20
Nick Andrews, Planning Officer for Older People, City & County of Swansea Adding Values’ – Moving towards genuine co- production in Social Services

Coproduction in social services

Embed Size (px)

DESCRIPTION

By Nick Andrews, City and Council of Swansea, at WCVA's Annual Conference.

Citation preview

Page 1: Coproduction in social services

Nick Andrews,

Planning Officer for

Older People,

City & County of Swansea

‘Adding Values’ – Moving towards genuine co-production

in Social Services

Page 2: Coproduction in social services

What went wrong with Preston?

• ‘Daddy created him for good, but he’s turned out evil’ (Wendolene Ramsbottom, A Close Shave, 2005)

• Let’s be truthful not cynical - ‘The facts are friendly’ (Carl Rogers,1961)

Page 3: Coproduction in social services

Social Services - A current focus on process, not people

• ‘Like the police service, adult social care is designed as a bureaucracy to feed the regime, not a service to meet older people’s needs. The regime constrains method. It is a bureaucracy of call centres, functional specialisation, activity targets, budget management, form filling and counting, designed according to the requirements of the regime. And the bureaucracy is cemented with information technology, all of which has been designed from the point of view of electronic data management and reporting, not solving people’s problems’ (John Seddon, 2007)

Page 4: Coproduction in social services

So called ‘personalisation’ in England – yet more process!

Page 5: Coproduction in social services

Back to the future - a thought from Lord of the Rings?

• ‘Much that was, is lost, for none lived who could remember it. Some things that should not have been forgotten were lost. History became legend. Legend became myth’

Page 6: Coproduction in social services

Learning from Two Welsh legends – both a little non-conformist

Page 7: Coproduction in social services

‘Tales of a Country Doctor’- in the spirit of co-production

• ‘While playing with her sister, our small daughter fell awkwardly and dislocated her elbow… it was not long before Dr. Davies arrived at the home. In no time, the elbow had been corrected – accompanied by a sharp cry of pain! He told the girl, the best kind of treatment for this sort of problem was an ice cream poultice applied internally. With that diagnosis, he disappeared to the village shop and was soon back with the ‘prescription’ in hand. Having helped himself to spoons from the kitchen, he sat down with all of us and shared the ice cream’ (Davies, et. al.,2009)

Page 8: Coproduction in social services

‘All real living is meeting’ (Martin Buber)

There are two ways of relating to people and the world:

• I-IT Implying coolness, detachment and instrumentality

• I-THOU Implying attachment, self disclosure and vulnerability

Page 9: Coproduction in social services

A call to put relationships before processes

‘A man or woman could be given the most accurate diagnosis, subjected to the most thorough assessment, provided with a highly detailed care plan and given a place in the most pleasant of surroundings – without any meeting of the I-Thou kind ever having taken place’ Kitwood (1997)

Page 10: Coproduction in social services

A call to restore humanity, friendship and reciprocity in

Social Services• ‘…and (the social worker)

came and you know, talked to the kids about it that evening… and when my dad died, and my oldest son was in a terrible state, she came that night as well, at 9 o’clock. So pretty impressive support really. And I am sure she would do that for everyone… that’s the person she is’ Service user quoted in Beresford, P. et al. (2008)

Page 11: Coproduction in social services

No them and us – ‘Do you get it?’

‘As an organisation, becoming person centred is about creating a culture where the service brings out the best in individual staff and those receiving the service. This involves enabling people living and working together to develop a feeling based service, almost like a family or community’ David Sheard, Dementia Care Matters

Page 12: Coproduction in social services

But where are we now? - a word of caution from the expenses

scandal ‘Compliance has

replaced conscience’ Jonathan Aitken, BBC Today programme 3rd June 2009

Page 13: Coproduction in social services

Another word of caution on individualistic consumerism

• ‘There is a need to replace an individualistic view of autonomy with one based on ‘interconnectedness and partnership’ that recognises the uniqueness of each individual, but also the interdependence that shapes our lives’ Nolan et. al.(2006)

Page 14: Coproduction in social services

Creating ‘enriched environments’ through the Senses Framework

Service users, carers and staff achieve:

•A sense of security

•A sense of continuity

•A sense of belonging

•A sense of purpose

•A sense of achievement

•A sense of significance

Copyright Dementia Care Matters

Page 15: Coproduction in social services

‘Enriched environments’ in a nutshell

Page 16: Coproduction in social services

Moving co-production from the margins to the centre

• Time banking and ‘Not a one Way Street’ stuff is great, but co-production mustn’t stop there!

• Older Peoples Services budget in City & County of Swansea is approx. £32m:

• 10.3% on assessment & care management (£3.3m)

• 42.5% on care homes (£13.6m)

• 42.8% on domiciliary care (£13.7m)

• If we can get co-production across all three, we’re talking about 95.6%

Page 17: Coproduction in social services

But beware ‘passing the buck’ masquerading as co-production

• ‘The term co-production itself dates from the 1970s, a time when movements to challenge professional power and increase citizen participation in community affairs coincided with efforts to reduce public spending’. Needham and Carr (2009)

Page 18: Coproduction in social services

Co-production in social work practice - rethinking our

approach to Unified Assessment

Page 19: Coproduction in social services

Co-production in care homes – from ‘hotel’ to therapeutic

community• Short term pleasures of

the kind elicited by the senses, e.g. watching a game of rugby

• Long term satisfactions linked to meaning and purpose in life – linked to biological markers of health (Ryff et al 2004)

• Ty Waunarlwydd care home, Swansea

Page 20: Coproduction in social services

Co-production in domiciliary care – from impersonal time task care plans to flexible relationship

centred support• ‘People who receive home care are frequently not satisfied with the way that

services are currently provided…. Many find the task-based approach of the majority of councils insensitive to their needs, requiring particular activities regardless of whether people want them done that day or at all. People tell us that this inflexible approach means that services are more accountable to councils than to them. It is also unsatisfactory for those who provide care and support, as it inhibits the proper relationships that should develop between care workers and the people they care for’. Denise Platt (2006)

• ‘All Together Now’ pilot in Swansea in 2009• Caring Support, Croydon – a multi-stakeholder co-op