she has developed here.

Beth Mount

                                                                                                 Beth Mount: Photo Credit to www.bethmount.org

Another key influencer of our work was the wonderful Judith Snow, who was an advocate for inclusion and one of the early pioneers of Individual Budgets and Circles of Support. You can read more about Judith’s life and work here.

 

Judith Snow2

                                                                                                      Judith Snow: Photo Credit to www.inclusion.com

Connie Lyle O’Brien (and her husband John) have taken a lead in thinking and creating new ways of relating to and supporting disabled people over the past 40 years, on a global basis. In addition to developing many of the person-centred planning systems used internationally, training thousands of facilitators and health & social care workers; they have also been authors of numerous inspirational publications and resources.

Connie Lyle O'Brien

                                                                                             Connie Lyle O’Brien: Photo Credit www.inclusion.com

Marsha Forest (& her husband Jack Pearpoint) founded the Centre for Integrated Education and Inclusion Press International. Marsha Forest was a remarkable leader, advocate and champion of inclusion for all.

Marsha Forest

                                                                                                  Marsha Forest: Photo Credit www.inclusion.com

Finally, we couldn’t let this day pass without honouring and remembering our wonderful Beth Fields who was part of our team for a number of years and who is sadly no longer with us. Beth worked hard to develop and grow our ‘Beat It’ music project which started a number of years ago as a result of the people we worked alongside expressing an interest in (and a love for) music. The people who Beth worked alongside and the musicians she supported are continuing to use their gifts and skills to bring music, life, energy and fun to the world- this is an enduring legacy which will continue to have an impact in the lives of people and communities she was involved with.

One of our core team values at Imagineer is fun, and we highly value every element of our work (past and present) which enables us to continue holding this as a value. The featured photo is a screenshot of our 2020 (lockdown) Christmas party, which we had over zoom. We had takeaway & wine, played silly games together and exchanged gifts. Mollie had made beautiful personalised hand-designed team mugs for each of the three us, which you can see in the picture!

Women over the years have been responsible for many breakthroughs in societal values, equality and inclusion. They have tirelessly promoted well-being and welfare for those who often don’t have a voice. We have much to thank women for and celebrate; and we continue to honour their legacy by building on it with our own work. Today, we want to celebrate, recognise and value all of the wonderful women we are connected with through partnering in shared vision, values and activities which help to make the world a better place. There are too many of you to mention; but we see you and we are grateful for you.

We’d love to hear about women who have influenced you and your work in relation to Health and Social Care, Community Development, Well-being and Welfare. Please do get in touch with us to share your thoughts with us at info@imagineer.org.uk

Online conference event

Yesterday (16th Feb 2021), we had the privilege of attending and sharing about our work at ‘It’s our community’ online conference, hosted by Citizen Network.

We wanted to share a short summary of the event, and encourage you to visit the YouTube channel to watch the event if you haven’t already done so.

Here’s the timetable of speakers:

Speaker list

Click here to watch the full conference or any of the individual talks.

The speakers

We heard from a diverse range of speakers all bringing their perspectives about citizenship, life in the community and how social care impacts their lives- both the good and the bad experiences. Many of the stories we heard were raw and painful. They illustrated the struggle so many individuals and families go through in order to get good support, and the vilification of those people in society who experience some of the greatest challenges.

We heard from professionals working within (and external to) the statutory systems which underpin our current social care system; and we heard some great examples of innovation, creative use of resources and stories of people and communities really being able to find their own solutions which could be cost-effective and enduring.

Liz shared how 12 years of delivering Support Brokerage to people and families had demonstrated that things could be done differently and really effectively- using resources creatively, flexibly and often at a much lower cost- by placing the resources and the control in the hands of the people and communities who needed them. The solutions to people’s needs often reside within the communities where they live. The current system is based very much on the medical model and the professional gift model- focusing on need, risk, deficit and diagnostic labels. The resources we need are already there, but need to be realigned and used in a way which makes sense to the people who need them. Our social care system is still struggling with the concept of relinquishing power and control into the hands of the people who use it. We need a radical reform of social care, where there is no charge for care to the citizen. Access to care and support should be a universal right. (2:10:50 into the conference, if you wish to listen specifically to Liz)

What we learned

The summing up of the event was shared wonderfully and articulately by Simon Duffy (Centre for Welfare Reform) commenting in response to Shadow Social Care Minister- Liz Kendall; that we need to think about what the basis of a long-term new vision for social care is. What we’ve seen for three decades is a drift- that the consensus building process has failed to bring about the changes we’ve been talking about for the last few hours (during the conference). This conference was framed as a progressive vision for social care. We first need to create a coherent attractive vision that ordinary people want. That work needs to be done by working together, particularly disabled people in the community, & civil society. Nobody is making firm commitments beyond platitudes to say this is the model we want and this is how we will fund it. It needs to be properly funded for it to happen.

