A number of councils realise they have become, as one director put it, “assessment for services factories”. Guards are placed on the door – in the shape of ‘one number’ contact functions (call centres). They are performance managed to keep people ‘out’ almost by any means, including throwing services at people, or people at services – and hoping they work.
If people force their way in they are processed – a bit like a sorting office. They are ‘triaged’, ‘handed off’, ‘referred’ and eventually end up on a waiting list or in an allocation meeting. In one council recently they acknowledged that all allocations to a team were collected and taken to an allocations meeting each week. The most likely outcome was that those referrals (actually they are ‘people’ and ‘families’) were placed on a waiting list.
Partners for Change is working with several councils that have rejected this approach – understanding that such experiences for people and families is just not good enough. If any of us described a bad customer experience (paying a mobile phone company bill, for example), all the components of that bad experience are built into our default adult social care processes. This involves all the usual suspects:
- fighting through the system
- telling our story countless times to people who aren’t really listening
- waiting without knowing if or when we will get to the top of the list
- decisions being made by faceless, nameless people we’ve never met.
The motivation for change is that a system built on ‘assessment for services’ is bound to result in ‘services’. That’s what it does. That’s what costs money.
I’d like to think that we are doing something radically different.
Partners for Change was set up to encourage councils to abandon all this, building a new approach based on conversations that are real. As one manager put it recently, conversations “based on what people want to tell us, not what we want to ask people”. It’s a simple but radical difference.
Partners for Change coaches and supports councils to help their workforce wean themselves off the deficit-based, expert-led approach to assessment, replacing it with three simple conversations:
Conversation one: how can we connect people to things that exist in their communities that will help their lives work better – based on their own assets strengths, interests and motivations?
Conversation Two: if a person is in crisis or their life has become unstable threatening their wellbeing; we have an urgent and immediate conversation about what will bring about the changes needed for the person to regain control – and stick to them like glue for a short period of time to maximise the chance of success of the plan.
Conversation three: (only when the other two have been exhausted) about ongoing support based on a fair and sustainable budget – with a support plan that doesn’t describe the maintenance of an object – but rather the ‘good life’ that someone would like to live.
These ‘assessment conversations’ are more Care Act compliant and more in keeping with real social work than the low value document-based behaviours we have somehow slipped into.
I believe Partners for Change, together with its partner councils, has developed a unique approach to ‘making it happen’. This involves rapidly moving through a series of precise steps that include:
- getting your story straight – articulating your new approach with its new rules and working practices
- co-producing the detail of how this will work in practice with frontline staff and managers
- establishing and rapidly starting ‘innovation sites’ that help you learn how to work differently
- collecting data to create ‘compelling evidence’
- using reflective practice techniques to raise the quality of practice
- scaling up based on your experience, your data and the strong commitment of staff who always end up saying ‘don’t make me go back to my old way of working’.
Councils working this way have all demonstrated a dramatic reduction in contacts that become ongoing packages – usually halving the ‘conversion rate’. If all councils can do this sustainably for all their people and communities then maybe the current austerity challenges aren’t so destructive after all.
And social work ends up spending more time on a lot less people – the people who really need them; for example, those 20% of people in older people’s residential homes who are regularly dehydrated (as reported in the press recently). Or those people with a learning disability who, to all our shame, are still living in hospital campuses.