Posted by: rickwilsontg | October 7, 2009

Community Action for Climate Change Network events

As previously reported on this site the Welsh Assembly Government, in collaboration with Science Shops Wales and supported by key partners, has been facilitating a number of regional networks for community and Third sector groups, wanting to contribute to efforts to mitigate the effects of climate change.

These Community Action for Climate Change Networks are running a second series of FREE events during November 2009.

In order to meet your local need to take action on climate change the events will offer an opportunity to:

  • network with others from community groups, from small businesses, form local authorities and others,
  • build on the learning gained at the Sustainable Behaviour change workshop that many of you attended on 15th September in Gregynog, Newtown,
  • develop local action plans, and
  • Identify future training and development requirements

Each event will have a slightly different focus for developing action plans and you are welcomed to come along to your local Network and /or whichever location suits your needs best.

Newport – November 12 – will explore action planning on a large scale

Llangollen – November 18 – will focus on a joint understanding of good practice for Small and Medium Enterprises and community action

Aberystwyth – November 26 – will use as live examples from three different community groups that are currently planning local action

All events will have inputs from a diverse group of speakers to stimulate our thinking and planning.

You can find out more information about these events by following this link and get an application to take part in the events by following this link.

Posted by: rickwilsontg | October 6, 2009

Building the Alliance for Citizen Directed Support

This was posted on the Wales Alliance for Citizen Directed Support website at www.wacds.org.uk this week.

The Steering group wants to launch our Alliance in Spring 2010.

Summer barbeque

Summer barbeque

Before this point we want to have achieved a number of things:

  • Have wide agreement to a set of principles for Citizen Directed Support.
  • Have agreed with partners some large demonstration projects involving large scale collaboration between citizens, commissioners and providers, this would include projects including multiple agencies, involve collaboration between, citizens, commissioners and providers, and involve transformation of service areas.
  • Have established a directory of practice experiments that fit within our principles that partners are exploring, these experiments would be smaller scale, such as re-development or particular elements of service, like assessment and care management, or new models of service delivery, or new forms of collaboration with citizens.
  • Have in development an evaluation framework for Citizen Directed Support that can be used by partners to review these projects and experiments.
  • Have a list of agencies, and individuals who are supporting aims of the Alliance.
  • Have agreed a representative structure through which the Alliance can mange it’s work openly and accountably.

So there is a lot to do, if you are interested in making this happen then there is a lot you can do.

  • Get involved, and get others involved, in building our principles – you can find out how by following this link, through this process you will also register your interest in the Alliance (so that kills 2 birds with 1 stone).
  • Start talking with partners about projects or experiments that you feel would fit within our developing principles, let us know your ideas.
  • Show your support of this process by commenting on this website.

I look forward to hearing from you

The work that we are doing in Swansea potentially fits well as one of the large demonstration projects described above.

Interesting stuff

Back in June we posted information about the Wales Alliance for Citizen Directed Support (WACDS), they have circulated this information.

The Wales Alliance for CDS Steering Group and Provider Network want us all to build the Welsh principles of Citizen Directed Support together.

We want to do this in a way that builds a strong, collaborative and open Alliance from the outset.

To do this we have created a wiki group at www.welshcitizensupport.wikispaces.com, a wiki is a website that everybody can change and alter together.

On this website you will find a set of principles for Citizen Directed Support in Wales that are growing and developing through contributions from Alliance members and Provider Network.

The steering group aims to have agreed principles that have wide support and agreement by the end of November 2009.

Please do get involved in this process, you can do this by:

  • Contacting debbie.chegwen@communitylives.co.uk to join the Wiki group, we will send you an invitation to join the group that will set you up as a member.
  • Add your thoughts and contributions to our evolving principles on our wiki pages.
  • Pass this information on to any agencies, groups or individuals that you feel have a stake or interest in this process and encourage them to get involved.
  • We will send out a regular email to wiki group members containing the latest text of the principles and outlining what changes have been made.

To find out how to use the wiki group, please look at this video we have produced to explain how our wiki group works.

Please get involved, there are lots of ways you can contribute;

  • You can focus on a particular principle, or all of them.
  • You can focus on making the language accessible, or spelling or grammar.

However you contribute you will be building principles that have the potential to transform social care in Wales, and demonstrating our shared role in this Alliance for change.

If you don’t what to use the wiki pages please let us have your comments either by contacting Debbie Chegwen 01792 646640 debbie.chegwen@communitylives.co.uk or placing a comment on the Alliance website at www.wacds.org.uk .

There is now a facebook group which you can join at http://www.facebook.com/group.php?gid=154370365756 .

You can find all this information on the Alliance’s website at http://wacds.org.uk/wiki_page/

The Alliance look forward to hearing from you

Posted by: rickwilsontg | September 28, 2009

Night time response service – developing locality based services

From the 21st September community living Services for people who have a learning disability in Swansea are piloting a locality based night-time response service.

