Roundtable on a Better Way and Adult Social Care
Summary of key points
There needs to be ‘a rebirth of humanity’, leading to more connection and community. The aim should be to create a new eco-system of mutual support for people within their communities - ‘local people caring for local people with local people’ - as well as more personalised services.
Change cannot be achieved without listening to people and hearing their stories in a way that focuses on strengths. There need to be a new kind of conversations, in which stories are exchanged and strengths are celebrated. Trusting relationships between residents, communities and professionals also need to be established, in which ‘lanyards are left at the door.’
Individuals, families, communities, the voluntary sector and businesses as well as services are all part of the system and need to join forces and work together.
Local authorities must move from being a ‘gatekeeper of public money’ to a partner for residents and voluntary and community groups.
Resistance within bureaucracies is enormous and requires change at many levels, from services and systems, to culture and mindsets.
Investment needs to be made in helping communities to connect up people and make sure they are inclusive.
In more detail
The roundtable considered how the Better Way principles and in particular our model of the behaviours required to achieve change might help create better support for adults in future.
The first speaker was Neil Crowther from Social Care Futures, who argued that we all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us. Social Care Futures is seeking to imagine, communicate and create a future where what we currently call social care makes a major contribution to everyone’s wellbeing and which, as a result, will enjoy high levels of public – and hence political – support; and it uses story-telling and imagine to help it do so.
Neil outlined what he called the ‘framing challenge’ at present, moving to a more positive story, for example, from ‘looking after our most vulnerable’ to ‘caring about and supporting each other’.
When organised well, he said, partnerships between local councils and others would weave a web of relationships, an eco-system of support, that primarily supports people in their communities. In this world, people would be the heroes in their own story, rather than being portrayed as vulnerable and passive as they too often are now.
The second speaker was Stephan Liebrecht, the Operational Director of Adult Social Care at Barking & Dagenham council in London. He explained that, when he joined the council, social workers had been largely reactive and their communications were full of jargon. They were undertaking 35 page assessments of need. To help shift from this model, he introduced active listening techniques. In the autumn of 2018, practitioners were asked to focus on the residents’ stories and then to retell these stories, focusing on the positives not deficits - a task which proved hugely difficult for them, initially, because of the cultural shift required. This process gave residents the space to speak about themselves, rather than answering questions from a drop down menu, and allowed practitioners to understand them and assess needs in a much more personalised way. Barking & Dagenham held a celebratory event in which three of these residents told their story, and some of their stories were made into songs. Social workers were then asked to spent time with a voluntary sector provider, a faith or neighbourhood group to explore what they might be able to offer.
These steps have moved them toward a Community Led Adult Social Care System, where social workers become a link between the resident and voluntary sector, and where residents are empowered to improve their lives with the support of the community. This requires the social workers to switch from being gatekeepers of state funding to a partner for residents and community groups. The council’s role has also moved more toward advising and supporting other professionals and community groups in partnership, seeking to promote prevention and early intervention, though still stepping when people need active care.
The final opening speaker was Clare Wightman, the CEO of Grapevine Coventry and Warwickshire, who told us about their work on a Healthy Communities Together project funded by the Kings Fund and the National Lottery Community Fund. Although it was still early days, she wanted to share their insights with us.
Clare stressed the importance of ‘person, place and first hand experience’. It is vital, she said, not to start from the existing institutions but from the people - forming strong relationships, listening to people with lived experience, sharing and building power and joining forces with everyone in the system, which includes not just services but families and businesses. Otherwise it is just ‘reorganising the deckchairs’. Resistance to change is enormous and there are lots of layers at which change is needed, from the services currently visible to everyone, to mindsets.
Their project is based in a particular community in Coventry and started by deep listening with an individual here called ‘Sam’, who has serious mental health issues and who was willing to join their team to help them deeply understand his and others experience of social care. The team also immersed themselves in the local community so that they became ‘part of the local furniture’, which led up to three big conversations with local people in a church, to which more and more people came as word spread. Sam’s story, not of victimhood but of his strengths, was at the centre and the events involved sharing stories and the professionals involved ‘parking their power, and taking their lanyard off’.
They are now at the stage where they want to create a plan for a healthy community, and to grow horizontal power. Six ongoing partnerships have been established and they want to create more across Coventry.
Points made in the subsequent breakout groups and plenary discussion included:
A revolution is required with a new settlement between the state and communities and a different role for professionals. Trust needs to be built up between the parties.
The vision should be ‘local people caring for local people for local people’.
Starting from people’s life stories can lead to a very different perception of needs, and can even save money in some cases, although it is also the case that social care is under-resourced.
Bureaucratic silos need to be broken down, and co-production must become intrinsic and should also take care not to exclude any groups.
The roundtable ended by inviting three respondents to give their reactions to what they had heard.
Olivier Tsemo from SADACCA, an Afro-Caribbean Community-based Association in Sheffield which has won awards for its services, said that what was required was nothing less than a rebirth of humanity, a ‘good society’, with a blended approach of community, connection and services.
Audrey Thompson from Doncaster, now in her eighties, commented at her surpise on being portrayed as a ‘vulnerable person’ in Covid. She talked about the importance of community social educators and training to help build community connection, which she had been involved in actively in her life. ‘If you cut the roots, you kill the tree’.
Khatija Patel from Ideal for All in Birmingham, a user-led charity and social enterprise working to make life better for disabled, elderly and vulnerable people and their carers, said she agreed with the points made by the previous speakers. It was important not just to join up people and services but also to empower people. And she asked, what next? Would the group continue…
Summing up, Caroline Slocock, the national co-convenor for a Better Way, highlighted the importance of humanity, community and connection in looking at the future of social care, rather than just focusing on discrete services. Thinking radically about social care requires new kinds of conversations between residents and everyone involved to find out what’s not working and what will; forging deeper, trusting relationships within the community, across services and sectors and in the way services are given, as Grapevine’s work vividly illustrated. This is partly about building the power of connection and community to enable people to live the kind of life they want, as set out by Social Care Futures, and also about local authorities, professionals and others sharing their power, as Stephan Liebrecht had described, so that everyone could join forces to create a better system of mutual support and care. What was also clear, from the discussion, she concluded, was how great the barriers to change are and how important it is to share knowledge and insights amongst ourselves, going forward.