1 An Asset Based Approach : The Deal for Adult Social Care and HealthAndrea Glasspell – Service Manager Ann Newton – Lead External Provider Manager Provider Management and Market Development, Adult Social Care and Health
2 Wigan Borough Five years ago, in 2010, Wigan Council received the biggest budget cut in it’s history. The cut was the third worst for any local authority according to the Institute of Fiscal Studies. What have we done? Over that time we have saved £100m whilst continuing to improve outcomes for the people who live in Wigan. How have we achieved this? Through difficult decisions: Saving this amount of money is especially hard- because now there are fewer simpler ways the Council can reduce costs. Transforming Services: Working together with the people of the Borough and our partners to change how we deliver services to our communities. But we know we still have big challenges ahead…… £60m efficiencies to make by 2019 5% of year olds not in employment, education or training 36% of children not ready for school 18% of the population 65+ resulting in increased demand for services 7.5 % of the population claiming out of work benefits (including Universal Credit) We need to make a further £60 million of savings by 2019. People are living longer which is great, but means that costs go up. Some adults aren’t living their lives to their full potential and often require a lot of support Children is some areas of the Borough are still not ready for school when they start. Wigan Borough has a higher level of deprivation when compared it to England Question: What are your current challenges? Are they similar to the Wigan examples you can see here or are you being presented with different issues?
3 The Deal For the Future, 2020 Key PrinciplesNew Reciprocal Relationship Between Public Services, Citizens, Communities and Businesses Building on Assets and Strengths Integrated Services – People at the Heart Engaged Workforce - Courageous, Positive and Accountable Confident Communities – Everyone Does Their Bit New Technology to Support Independence and Control Positive Risk Taking Partnership Working For Better Outcomes Five years ago the Financial Times reported that Wigan Council faced the third worst cuts of any local authority in the country. With more than £100m slashed from the budget already and another £60m to find by 2019, we’ve had to change the way we do things. The Deal for the Future sets out where we want to be by Here we take a look at where we were, where we are and where we want to be… Question: How do these objectives compare to your own?
4 This means a redefined role for the council and public services as a whole – it is less about doing things to people and communities and more about creating the capacity, interest, expertise and enthusiasm for individuals and communities to do things for themselves A new relationship –developing and doing with people rather than for and to. Wrapping services around families. Integrating. Tell your story once. Using technology to promote independence. Finding out what people and communities are good at and building on that – supporting people to help themselves and each other. Independent people. Strong communities. Ensuring that the workforce has the right set of skills. Keeping up to date with what works and doing that. Question: If you were producing a deal of your own, what would you add?
5 Story so far…. Engaging with local groups£7 million Community Investment Fund Visual Campaigns 2 way communication Behaviour Change Programme
6 Have your say Deal in Action – rolling programme of engagement for residents of the borough to have a say. Week of activity within each community of the borough Have your say event - Chief Executive & Leader of Wigan Council along with Elected Members invite residents to a question & answer session Opportunity for residents to get involved and find out more about their community
7 Community Investment Fund:Launched July 2013 Pump-prime creative, bright ideas Shape the existing market Investment NOT grant Focus on: Innovation Reducing demand on public services Community driven
8 Impact so far: 32 big ideas, over 100 small projects£2.4m of external funding brought in £800k recurrent savings Year 1 investments demonstrating outcomes : 41 people in employment 2677 people accessing day activities 150 regular volunteers 20 people rehoused 5 business start ups Return on investment £1.48: £1
9 It’s a movement not a project - interrelated and connected elements.Deal for Adult Social Care and Well Being Deal for Providers Deal for Children and Young People BeWigan experience One Team One Council, listening into action Deal Values and Behaviours Core set of reform principles Community Investment Fund Deal for Action and Have Your Say Public Service Reform and Place based working Relentless service redesign Deal for the Future
10 The Deal For Adult Social Care and Health in WiganAn Asset Based Approach
11 A story about walking in the woods in a red cloak………Introduction A story about walking in the woods in a red cloak……… Read the Story to delegates Ask them to complete the quiz: Consider each of the statements below and decide whether the statement is True or False. If you think the statement is true use a tick, and if you think it is not true use a cross Spend 5-10 minutes Go through the answers, talk through each one. Using the Red Text in Trainers Answers and notes for facilitating the quiz
12 Thoughts This exercise was intended to illustrate that we often make assumptions without even realising. The asset based approach means working in different ways, listening more and talking less, allowing new plans to emerge rather than imposing them It changes the roles of professionals, frontline staff and managers. Now going to explore asset based approaches in more detail
13 Assets v Deficits