Night-time response workers

Night-time response workers

This has developed in partnership between City & County of Swansea, Community Lives Consortium and Walsingham Wales.

The idea is simple, we will try to re-model the existing sleepin support that is dispersed across 12 different supported housing schemes in the Gorseinon area and replace them with 2 community based wakeful staff that can arrive at any of these addresses within 15 to 20 minutes.

Why are we doing this?

  • We want to create a community based night-time support service that is more responsive to people’s needs where ever they are living in the community, this is a logical extension of the Targeted Support programme we have been exploring to create more responsive and consistent services in the community.
  • We need to respond to the working time directive and its implications for sleep-ins. We will no longer be able to provide night time cover in this way without paying the rate as working hours. This would mean eventually changing all sleep-ins to a wakeful shift which would have significant funding implications for the local authority.
  • We want to develop a service that is better able to utilise the potential of Assistive Technology for efficiently supporting people in the community.

What would this Social Care Response service look like?

We are delivering a response service that contains:

  • Initially half time Response Team Manager
  • A team of staff paid to stay awake at a local base paid at wakeful rate. Staff will be available to respond to a number of support needs during the night time.

The initially response staff will respond to calls from;

  • Staff and managers currently supporting tenants – These calls will be from a wakeful member of who requires additional staff assistance to provide support. An example would be in the case of when two staff are required to deliver personal care when there are manual handling guidelines in place. Once this support has been provided there is no longer the need to have two people at the service and the response worker returns to the local office.
  • Call centres responding to Telecare used by tenants - In this case response workers will be responding to assistive technology alerts. They will receive a phone call from the call centre and will go to the service to respond accordingly. An example may be that a sensor has been triggered when a service user has got out of bed but hasn’t returned to bed after the ‘normal’ amount of time. The response worker will go to the service to check that everything is ok.

How have we set this up?

In order to test this model of service out we have mapped out the community living services and have decided on a geographical area where there is a natural cluster of services.

There has been an assessment of these services to determine what type of support is required at night. These services have been colour coded as Red, Amber and Green.

A red service is a service whereby a member of staff is definitely needed at the service at night. This would need to be a wakeful member of staff in order to comply with the working time rules.

An amber service is a service whereby a response service could be used if certain risks were resolved by, for example, looking at assistive technology.

A green service is a service whereby a response service could be used if the response staff could arrive in a timely manner. E.g. within 15 – 20 minutes.

In putting this in place we are working through 5 implementation phases:

  • Phase 1: May to July 2009 – We will be explaining this pilot to staff, relatives and service users. The Response Team Manager will develop the necessary systems and policy framework for the effective running of the service. They will also recruit and train the response workers.
  • Phase 2: August 2009 – The Team were in post and receiving training.
  • Phase 3: September and October 2009 – All of the green services will use the response service. This will be reviewed.
  • Phase 4: November to March 2010 – Technical difficulties will be resolved with the amber services and these may turn into green services.
  • Phase 5: March 2010 -A review of the response service will take place before it is rolled out across other geographical areas in Swansea.

It will be interesting to see how this re-modelling of service develops, it is another potential approach to developing more integrated, responsive, locality based models of service.

Posted by: rickwilsontg | September 28, 2009

Fit for the Future

Fit for the Future

I came across this document from the brilliant Forum for the Future and the NHS Sustainable Development Unit called Fit for the Future.

This document looks at the social, political and economic responses to climate change that we might see over the next 20 years and the impacts that these will have on our health and the types of healthcare provision available to us. The report presents four scenarios describing radically different worlds in which the NHS might operate.

Helen Clarkson of Forum for the Future suggests that:

  • ‘We strongly believe that this isn’t necessarily bad news. By focusing on our wellbeing and leading more sustainable lifestyles we can find the low-carbon/high quality-of-life sweet spot. That’s something not just for the NHS to consider but other organisations in the public sector, and all of us as individuals.’

This document echos with respect to health much of the logic that we have employed in developing approaches to sustainable social care, specifically:

  • Helping people to take much greater responsibility over their lives and their services, and supporting communities to be more assisting of it’s members.
  • Developing a far more effective model for early intervention and creating resilience rather than dependance.
  • Ensuring that public services do not just adjust themselves to the potential impacts of climate change but become the conduit for wide-scale community behaviour change with respect to sustainability.
Posted by: rickwilsontg | September 28, 2009

100 words on Citizen Directed Support

Back in June in the post From In Control to Citizen Directed Support I suggested we all have a go at coming up with 100 words at answering the question ‘What does Citizen Directed Support Mean to us?’.

The officers of City and County of Swansea have really engaged in this and came up with a range of definitions for personalisation and Citizen Directed Support, thanks to them for these 100 word definitions.