The vision is not hard, but it does require real work. We can evidence this by working together, and there’s a lot we can do ourselves. The other things we ultimately need national politicians to do will be easier if we can lead the way. Let’s reinvent social care.

Citizen Network will be publishing all of the films and a report following the conference.

What do we mean, when we talk about ‘Community’?

The word ‘community’ can mean different things to different people. We can talk about community as a group of people with a shared interest or set of beliefs such as a sports club or a faith community. We can describe community as a geographic area in which people live, work and socialise. We can also use the word ‘community’ to describe a people group with a common ethnic or diversity label, a common ideology or political leaning.

For the purposes of this blog, we’re going to think of ‘community’ in three different layers:

  1. Individual level: A citizen living within their local neighbourhood and with a network of place-based and relational connections unique and specific to that person (“My Community”)
  2. Neighbourhood level: A larger group of people sharing a common geographic base, relational connections, facilities, resources and spaces; with a shared sense of ownership which is connected to that hyper-local geographic area (“Our community”)
  3. Society level: A population based on the more complex systems and values embedded within law and citizen life. (“THE community”)

Bumping Spaces- the places where community happens

Geographic communities (or neighbourhoods) are made up of a series of ‘bumping spaces’ where people congregate regularly on certain days or times of the week; and for certain events or activities. Bumping Spaces are unique to each individual community and are often the beating heart of where relational connections take place. These may be formal spaces such as community centres, libraries or GP surgeries. They may be hospitality-based spaces such as cafes, coffee shops or pubs, or they may be informal bumping spaces which take place around a particular community activity. Have you ever taken a moment to consider where the primary ‘bumping spaces’ are in your own neighbourhood? Sometimes it is surprising to discover where people congregate and where those relational connections are occurring. For example- if you ever walk past a primary school at the beginning or the end of the school day, you are likely to see a group of parents congregating- chatting, sharing stories, laughing together, commiserating each other over a poor nights sleep, and taking their children to the park to play together after school. If you ever walk in a park or countryside area, you are likely to pass many dog-walkers who stop and chat to each other, whilst their dogs play together. If you walk down a nearby canal towpath or riverbank you are likely to see barge-dwellers, boat owners and local fishermen who pass the time of day together. Community develops where natural connections occur.

How does Independent Support Brokerage assist with Community development?

In the practice of Independent Support Brokerage we often have conversations with people who are isolated and may have only paid workers and professionals in their lives. They don’t often use the phrase ‘My community’ because they don’t recognise or feel a sense of belonging to a particular community. One of the key ingredients in developing independence, resilience and wellbeing is community. Whilst we can’t prescribe community for people as such; we can provide assistance and ‘scaffolding’ to enable people to begin to develop their own natural connections and relationships- based on accessibility, interest, availability and encouragement. Often, people are held back from developing these connections, because they hold limiting beliefs about what is possible, whether they will be able to access anything, whether anybody will be interested in getting to know them, and how much things might cost.

The functions of Support Brokerage open up the conversation with the person by first understanding the essence of them- what makes them tick, what they’re passionate about, what’s important to them. What really brings them to life, what makes them smile and what they’re really good at. These early ‘discovery’ conversations  provide the seeds for discovering opportunities (often at the ‘neighbourhood’ level)- for thinking about what might be possible and how we might go about achieving it. That’s the starting point for helping people to connect to their community.

The fuel for driving these types of conversations is resourcefulness.

People who access social care or health funding for their care & support needs are often restricted to a blinkered ‘service’ based view of what is possible. Often their understanding of a good life and good support is limited to a narrow understanding of ‘time and task’ based support- such as domiciliary care visits for Personal Care or meal preparation; or perhaps attending a designated day service or activity group for people with a similar diagnosis or disability. The Care Act actually intended the conversation to move away from traditional service-based solutions, and to actually start with the person and their ‘assets’ (their home, their relationship connections, their skills and other resources available to the person- in other words, the things which are ‘strong’ and available in a person’s life); in order to develop a plan which really supports the person to have a good life, and promotes and upholds their wellbeing- helping them to be really integrated into their local community and part of the diverse group of citizens who reside there. Most of the solutions to having a ‘good life’ reside within Communities in the first place.

Find out more

About us:

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Liz Leach-Murphy Founder of Imagineer Development CiC

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

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National Brokerage Network

Do you know what your rights are under Care Act 2014?

In the practice of Independent Support Brokerage we often have conversations with people who are accessing social care support for the first time and discover that they don’t have any awareness of their rights under the Care Act.

This can make the whole process of navigating a social care assessment very tricky. How do you know what to say if you don’t know what your rights are?

The emphasis of the Care Act is on well-being and the ‘well-being principles’. It is supposed to be a ‘whole life’ or ‘holistic’ process, but often the social care practitioner carrying out the Care Act assessment focuses solely on the narrow view of individual  ‘outcomes’ rather than the overarching well-being principles; meaning that they may not focus on the correct areas of life where the person needs most support.