14 An Asset Based ApproachAsset based thinking Deficit based thinking Strengths based What can I do, what can you do? We’re all in this together People have the answers People can control their lives and make decisions How can we create community spirit? Problem orientated How to fix the problem Us vs Them Problems are embedded Do things to people People are a problem People can’t be trusted to be in control / make decisions The language of ‘assets’ is being used more widely in health and social care literature as the emphasis shifts towards prevention and the need to work differently to tackle persistent inequalities. A number of well-established ways of working and approaches exist, such as coproduction, personalisation and strengths-based approaches, which support and are based on underpinning principles and values similar to those of asset-based working, and support a focus on assets. Assessing assets alongside needs may give a better understanding of the health and care requirements of individuals, enabling a shift towards more empowering, sustainable and holistic approaches for delivering services. Question: Do you have any examples of asset-based thinking which aren’t included on the list?
15 The blank mind Seeing people with a fresh pair of eyesValuing the unique strengths and qualities of people Challenging your and their assumptions Expanding the possible This is our definition of the blank mind Expanding the possible is about taking risks and not being held back by processes and ungrounded worries – we all have a role in helping people to lift their heads up and realise the possible
16 A change in mind set: Leadership buy inEthnographic learning and development experience Core behaviours that everyone can relate to Tools, processes and systems Management permissions
17 Making it happen: it’s simple but profoundADULT SOCIAL CARE & HEALTH Making it happen: it’s simple but profound The Deal for Adult Social Care and Well Being is a radical reimagining of how we work. Customers and citizens are viewed as unique individuals with assets, gifts and talents, rather than a collection of needs and deficits. We support people to live the best life they can, rather than fitting them into a prescriptive range of traditional and expensive services ‘Different conversations’ with residents to better understand individual assets, recognising strengths, gifts and talents using an ethnographic approach, rather than current deficit model Connecting people with community solutions for example a local community hub, social group or buddy Developing community capacity through co production, different relationships, asset transfer Developing new ways of working by liberating the workforce through permission and support to be innovative and creative, in return for a pledge to be positive, accountable and embrace new ways of working.
18 Market Development & Community Knowledge OfficersBIGGER PICTURE – SO HOW DOES IT ALL WORK Early Intervention, Hospital Service & Support & Safeguarding Different conversations Asset based approach to assessments Sign posting Sharing knowledge and ideas Personalised support plans Providers Development of CIC’s and community Providers Having different conversations Identify gaps and solutions to resolve them. Engage with Community Book Market Development & Community Knowledge Officers Develop solutions to meet the needs and aspirations of Wigan citizens, based on information re gaps. Understand what’s out in the community Support front line staff Locality Based Community Connectors & Community Link Workers Depending on the level of complexity a paid Community Link Worker or a volunteer Community Connector will provide buddying or handholding support to enable individuals to participate and engage in community opportunities We are currently designing the infrastructure, systems and processes that will enable full mainstreaming of the Deal: We have recruited Community Knowledge Workers and Market Development Officers We are working with Community organisations to ensure easy access to Community Connectors We are working to develop a user friendly on line resource directory, bringing together information on a wide and diverse range of community opportunities We are developing a new customer journey and underpinning operating model We have recruited more Social Care Officers As mentioned previously a further Training Session will be delivered over the next couple of months, focussing on team specific systems and processes
19 THE CONVERSATION TOOL
20 Knowing our community:Take notice of the local community “Know your Community Tours” New roles: Community Knowledge workers – knowing their patch Volunteer community connectors Community link workers within primary care Connecting people to things that make them tick We are currently designing the infrastructure, systems and processes that will enable full mainstreaming of the Deal: We have recruited Community Knowledge Workers and Market Development Officers We are working with Community organisations to ensure easy access to Community Connectors We are working to develop a user friendly on line resource directory, bringing together information on a wide and diverse range of community opportunities We are developing a new customer journey and underpinning operating model We have recruited more Social Care Officers
21 Our community knowledge officersGet to know your community knowledge officers Talk about the role of Community knowledge officers and how they can help. As previously mentioned if you require a community knowledge officer for an individual you access this service through the community knowledge inbox. OUR definition of Community knowledge officers They are individuals who assist people in building confidence and self-reliance which enables them to participate and engage in activities within their community that are meaningful to them. We have volunteer connectors and paid connectors – paid community connectors are called Community Link Workers (CLW), CLW will assist people with more complex needs. This connecting could be through buddying, handholding and simply assisting someone to get from A to B. We have Community Connectors ready to go – so contact the Community Knowledge Officers and they will help you link people with their communities.