Personalisation to me means the incorporation of a number of concepts. Enabling, empowering are two but behind that is ensuring that people have enough information to make an informed choice without constraint. It also means that people have the right to give the right away to trusted others. Not everyone wants responsibility and we cannot thrust it upon them. The very fact that people are touched by our services means that they have needs that they are unable to deal with at the time. Personalisation suggests that we assist in enabling people to address these needs in whatever way is right for them.

‘Citizen Directed Care allows and encourages individuals to have greater control over the services they need to obtain the independence, well-being, social interactions and autonomy which they want. It allows and enables individuals to take a greater degree of personal responsibility for their lives and lifestyles and to choose how they will engage with agencies or others to deliver services in ways which will meet the outcomes which are best for them. It will enable individuals to understand their rights and entitlements, whilst also recognising the constraints imposed by society and the responsibilities of being a citizen.’

  • A fundamental shift from a consumerist model of care to a model of co-production
  • Capacity building within the community, and building individual social capital within these communities (interdependence)
  • A move from individuals being recipients of a service to active participants
  • The outcomes agenda, individual budgets or direct payments alone will not ‘transform’ social care and a more fundamental cultural shift is required
  • This will require understanding and sign up from politicians, senior and middle managers, staff and service users and their families
  • Understand the changes that need to occur throughout the Commissioning Process
  • It will require a change in roles for professionals and front line staff
  • A change to how we perceive risk as an organisation, a change to how we contract and understand and manage performance
  • A change to how we allocate and manage budgets
  • Key phrases; feeling in control and having shared responsibility, having choice, flexibility and responsive services.

Personalisation should mean exactly that. As an authority we should be prepared to develop a range of solutions and options for people to have support and take action from the  individual discussions we have with people. People will vary on the levels of choice and control they aspire  to and how  they direct their own support and we need to respect that. Many will have their primary focus on improvements to the reliability, consistency and quality over the sorts of services they already receive and we need to achieve this while fostering a culture that allows for innovation for those who wish.

Personalisation is finding out what matters most to service users and carers and using this knowledge to make a positive difference to their lives. It supports their interdependence and well being, through a relationship centred and collaborative approach to the achievement of personal outcomes, in a manner which values and respects everyone concerned.

This requires:

  • A common understanding of outcomes

  • A commitment to social justice and equality

  • Increased service user and carer control

  • Supportive risk management

  • Working within the context of families and communities

  • Making the best possible use of all resources, including those within  families and communities

  • Supporting frontline staff and volunteers

Personalisation is putting the service users with their family and carer(s) back in the centre by self assessing or co-assessing holistically.  It’s about the ethos that the individual/customer knows best, allowing/enabling people to shape and control their own services – thereby their life.  It’s about putting more resources into prevention and reablement, making people part of their community and vice versa.  Transparent allocation of resources to provide a full range of services, developing the marketplace, making choice real.  Access and inclusion where citizens have equal rights and opportunities.  It’s about supporting better health and social care outcomes by seeing images of possibilities by good support planning.  Give staff and users permission to do it differently, not prescriptions.

  • Individuals are supported to have as much control over their support planning as they choose or are able to manage, through a range of methods such as individual budgets or use led services.
  • They are equally helped to become part of mutually supportive communities which they have investment in and influence over.
  • Agencies deliver services to individuals achieving explicitly agreed individual outcomes.
  • They also actively support communities to build their capacity for collaboration and mutual assistance.
  • Explicit shared systems of communication exist between individuals, community groups and agencies to support collaborative decision making and local adaptation.

The Wales Alliance for Citizen Directed Support is now picking up this approach and are building on the work to create a shared definition for Citizen Directed Support across Wales. You can find out about their work at their website at www.wacds.org.uk

Posted by: rickwilsontg | September 10, 2009

Time Together – very first draft

This is the first potential action research experiment that could come out of the Sustainable Lives process.

Julies birthday

Building community relationships - Julies birthday

This document called Time Together Gorseinon is a proposal to collaboratively remodel services in a local community.

It will bring commissioners, provider and citizens together in a close partnership to build mutually supportive relationships and to put people at the centre of setting priorities and developing services.

Time Together has 3 aims:

  • To create a collaborative Time Together Alliance of social care and support provider organisations, commissioners, and community leisure groups to work together to coordinate and develop person centred support to people living in the Gorseinon area.
  • To develop in partnership with the citizens of Gorseinon a membership based Time Together Network within which members can contribute to the work of the project and the social care and support of each other and are rewarded by time credits through which they can access community activities and events and eventually support provided by other network members.
  • To use the Swansea People social networking website to support equal and open communication between agencies, citizens and community groups to support the work of the Alliance and the Network.

At the moment this idea is really up for discussion, but it would be a practical way forward to creating empowering citizen led social care while building social capital within our communities.