It can often mean that the focus is taken completely away from the factors of a person’s life which determine their well-being, and therefore resources or services provided by Adult Social Care to meet that perceived need are just not a good fit for the individual.

It’s a little bit like talking to a mechanic about the problem with your car, then at the end of the conversation finding out that the mechanic knows all about motorbikes but not much about cars at all.

The well-being principles

So let’s look at the well-being principles first:

These are the principles (enshrined within law) which are recognised as the determinants of well-being, in relation to Social Care eligibility.

Care Act eligibility

When a person requests (or is offered) a Care Act assessment, their eligibility for support is determined by the following criteria:

Care Act outcomes

The ‘outcomes’ specified under the Care Act are:

Your rights

Anybody can ask for a Care Act assessment, and they should not be told that they are not eligible for support under the Care Act unless an assessment has taken place. In some areas of the UK we have seen ‘screening’ assessments being used by some Local Authorities as a way of filtering people out for assessment, but this is not within the guidance (or the spirit) of the Care Act. We have also heard from people we have worked alongside, where they have had a telephone conversation with a social care practitioner (such as a social worker) without any awareness that an assessment was being carried out, and have later discovered that their assessment took place over the phone. Most people would be unaware that they can challenge this.

There is little information shared within the public domain, and in accessible language- which explains people’s rights simply and helps them to navigate the assessment and support planning process. For example- most people would be unaware of their right to lead on conducting their own assessment (should they wish to) and to gather and share the information which goes into the assessment themselves. Could this be due to suspicion from Local Authority officers that people may abuse the system or manipulate information in order to secure support? Or is it due to Social Care departments being so stretched that they are being forced to adjust their practices around assessment and support planning to ensure minimal admin burden and lower uptake of resources?

Again- many people are not aware that they have a right to request a copy of their completed Care Act assessment and to request amendments to any of the information that is inaccurate (or missing) from it. There is often a delayed response when such a request is made; or when the assessment is shared with the person it is clear that there has been poor evidence capture and complete lack of detail- often by a practitioner who has not spent any meaningful time with the person they are assessing in order to understand their individual circumstances thoroughly. Could this be due to overstretched caseload and lack of capacity with social workers? Is this impacted by the person being uncomfortable disclosing personal information and details about their individual circumstances to a complete stranger? Could this be due to poor assessment skills, or a deliberate way of managing a very stretched resource?

Finally- at the conclusion of the assessment process, if the person has met the eligibility criteria there should be a clear discussion about the ways the person is entitled to receive support via a Personal Budget. Often, the person is only made aware of the option of a commissioned provider service (such as domiciliary or residential care) or a Direct Payment. Often people are talked out of the Direct Payment option by being told it will be stressful and burdensome to manage. Practitioners carrying out the assessment may not have the full complement of knowledge, insight & skill to help the person navigate their entitlement to support in the way which makes most sense for them individually.

Find out more

In our next few blog posts, we will be expanding on this area of thinking further. If reading this blog post has made you question your own level of knowledge and understanding in relation to the Care Act and people’s rights, you may be interested in joining our Quick Bite for Lunch webinar series on  ‘Rights’ which is starting on Weds 20th January 2021 at 12.30pm.

We’ll be exploring the whole area of ‘rights’ in relation to Social Care and Health assessment- sharing our professional  experience of supporting many people through the Care Act assessment and Support Planning process in different Local Authority areas across England over the past 10 years.

There will be an opportunity for participants to share their personal experiences and ask questions too.

Visit our ‘webinars’ page for more information or email us: info@imagineer.org.uk to request a booking form.

About us:

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Liz Leach-Murphy Founder of Imagineer Development CiC

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

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National Brokerage Network

What a year!!

Here’s our year in review. Looking back over 2020 it is easy to be drawn into endless conversations and reflections about the Global Covid-19 pandemic- how it has changed life and society. Whilst it has had a significant impact and influence on our work at Imagineer and the National Brokerage Network this year, it’s also important to step back and review our year from the wider perspective. At the beginning of the year, Imagineer was functioning as a locally-based organisation in West Yorkshire, delivering support brokerage and brokerage management (mainly on a local level); and our training offer mainly focused on the delivery of support brokerage training and person-centred approaches which was delivered in person as classroom-based training.

2020 year in review

Before the pandemic….

We started the year by being added to the Think Local Act Personal (TLAP) directory of innovations in community-centred support, for our work on Support Brokerage and Self Directed Support. We became involved in the Social Care Innovation Network and were invited to participate in the Action Learning Set for Self Directed Support. We attended a number of sessions in London for the Action Learning Set and helped to develop the SCIN toolkit for providers and commissioners. The last session we attended was in March just before the first national lockdown started. Elsewhere, we had begun to have some exciting conversations about innovative projects, partnership working with like-minded organisations and new consultancy work. We had 2 social work students on placement with us alongside the Imagineer staff team. We were really excited to get stuck in.