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23 MAKING IT REAL - BUS TOURS OR VISITS TO PROVIDERSMinibus tours are not a passive audience experience, opportunity to share what you know and to have the time to see some examples of the fantastic activities going on in the area that work. Mention using team meetings differently – challenge everyone in the team to visit local community, talk to informal community leaders eg Dr receptionists, hairdressers, friendly pub landlords, local café owners, postal workers etc then competition who can feedback the most to rest of the team.
24 Supporting staff to deliver on The Deal
25 Because how we do things is just as important as what we doOur behaviours Be Positive… take pride in all that you do Be Courageous… be open to doing things differently Be Accountable… be responsible for making things better We are introducing a new set of behaviours ‘beWigan’. BeWigan creates a shared culture that celebrates how we are, our fresh and unique approach to public service, our successes and achievements, and sets out how we expect staff to behave to deliver our part of The Deal. Because we wanted to develop a really simple set of behaviours that all staff understand. We decided to build on the hugely successful principles of The Deal / asset based approach developing in adult services. Part of the new behaviours is about being open to doing things differently and being prepared to having a different conversation. Having a different conversation means different things to different services. Above all, this is about giving staff permission to work more imaginatively and more creatively; to leave behind traditional ways of thinking and traditional methods; and to be at the forefront of a new way of working that has the potential to impact positively on people’s lives in Wigan. The behaviours are: Be positive, Be courageous, Be accountable Because how we do things is just as important as what we do
26 Our behaviours.. What this means
27 The Deal – Asset Based, Ethical Commissioning – Key FeaturesThe Deal Approach to Commissioning – Asset Based Approach Different conversation with citizens, providers, procurement – design right service, select right providers, right support at the right time. Partnership with Experts – Citizens contributing to design and selection – coffee mornings – survey - ‘I Statements’ Embedded in Specification, user of service on the panel. Providers – early engagement, what's working not working, maps, price, volume – contribute to design of specification. Procurement and Legal – Engaged early in journey, effective facilitators, solid process to select right partners for the future. Question: Do you have any additional examples of how your authority is making a difference?
28 The Deal – Asset Based, Ethical Commissioning – Key FeaturesHighly Valued Workforce - Excellent quality of care and support at home delivered by skilled and compassionate workers = In return decent reward and support package Ethical providers – share a common set of values, characteristics and behaviours: - Responsible and supportive employment practise - Rooted in asset based, community orientated support - Clear focus on strengths, gifts and talents, building resilience and community connections - Develop mature, collaborative partnerships Question: Do you have any additional examples of how your authority is making a difference?
