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.
Imagineer supported a lady who had been identified as eligible for social care support. She was supported by the direct payments team from her Local Authority, but the social worker refused her a direct payment on the basis they did not believe she could manage the arrangement. This resulted in a commissioned provision being identified. The provider of the commissioned support focused on meeting contractual requirements and was not prepared to meet the woman’s needs in a personalised way. The provision broke down on two occasions. A new social worker began working with the lady and arranged for a new provider to meet her, without having a conversation with her about who she wanted to be supported by.
When the lady raised the fact that she wanted to explore other options available to her, the social worker ceased the direct payment, and she was left without support. Imagineer supported the lady to make a complaint via the Local Government Social Care Ombudsman, which was upheld and resulted in the social worker offering to carry out a new assessment. The lady refused because the whole process had been so traumatic. She decided to self-fund her own support in a way which makes sense for her, so she has self-funded a cleaner to help her with domestic tasks, and somebody to take her shopping. Imagineer provided Support Brokerage through each stage of the process until she reached the solution which made most sense for her.
If you’re interested in the range of ways in which Support Brokerage can assist Self-funders in arranging their own care & support, please contact us at: firstname.lastname@example.org
It’s #socialworkweek2022 and we wanted to take some time to acknowledge and reflect on our work alongside social workers over the past 12 years at Imagineer.
Prior to the Covid-19 pandemic, we regularly took social work students on placement from 4 different educational institutions: Huddersfield, Bradford, Leeds & Bradford College.
It was really interesting watching the journey in the thinking and understanding of the social work students. At the beginning of their placement, some students would struggle to understand how they would be able to meet their placement requirements because Imagineer was not carrying out statutory Care Act Assessments; but after completing the Support Brokerage training they would begin to understand how a knowledge of the legal frameworks and the Personalisation agenda enabled them to support the people they were working alongside in a far more flexible, creative and person-centred way; enabling people to have more choice and control and to self-direct their care and support arrangements as well as developing their social connections, skills and ability to self-advocate. Support Brokerage is about far more than social care.
One of the interesting things we learned was that there was quite a difference in the course content and social work training between each university. Each student undertook the Support Brokerage training, the Person Centred planning training and the Graphic Facilitation training offered by Imagineer, giving them a great grounding in Strengths-Based approaches.
During their placements with us, some students led on different projects such as mapping accessibility around the town centre; Supporting and enabling people to participate in Voting; and Equality training. All of the students had an opportunity to join in with the ‘Beat It’ project, which was a music project set up by and determined by some of the people accessing support from Imagineer- a result of listening and determining how people wanted to spend their time and develop their skills. The students began to appreciate that by spending time with people while they were doing things they loved and following their interests- they learned a lot more about the person and understood far more about what good support could look like. They began to see creative ways of building the right support around people which enabled them to thrive and experience authentic citizenship within their local communities.
One of the principles we instilled in our student social workers was about working together and alongside each other as allies- drawing on each others skills, knowledge and experiences to enable the best outcomes for the people we were supporting.
We have worked alongside many brilliant social workers as allies- supporting the people we work alongside to get to a better place in their lives. We want to thank all of the wonderful social workers who are finding creative, flexible and person-centred ways of supporting people to live good lives, receive good support and experience overall wellbeing; recognising that enabling people to be in the driving seat of their own lives as well as their own care and support arrangements is absolutely the right thing to do.
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.
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) has been involved in developing Small Supports projects in a number of areas.
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.
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.
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..
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.
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.
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.
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.
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.
(Based on an image concept by @waitbutwhy)
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 ICB) 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.
People with life-limiting and life-threatening conditions face many barriers in accessing the right support to get the best quality of life and to achieve the outcomes that matter most to them. This is the case not just for health and hospice care — including the delays in referral to hospices and palliative care services and the hesitancy of people and families in accessing these services — but in terms of accessing equipment, psychological and social support, peer support groups, understanding financial entitlements, and other activities and support sources that exist in their community.
Support Brokerage has a very clear ‘person focus’, doing what needs to be done to support people to get to where they want to be in life. Support Brokers work alongside people who are experiencing complicated or challenging life circumstances. They act as independent facilitators, supporting people to plan to live the life of their choice- working directly for the person and supporting them to stay in control, to understand and explore a whole range of opportunities and to confidently take action to achieve their desired outcomes.