When lockdown began…

With the national lockdown in full force at the end of March, we knew that we needed to make some decisions to ensure the continued stability of Imagineer and the National Brokerage Network. All of our activity was moved online, via zoom platform. We began experimenting with and developing new ways to connect with people, provide support and deliver training and consultancy. We developed and shared a ‘support your street’ pack for people who wanted to offer help and support to their neighbours during lockdown. We set up and ran weekly ‘brew crew’ online coffee morning sessions as a way to keep some of the people we work alongside connected and socially engaged. These sessions proved really popular, and the topics and activities for each week’s session were planned by the people who attended.

Doing things differently, and working in partnership

Alongside the need to change the way we were working due to the global situation; we had been developing our business plan to shape the future direction of Imagineer and National Brokerage Network. The business plan took a different direction as we realised that the need to deliver our work online was likely to be a long-term change rather than a temporary response to the Covid-19 pandemic.

We worked alongside Andy Peers to develop our plan, and brought in a number of other partners along the way to help us achieve our objectives. Pivotal have helped us with the development of our website and e-learning platform, Yolk Marketing have been helping us to develop our marketing plan and Pat Bannon has been instrumental in helping us to develop new film content to showcase our work. We developed our digital and technical skills, widening our use of software applications and digital technology to enhance our work online. We were also very happy when Alan Hiscutt accepted our invitation to join our board of Directors as Chairperson earlier in the year, and also Aarron Cammiss who has joined us as a Board advisor. The board of Directors have been focused on steering Imagineer & NBN through the challenges of the Covid-19 pandemic and ensuring we have a stable foundation for us to continue our work into 2021, and beyond. We are very grateful for their wisdom and experience. The input, support and resources provided by all of our partners this year have been so significant in our journey and we would like to thank each one of you who has been involved in the process.

The re-development of the website afforded us the opportunity to review the way the National Brokerage Network was structured, including our membership structure. We have been very busy re-developing the ‘find a support broker’ function on the website and building the organisation directory for our partner organisations. We look forward to seeing the NBN membership growing in 2021 as more people complete their Support broker training and accreditation.

Liz and Sarah began to develop online training content, webinar topics and thought leadership work- leaning into our connections with Citizen Network, Centre for Welfare Reform and other partnership organisations. We dedicated time to develop our networks, connections and relationships to build on our knowledge of what is happening in the health and social care sector; and in the wider conversations about citizenship, communities and welfare. We also embarked on some new project-based work which was enabled via grant funding from The Longleigh Foundation, Imagineer Foundation (Supported by Peoples Postcode Lottery), Calderdale Community Foundation , Charities Aid Foundation, REACH fund, Awards for All and YOR4good. We are also grateful to Beware of the Bull for their support with grant funding applications. We hope to be able to share more about these projects in 2021 as we pick up pace again following the restrictions we have experienced in 2020, due to the pandemic. We’re extremely thankful for the grant funding we’ve received this year enabling us to develop our business model to online delivery and enable the future sustainability of Imagineer and National Brokerage Network.

In the background, Mollie has been working hard to develop our Graphic Facilitation services, online Graphic Facilitation Training and a graphic bank of images for our website, social media and training content; alongside producing some fabulous visual content for different projects we have been working on. Mollie’s unique and distinctive graphic style has become our ‘visual language’ as an organisation, and has brought really vibrant colour and depth to our work- we are very proud! Our favourite pieces of work this year have been where the three of us have collaborated together, bringing each of our skills in training delivery, facilitation, writing and graphicing to provide a dynamic, inspiring and creative experience for the people and organisations we have been working with; and to share our work with wider audiences. Each of us have also continued to work alongside people and families in delivering Independent Support Brokerage and Brokerage Management support in order to underpin our ongoing knowledge and experience as practitioners.

Developing our work and extending our reach

In June, we presented a webinar in association with Centre For Welfare Reform & Citizen Network, entitled ‘exploring the strength of community’; and a few months later, we published a detailed paper via CFWR to complement this.

Later on in November, we wrote and published a further paper entitled ‘what does good look like?’ documenting over 10 years of Support Brokerage delivery and sharing stories of what has worked well, through the eyes of people we have worked alongside. In November, we also began our first ‘quick bite for lunch’ webinar series– designed as short practical sessions which people could attend for 30 mins during their lunch break. We wanted to create an opportunity for networking, staying connected and sharing good practice and creative ideas. By this point in the year, people in our networks had been working from home for many months, and we recognised the importance and value of being able to connect with others informally as an opportunity to reflect and explore new ways of doing things. The sessions were great fun, and well attended. Each session, we would start with a short opening presentation on the topic, followed by time to share stories and ask questions- whilst eating lunch together! We also provided a tool or resource at the end of each session for people to take away and introduce in their work. Our first series focused on person-centred approaches. We will be continuing with these in the new year, and have already developed the content for the next few series! You might want to keep an eye on our webinars webpage for information about new ‘Deep Dive’ and ‘Thought leadership’ webinars we are developing for the new year too!