29 12 Minimum Customer Requirements by Wigan Citizens – Key Feature of SpecificationI want you to turn up at the time we agreed and give your best every visit. I want you to be pleasant and friendly and help me to be at ease in my own home. I want to feel in control of my care and support. I want to know who is supporting me and to have a say about whom and when this will be. I want you to take your time with me, be careful and patient, don’t make me feel rushed. I want you to get to know me well and enjoy meaningful conversations with me, take in interest in my life, my family, my friends, my past and my future. I want you to focus on me when you are in my home, I don’t want you to talk over me with another carer worker or be on your mobile phone. I want you to help me to be safe, happy and healthy in my home and community, using your common sense and flexibility to make this happen. I want you to be well trained and able to support me safely, I want to trust and be confident in you when you are supporting me. I want you to respect my privacy and keep information about me confidential. I want you to know me well enough to recognise when I am feeling unwell, acting early so that I have the best chance of getting better quickly. I want you find out about the things that make me ‘tick’ and support me to maintain and find new interests and activities. I want you to support me to live a life beyond my home, maintaining friendships, making new relationships and sharing my skills and interests with others.
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31 What is making a differenceDifferent conversations leading to different answers and different ways of engaging. Time with clients to really listen to what they want and not what we tell them they need. Establishing root causes of problems allows sustainable outcomes rather than short term presenting issues. Connecting people with either community support or statutory services. Gathering information but stop assessing. Concentrating on the positives and so will the client. Freedom to apply common sense and a “What’s Best” approach to every situation Understanding the client’s point of view – the consequences of shame. Question: Do you have any additional examples of how your authority is making a difference?
32 “Different conversations” - what does this really mean to people?Chance to chat to others who live nearby, who I’d never have met What I am good at or interested in… Time to get to know me and build trust… You were different, you talked about what’s important to me Suggestions and ideas I wouldn't have thought of.. Helped me feel active and healthy Felt I had something to give “Different conversations” - what does this really mean to people?
33 More activities that people actually want to doProviding something meaningful This is why I chose a career in social care Greater freedom to do things differently The importance of knowing a person’s story Understanding what community can offer Allowed me to think differently “Different conversations” - what does this really mean for frontline staff?
34 10 Essential Components Strong Narrative - A simple concept that everyone can understand but is profound in its implications A belief that this is a crusade not a project - Rooting the approach in public service values – “its why I became a social worker” Leadership at every level - Commitment and senior sponsorship. leadership at every level Workforce culture change - Core behaviours that define how we work, whatever the role. Changing day to day practice so it becomes how we work A different relationship with residents and communities - building self reliance and independence
35 10 Essential Components Permissions to work differently - Leadership backing– ‘we will support you’ Redesigning the system - Testing our systems, processes, ways of working against our principles - ‘do they make the culture and behaviours we want more or less likely?’ Enabling staff with the right tools and knowledge –using new technology to support new ways of working A new model of commissioning and community investment- Market development and new arrangements for commissioning Supportive enabling functions - Breaking down barriers to progress and facilitating the change – HR, finance, IT, legal
36 GM Reform Principles: A new relationship between public services and citizens, communities and businesses that enables shared decision making, democratic accountability and voice, genuine co production and joint delivery of services. An asset based approach that recognises and builds on the strengths of individuals, families and our communities rather than focussing on the deficits. Behaviour change in our communities that builds independence and supports residents to be in control A place based approach that redefines services and places individuals, families, communities at the heart A stronger prioritisation of well being, prevention and early intervention An evidence led understanding of risk and impact to ensure the right intervention at the right time An approach that supports the development of new investment and resourcing models, enabling collaboration with a wide range of organisations
37 Questions and Discussion:How can you engage your providers to adopt an asset based approach? How can you be sure that your providers are having different and appropriate conversations? How do you develop a performance framework that is built on an asset based approach? Do we have healthy relationships with our providers? Want to work with us, Co-Produce Engage providers via Co-Production, example in Wigan The Deal for Providers / Provider Forums / Rolling out our asset-based approach training to providers. (In-house and external) Ethical Homecare Framework- only want to work with ethical providers Challenge with legal and audit- traditionally, open pay if complete all outputs within service specification and contract- need more flexibility in contract monitoring.
38 Thank you Any Questions?