The ultimate aim of Support Brokerage is to see people taking full control of their own lives.
We know that people with life-limiting conditions don’t have time to waste; every moment counts in your life, as you live with a limited lifespan. You want to focus on living well, doing things that you enjoy, making memories, spending quality time with those you love, and to achieve that, having good symptom control, the support of services that treat you as a unique individual, accessing benefits, homecare and other entitlements, and all your professionals working together, communicating effectively and sharing information to reduce the burden of health- and care-related admin.
You may have very little time to come to terms with your situation and so you may suddenly be thrust into a new world, a world that speaks a foreign language and seems far too clunky and complicated when you just want to receive the things you need, see the people you need to see and get on with living.
You become a “patient” and your family members instantly become “carers”. This can be tremendously traumatic, on top of the trauma of the illness and its effects on your health, body, abilities, appearance and identity.
Liz Leach (Imagineer Development UK CIC), and Lucy Watts (Lucy Watts Ltd and Lived Experience Learning Ltd) are hosting a webinar on 15th September 2021 (10.30am-12pm) to discuss what gaps exist in the support of people with life-limiting and life-threatening conditions and their families.
We want to explore with people what the gaps are that exist, what difficulties they face, and for us to then see how Support Brokerage can bridge these gaps and provide additional support to get the best quality of life, the necessary care and achieve the desired goals
and outcomes for people facing these conditions.
We want to understand from people with such conditions and family members what can be done to improve their lives and experiences. The webinar will be an opportunity to explore what Support Brokerage is and how it can help people; as well as provide a space for feedback and discussion to gather people’s lived experiences- mapping out what works, what doesn’t and where improvements can be made — and what additional support is needed to achieve these improvements.
Liz is an experienced Support Broker and the Founding Director of Imagineer, with a long history of work in Health and Social care- particularly Self-directed Support and Person-Centred approaches.
Lucy is a Support Broker, Independent Advocate, Consultant and Facilitator who lives with a life-limiting condition, extremely complex medical needs, and accesses hospice and palliative care services.
Meet Angie….she’s been an Occupational Therapist (OT) for 30 years, working in NHS and (more recently), independent OT roles to support people with developing and maintaining their independence and well-being.
The introduction of Personalisation within the Health and Social Care sector made absolute sense for Angie and resonated with her value base and skill set as an Occupational Therapist.
Angie began to explore ways of helping people to take control of their own lives within her work as an OT; and her exploration led her to reading about the concept of Independent Support Brokerage. She began to recognise that her formal OT approach fitted more with the ‘Professional Gift model’, than the ‘Citizenship model’ (which was the approach followed within Independent Support Brokerage). Angie completed her training with Imagineer as an Independent Support Broker, and she joined the Support Brokerage Network (formerly known as National Brokerage Network), which is a community of practice for Independent Support Brokers and organisations who implement the values and approaches of Independent Support Brokerage within their work.
Angie has written a detailed article about her own individual journey in becoming a Support Broker; in particular- the story of one young man whom she has worked alongside to Self Direct his own support. Angie now uses her professional skill set as an OT combined with the skills and approaches of Independent Support Brokerage to offer personalised, bespoke and enabling solutions and ideas for people to lead their lives in a way that truly makes sense for them:
You can read Angie’s full article here.
You can read more about Support Brokerage here.
If you’re interested in the work of Imagineer; and would like more information about what we do and how to get involved, you can sign up for our mailing list & monthly newsletter here.
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:
Click here to watch the full conference or any of the individual talks.
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)
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.
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 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.
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.
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.
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. For further details, visit 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.
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We connect with the world around us via People, Places and Opportunities. People who receive Health and Social Care service-based support often have limited networks which mainly consist of paid workers, professionals who are in their life on the basis of their label or diagnosis, and limited friend/family involvement. The potential and momentum of people’s relationship connections can really begin to unlock opportunities; which do not reside within formal statutory or service-based provision.
A key aspect of Independent Support Brokerage is exploring people’s connections. Not only does this help us to establish who the important and significant people in a person’s life are; but we can begin to identify opportunities to build further connections through which relationship ‘chains’ can be created. This approach can provide a springboard into new networks, communities and opportunities, helping to reduce dependency on statutory provision which is often very costly and exists on the basis of a financial transaction rather than a relational connection.