Towards the end of the year, we had begun receiving invitations to share the work of Imagineer & NBN into regional and national events relating to welfare reform, personalisation of health & social care, strengths-based approaches and community development. We have had some really encouraging and thought-provoking conversations about re-thinking systems and processes which have become ‘stuck’ and we’re really excited to see how these conversations will progress in 2021. Our heart is to see a growing movement of people and communities really in the position to determine how they can become stronger and more connected.

Looking back and celebrating how far we’ve come

In early December, we released our video ’10 years of Imagineer’ documenting our activity and achievements as an organisation over the past decade. The video was produced by Pat Bannon and we are very grateful for his support with helping us to create this brilliant record of our work so far.

By the end of this year, we will have delivered a total of 6 accredited support broker training courses and over 36 new people trained in Support Brokerage, many of whom have now become members of the National Brokerage Network. We have also delivered some bespoke training to organisations and we have begun engaging with a number of exciting community-based consultancy projects with 4 new organisational partners we are regularly delivering consultancy work and training with. We are also regularly providing mentoring to people practicing Support Brokerage.

Looking towards the future

Our 2021 diary is already looking very busy and we are so excited to see the impact of our work on the development of Self Directed Support and community-centred approaches in different areas around the UK and beyond.

We know that this year has been a difficult and challenging one for many people (ourselves included) and there have been many losses and sacrifices along the way, but we are so very thankful for the opportunities and development we have seen as an organisation this year. We’d like to acknowledge and thank those people who have travelled with us this year through various stages of the journey, including those who are now on their own different journey whilst we continue to pursue ours.  We’ve made some great new friends (as well as strengthening connections with old friends), collaborated on some brilliant projects and had some really exciting conversations about doing things differently. We remain firmly committed to our social mission “to facilitate an empowering society and culture that supports people to live their best lives” and this remains the benchmark for all of our work.

We wish you a peaceful Christmas season and we look forward to 2021 with hope and excitement for the opportunities, connections and partnerships ahead.

Team Imagineer- Liz, Sarah & Mollie

 

What does Support Brokerage look like in practice?

When we’re delivering training or webinars about Support Brokerage we often explain it using the analogy of a car and a journey.

The car

The car represents a person’s life. The person is the driver of their own car. This represents the core principle of Support Brokerage, which is that the person is in the driving seat.

In other words, as Support Brokers- in all of our practice and interactions we are continuously revisiting the principle that the person we are working alongside is taking the lead in making decisions about their life- where they want to be going, what they want to be doing, how they want to be supported and who will be involved. This is a core principle of Self-Directed Support.

Now to continue with our analogy, all cars need fuel for the journey.

The fuel & the Support Broker

 

Some people need assistance with putting ‘fuel’ in their car. This is where the Support Broker can become involved. Support Brokers are multi-skilled individuals who come from a range of different backgrounds. They have knowledge and experience which they can bring to assist the person they work alongside. Support Brokers can be people with lived experience, people who have worked in the Social care sector, Health professionals, Housing professionals or Community/Third sector workers. The Support Broker brings their range of skills, experience and knowledge, and uses this to assist the person with adding ‘fuel’ into their car. The ‘fuel’ we see in the image is referencing a range of different ‘strengths-based’ approaches which a Support Broker can lean into as they are working alongside the person to assist them with achieving their objectives.

The term ‘Support Broker’ is neither a job title, nor a job description, because the tasks which a Support Broker carries out will vary with each person they work with. Remember that the person is in the driving seat, and they will determine the remit and involvement of the Support Broker.

Now that the fuel has been added to the car, it is ready for the journey.

The journey

Remember, the person is in the driving seat. Once they have fuel in their car, they may decide that they need no further assistance from the Support Broker and decide to continue the rest of their journey independently. However, they may require some support to plan their journey and/or navigate the various destinations. In the image below, you will see that there is a passenger in the rear seat of the car. This is the Support Broker, who is holding a map and calling out directions- all the time acknowledging that the person is still in the driving seat and they are in control of the journey. At any point, the person could ask their Support Broker passenger to get out of the car!

For some people, they may have multiple ‘passengers’ in their car- these may be close family members or friends & members of their local community who are very involved in the person’s life; alongside the Support Broker who is also a passenger. We sometimes refer to this (or formalise this arrangement) as a ‘circle of support’. The principle of ‘passengers’ and the person in the driving seat still applies.

The journey of Support Brokerage may include visiting one or more destinations which help to bring the person closer to achieving their objectives. These include the ‘keys to citizenship’ of: Life, Love, Help, Purpose, Money, Home and Freedom.

The Support Broker may be tasked with carrying out specific actions as part of this journey, which could include person-centred planning, support with navigating the social care or health assessment process, identifying resources which help to achieve the person’s objectives and developing a support plan. The range of tasks is broad and should not be defined as an exhaustive list.

As with any journey, the longer we spend in the car and in the driving seat; the more confident we become and the more skilled and experienced we become at driving the car. This is also true of the input of a Support Broker. As the person becomes more confident and skilled at advocating for themselves, knowing and understanding their rights and being able to take the lead in discussions about their own support, the Support Broker is able to step back with the aim of not being needed at all in the end. For some people, it may be that they will always need some element of involvement from their Support Broker, but this should never be assumed and should regularly be revisited as a conversation with the person about how they feel things are going and how confident they feel about doing things independently.

Are you interested in finding out more?

Imagineer offers a range of training & mentoring services to support the knowledge and practice development of practitioners; and also to help people to know and understand their rights. Our next Support Brokerage course is running in February 2020.  Consider signing up for our ‘Quick bite for lunch’ webinars which explore practical ideas taken from Independent Support Brokerage. These practical approaches can be embedded within your practice. We are also planning a series of ‘Deep Dive’ webinars for the new year, which will be advertised on the ‘Webinars’ page of our website.

You can also subscribe to our mailing list if you would like to be kept up to date with what we’re doing.

If you can’t find what you’re looking for on our website, please send us an email: info@imagineer.org.uk

About us:

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Liz Leach-Murphy Founder of Imagineer Development CiC

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

Follow us on twitter

Find us on Facebook

Find us on LinkedIn

National Brokerage Network

It’s quite common to hear about ‘person-centred approaches, ‘choice and control’, and ‘self-directed support’ in Adult Learning Disability and Autism services; but we don’t often hear about innovations and personalised approaches in the delivery of older people’s care and support arrangements.

Imagineer has been delivering training in person-centred approaches including support brokerage for many years; and recently we were approached by a forward-thinking provider organisation in Devon- Love2care

This organisation provides home care support services mainly to older people across the Torbay area of Devon. They are rated as ‘outstanding’ by CQC and have a really unique, creative and personalised approach to the way they deliver their services.

Traditionally there are 3 main types of service model adopted for the care and support of older people:

The founder of Love2care Devon- Maddy Bird was keen to train her staff team in the principles of self-directed support and to develop their skills as Support Brokers so that they could really open up the way they supported their clients both at home beyond the traditional models of support, and also when there were any transitions into a hospital environment or a change in their care and support needs. Love2care commissioned Imagineer to deliver the full accredited Support Broker training to an initial group of staff at the organisation. Due to Covid-19 restrictions, the training was moved to online delivery, via the Zoom platform.

Maddy talks below about their experiences of doing the training and the impact it is making on their work as an organisation:

Love2care has people at the very heart of the service, and when we talk about ‘people’ we don’t just mean the person we are caring for.  We mean them –  absolutely, but their loved ones also – the carers who provide paid and unpaid support. We also value our team and employees, as people. We focus on getting to know what matters most on an individual basis – not just feeling like we are completing a set of tasks for someone; but that we are facilitators and part of a support system, as advocates, listening ears, and objective eyes.

I often say to people that Love2care is a person-centred organisation, because although we may be juggling a lot of changes or difficult situations; we are disciplined in our practice, ensuring that others don’t feel that strain. We are careful to ensure that people feel listened to, heard and valued. We then support each person to look at ways to address what it is that they want to achieve.

Our service is very much focused on building & maintaining positive relationships, and having clear boundaries.  We work hard to avoid getting caught up in bureaucracy. We truly try to work with the people we support, so that they can live the life they want to. For me, the word ‘facilitators’ is very apparent within the organisation.

My work background prior to Love2care was in a corporate organisation, and my role was ‘brokerage manager’ – working under a ‘prime provider’ framework with my local authority. I loved being able to help secure care and support for people, but what I quickly realised was just how ‘un person-centred’ the processes were. I felt that (for me) care has been a vocation, and a journey, and yet throughout my career I was starting to come further and further away from the person. I was brokering care and support for people whose names I didn’t know, as it was done via an excel spreadsheet. For me, this just wasn’t ok. 

I felt that I needed to do more.

I then established Love2care, and through my work, I have just always had a passion for changing that experience. I have been able to do that via Love2care in some areas, but I then had a vision that my team around me would have the competence and the desire to support people more, enhance their lives, and also have meaningful conversations. 

I think within our service we regularly felt like we had more to give, but less autonomy through local authority contracts. We equally wanted to support our local community – so there were definitely feelings of restriction and limitations in our role. I developed an idea using support brokerage, and using our CQC registration, which explored a new model of care offering the potential to free up social care time and resources; and work in a much more personalised way with people to self-direct their own support.  