Supporting people to identify and develop their connections can result in an enriching experience for all involved, and can help to develop community-based resilience over time.
Who we know, and who they know!
Where we go and who we might bump into or develop a connection with when we’re there!
What we’re interested in, which we might have in common with other people we could then form a connection with on the basis of shared interests, skills, passions, hobbies or beliefs.
One particular way we can support people to identify and develop connections is through using an approach called ‘community treasure chest’.
The focus of the approach is the principle that individuals within groups of friends/neighbours, a circle of support or small community-based grass-roots organisations all hold ‘treasure’ which can be gathered to share with the group; and this ‘treasure’ provides points of connection which enable them to achieve outcomes & objectives.
As individuals within the group, you each take turns to share information about people you know who may be useful for others to connect with; your passions, obsessions & interests; your skills, training and knowledge; and something you are interested in learning about or doing. By doing this, key information is gathered which can then inform action planning, support planning or even business planning.
In the scenario where a Support Broker is working alongside a person to help them self-direct their own support, they can use this approach to build on the information they have already gathered about what the person is interested in; their hopes, dreams and aspirations. This helps the Support Broker to identify where connections can be made from the person’s existing network in order to grow those connections and relationships further.
A gentleman used a regular bus route and the bus driver got to know him. The gentleman would always get off the bus at the same place, and while he was waiting to get off, they would always have a chat together. The gentleman’s family & friends noticed that he talked about the bus driver a lot and they explored how they could help to build on that relationship. The bus driver frequented a local pub and invited the gentleman to join him for a drink. In time, the gentleman got to know other people in the pub and became involved in many social activities which were connected to the pub community such as quiz nights, karaoke etc. It was discovered that the gentleman supported the same Rugby team as other people he spent time with at the pub, and he was invited along to go to the matches together with them. Over time, he began to make friends with other supporters who attended the same matches and he became involved in a much bigger community network on the basis of his shared love of Rugby. These connections grew from the basis of one initial relational connection in the gentleman’s local community and his day to day routine.
Working with people’s connections is a ‘Strengths-based approach’. In other words, it is focusing on things which are positive, good and strong in the person’s life and then building on those things; rather than starting from a perspective of ‘need’, risk or deficit.
We’d love to hear from you about your stories and examples of how people are being supported to build their relationships and connections. Please email us firstname.lastname@example.org if you have a story or example you’d like to share.
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 website for further details.
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People we work with often ask ‘What supports wellbeing?’
The Care Act 2014 has an emphasis on Wellbeing and therefore it is a key aspect of all assessment and planning work in Health and Social Care.
In the practice of Independent Support Brokerage and Person-Centred Planning, we often talk about the concept of ‘purpose’.
However, it’s often missed in the health & social care process as an integral element of a person’s life- so why should we place such emphasis and importance on it?
Research study on purpose and mortality
A recent study conducted in the USA in 2019, followed 6985 adults over the age of 50 to identify a link between life purpose and all-cause mortality rate.
This is huge. This provides evidence which connects a person having a clear purpose in life; with their well-being.
How does Independent Support Brokerage link to the concept of purpose?
Stories of how Support Brokerage has enabled people to pursue their sense of purpose:
Jenny was living in a cramped home with parents as an adult, with no sense of future direction. Through accessing Independent Support brokerage, Jenny was able to move into her own home, employ her own support team using a Direct Payment, and set up her own business.
Billy was facing a future after school which was very lonely and isolated, and without any particular direction. With some Support Brokerage input, Billy became involved in what was going on in his local community, joined local clubs and began speaking at events about inclusion.
Nicky was a lady in her mid-40s. She had been placed in a home for older people because that was the only provision ‘available’ to her, which could meet her complex support needs. The home was out of area- far away from her family and the community she knew well. With input from a Support Broker and key family members, Nicky was able to develop a plan to move into her own home back in her local community. Her family helped her to recruit & manage a team of Personal Assistants using her Direct Payment, which enabled her to be close to her family and back with her relationship networks and connections.
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.
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.
Subscribe to our mailing list to be kept up to date with what we’re doing.
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
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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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?
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.
Visit our website for further details; and subscribe to our mailing list to be kept up to date with what we’re doing.
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:
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