We really enjoyed our training. There were a couple of things for me, firstly being able to invest in my team to develop them personally and professionally; giving them a skill set and knowledge base that not all front-line social care staff have the opportunity to normally receive. The training is giving them the confidence and competence to be able to have more in-depth conversations, and autonomy to look beyond a task list for people.

Secondly, what I also took away really positively was that our care and supporting planning was really person-centred already. Recognising that as a home care provider, we had the resources and we were utilising them; but through completing the training we were able to go deeper. I now have more resilience and flexibility within the service, to offer people we may not necessarily need to provide with direct support, but to offer them a brokerage service that means they are feeling heard, and that they can self-direct their own support.

My staff team have the autonomy and confidence to go beyond the norm. They understand how to look at different resources, so people remain independent for longer. Even just our conversations as a team have changed – I feel that we have given people more choice and control – allowing them to make the decisions they want for their lives.

Our local commissioners are really enthusiastic about us thinking differently. We are looking at developing Individual Service Funds (ISFs) within our local teams; however, due to the restrictions of Covid (and now heading into winter pressures), I think there is some delay – even though in one sense and in an odd way, I also feel that because of Covid – we are years ahead.

We will keep doing our thing, and hope that people see that a new model of care could really make a difference.

Surely we have to try?

Are you interested in finding out more?

Imagineer offers accredited support broker training, mentoring and other training/resources relating to self-directed support and strengths-based approaches regularly throughout the year.

Visit our explore our website for further information which can be found under the drop-down menu heading ‘What we do’’ for further details, and subscribe to our mailing list to be kept up to date with future training dates. 

To find out more about the work of Love2care- Devon, visit their website: https://love2care.uk/about-us/

About us

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

 

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC.

Maddy Bird has worked within Adult Social Care for 10 years, in various roles from Community Carer, Care Coordinator, Brokerage Manager in a prime provider commissioning model, and is now founder and leader of an Outstanding Rated organisation, Love2Care Devon – established in 2017.

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How can a person experience real choice and control to implement good support which works well for them; in a system where professionals and provider services hold all of the power?

Let’s look at an example:

Harry is a young adult who has been in the Health and social care system since he experienced a crisis at home with his parents. There had been a number of significant changes in his life to college, community-based activities and natural relationship-based support from people he knew well in his local community. These changes had removed all of the structure and familiar routine Harry needed to function well. Harry found all of the changes really difficult to cope with which resulted in him becoming highly anxious and unwell- eventually being admitted to hospital under the Mental Health Act.

From the beginning, there was a focus on the ‘mental health’ symptoms which Harry was displaying and no acknowledgement of his underlying needs; and (critically) his Autism diagnosis. As a result, Harry then spent several months bouncing between hospital units, the family home and inappropriate provider placements which did not understand how to meet his needs, as his anxiety levels continued to escalate. On a number of occasions, the local police had to assist in ‘subduing’ Harry and physically escorting him to the local A&E department (often causing physical injury and further distress to Harry).

Harry began to be labelled by health and social care professionals as ‘complex’ and ‘challenging’.

Multi-disciplinary meetings involving many professionals to discuss Harry’s support took place without involving Harry or his parents. Very few of these professionals who were making decisions about his future had ever actually met Harry in person! Harry’s anxiety continued to grow because he was not clear about the plan or the options for his future.

While this was happening, Harry had a change of social worker and moved to a new provider placement. Harry’s new placement was out of the local area – far away from his home community, his family and his friends (and definitely too far for Harry to access his home community without planned support to get there). It was intended to be a short-term placement while something closer to home was identified.

After Harry moved, the social worker and the support provider began to tell Harry that he would stay there long-term and that there were no options to return home to his local community. He was told that he should be grateful that there was a place for him to stay! Harry’s desperation increased as he did not feel safe or understood by those who were responsible for his well-being. The social worker and provider organisation actively discouraged the involvement of Harry’s parents (who had been advocating in his best interests the whole time) in meetings to discuss his future support; stating that Harry was an adult now and could make his own choices. Despite this, Harry was still not invited to his own meetings! Information shared with the new provider by the parents about Harry’s processing, communication and sensory needs were dismissed. The parents were made to feel like they were being a nuisance, and were very concerned that they were not being taken seriously.

Harry’s story is real (the details have been changed for anonymity). Sadly, this is not an isolated example.

At Imagineer, we are often approached by people or family members experiencing very similar scenarios of having no power and no voice to influence how their care and support is arranged – often with extremely damaging consequences to their psychological, emotional and physical well-being.

What is wrong with the above scenario?

  1. Harry was not involved in any of the meetings or given the choice, or appropriate independent advocacy support to be involved fully. His parents were blocked by professionals in the Multi-Disciplinary Team (MDT) from having any involvement in decision-making.
  2. Harry was told by his social worker about what he could have as a commissioned service (without any reference to other Self-Directed options). It wasn’t presented as a choice. The service provided to Harry was from a ‘framework’ contract/approved provider list selected by the Local Authority commissioning and procurement process- no consideration was given to other options that Harry could consider outside of this process.
  3. Harry was placed with a support provider away from his local area, far from family, friends and local community connections – he felt isolated and scared.
  4. The failure by the MDT and the support provider to recognise Harry’s communication support needs and to understand how he processed information and made decisions, further impacted on his anxiety levels and led to him being further labelled as ‘challenging’.
  5. The process of arranging Harry’s support took place without any acknowledgement of Harry’s autism diagnosis and without any reasonable adjustments which would help him to feel in control and understand his choices.

What should be in place to help people like Harry and his family to experience real choice and control and to ensure that professionals and provider services don’t hold all of the power?

  1. Care Act 2014/Children and Families Act 2014 guidance states that the Local Authority should involve the person and their family throughout the whole process – professionals should listen to and take on board information provided by the person and their family/representatives.
  2. Advocacy – the person should be given an opportunity to involve somebody (whom they choose) to be their advocate. If they don’t have anybody who can act in this capacity, the Local Authority has a duty to provide this service. The advocate should act independently of the Local Authority and in the best interests of the person.
  3. Independent information, advice and guidance/signposting/navigation through the social care process should be available – Harry and his family should have been given clear information about all Personal Budget options without any feeling of pressure or underlying agenda to choose a particular option.
  4. The social care process should be worked through logically to support the identification of a Personal Budget option which gives maximum choice and control (Eg. Direct Payment/Individual Service Fund) – Harry should be able to make an informed decision about the best Personal Budget option for his circumstances. No professional should make this decision on his behalf unless there is a concern about Mental Capacity or Safeguarding which has been assessed and documented.
  5. Support Brokerage input could be accessed by Harry and his parents to research, cost and broker a package of accommodation and support which works for Harry so that they are able to make an informed choice which is not externally influenced.

Are you interested in finding out more?

Imagineer offers a range of training and mentoring services to support the knowledge and practice development of practitioners; and also to help people to know and understand their rights.

Visit our training pages which can be found under the menu heading ‘What We Do’ for further details; and subscribe to our mailing list to be kept up to date with what we’re doing. 

 

Further reading:

To keep up to date with citizen’s rights in relation to the provision of advocacy and involving those people who are close to them when planning health and social care support; refer to:

About us:

Liz Leach-Murphy Founder of Imagineer Development CiC Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Sarah Holmes, Co-Director at Imagineer Development CiC Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

Follow us on twitter: @imagineercic

Find us on Facebook: https://www.facebook.com/ImagineerCiC

Find us on https://www.linkedin.com/company/imagineercic

 

How can you make an informed choice and be in control of your life when you don’t understand what your choices are?

Let’s imagine you’re visiting a friend for dinner, and at the end of the meal, they get their box of ‘Celebrations’ out. (Apologies for the English chocolate reference if you are reading from a different part of the world where these are not available….Celebrations are a box of chocolates with a random selection of miniature varieties of chocolate bars).

The box is already open and it appears that there are only two options left- the ‘Bounty’ sweets and the ‘Milky Way’ sweets.

You really want some chocolate and neither of those brands would be your favourite. But because that’s all you have to choose from, you go with a ‘Milky Way’. Sound familiar?

Now imagine a different scenario where you visit your friend for dinner and they bring out a brand new unopened box- with all of the different varieties to choose from. Would you still choose the ‘Milky Way’?

I know I wouldn’t!! (It would either be a ‘Galaxy’ or a ‘Teasers’ sweet for me).

When one or two options are the only choice you’re given, that’s what you’ll choose from. You might not even think that you have a choice! Maybe you have been told that there isn’t a choice and you should be grateful for what you’re being offered!

What happens when you have the whole range of brands available? Would your choice be different? Probably!

It’s the same with choosing care and support options for planning, arranging and implementing Health, Social Care and Welfare support. Many people are only told about one or two options at the point of assessment. Some people aren’t told that they have a choice at all – they are simply told what they can have.

This simply isn’t right. The Care Act 2014 outlines the range of options available to a person who has been assessed as eligible for support.

So often, people aren’t made aware of their rights when accessing Care and Support.

So how do we help people to make informed choices?

Are you interested in finding out more?

Imagineer offers a range of training & mentoring services to support the knowledge and practice development of practitioners; and also to help people to know and understand their rights.

Visit our training pages which can be found under the menu heading ‘What We Do’ for further details; and subscribe to our mailing list to be kept up to date with what we’re doing.

Further reading:

To keep up to date with case law and to improve your legal literacy in the area of Health & Social Care law, visit:

Luke Clements website

Cascaidr Website

About us:

Trainer, Support Broker and Community Consultant Liz Leach-Murphy Founder of Imagineer Development CiC
Liz Leach Murphy

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space

Sarah Holmes

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a test bed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training & consultancy services in Support Brokerage, Person-Centred and Strengths-Based Approaches.

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