You can download Time Together Gorseinon here

Here is a belated update from our July meeting.

In this meeting we worked on our shared principles of Citizen Directed Support. This was particularly important in preparation for a workshop Swansea Social Services was organising to look at the transformation of Social Services in Swansea in the light of the personalisation agenda.

We put together these 5 principles, which are still evolving with continuing discussion.

  • Personal Control – People are supported to maximise their control of the assistance and services that they use to live their lives in the community.
  • Mutual Support – People are supported and encouraged to develop, and be part of, communities around them within which they are inter-dependent and mutually supportive of each other’s needs and abilities.
  • Shared Communication – People are supported to communicate with each other, interest groups, and with agencies in an equal and open fashion, this communication supports collaboration and coordination.
  • Valuing Relationships – Individuals who use, support and deliver services are trusted and valued as builders and contributors.
  • Shared Outcomes – Outcomes for services and support are agreed and reviewed by people who use, support and deliver services. These outcomes support successful lives, and sustainable services & communities.

We also went on to discuss the action research experiments that we want to develop to explore these themes of sustainable social care. We will publish the detail of these experiments as they form.

The programme for this meeting can be downloaded here Meeting of the 21st July 2009

Please give us you views and comments

Posted by: rickwilsontg | July 23, 2009

Mutual Advantage – Cooperative Dom Care agencies

I met up with a Mick Taylor of Mutual Advantage on Tuesday, a really interesting man. He is running a project entitled Collaborative Self Managed Care Project, the essence of this is supporting people who have Direct Payment’s or any other source of Individual Budget to work together to set up clusters of little co-operatives to provide very local mutually owned domiciliary care agencies, these cooperatives involve people delivering and receiving services in an active partnership.

This project has a wealth of practical delivery experience, and what interested me was that because the agencies were very small (150 to 200 hours per week), the delivery processes were very simple. The clusters then shared processes and resources that required more scale.

I think user led services will be a useful part of sustainable, adaptable, citizen directed services, and this looks a very practical useful way of achieving this.

There was a Guardian article about one of the projects  ‘Caring Support’ you can find the article by following the link to Quality Ingredients.

Posted by: rickwilsontg | July 23, 2009

Choice is back in fashion.

I am meeting with Geoff Thomas of Timebanking Wales to look at a co-productive approach to Locality Building that we could explore explore in Swansea. As part of our preparations he sent me this and I thought it was great, so I am including it as a post.

Timebanking Wales

Timebanking Wales

The old word choice is back in fashion. But what are its new followers failing to say? The answer is obvious. “Don’t mention competition” is the unspoken imperative. The promise to give citizens choice carries with it the promise that services are likely to improve as a result. Many politicians believe this. Their reasoning is thus. Choice for citizens means insecurity for providers. Insecurity keeps providers on their toes.  When providers must compete with rival providers and face closure if they fail, then they will work harder and strive more assiduously to find out what citizens want. The citizen’s “choice” thus becomes a means to an end; a state of competition whose inherent insecurity will push service providers into raising their game.

But when people say they “want choice” what they usually mean is they want to see improvements in services. “Give me a choice” is often a polite way of saying “listen to my voice”.  The prospect that social care agencies should battle with rivals for survival not only alarms people, it is a nonsense. Collaborative working where agencies and citizens pool resources for strategic ends will yield much better results.

We simply need to remind ourselves of Bevan’s maxim that

  • “for us (people and agencies working together) empowerment meant the use of collective action to transform society and so lift all of us together”.

The key words are “collective action” not “competitive action”. Competition not only carries with it fragmentation of supply, it ultimately blinds providers to what should be their primary goal : the public good. It can also distort the citizen’s view that being ‘IN CONTROL’ simply means being empowered as a consumer in the market place.

In the past service delivery has frequently been AGENCY DIRECTED and rightly has been criticised for wielding this unequal weight of power within a relationship. Clearly there needs to be a new conversation that has mutual benefit; primarily harnessing and nurturing the growth and development of people in communities.

The BIG post war mistake was to airbrush mutuality from the operating structure of public services, replacing it with a state model of “AGENCIES IN CONTROL” that came to provide goods and services ‘for’ or ‘to’ people. By disengaging citizens as active agents of change, the agencies as designers and deliverers failed to engage the creative input of service receivers. The citizen was relegated to consumer, a watchdog barking at the heels of the service provider.  So how should this issue be addressed?

As stated previously, one political answer is to risk turning down another cul-de-sac by introducing choice and competition into public services, assuming that competition between drivers will improve service delivery.  But a change of driver is not a fundamental change of direction. If we are heading in the wrong direction then changing drivers will not get us very far, apart from bitter arguments about who is best qualified to drive the rickety train. A better answer entails creating in the 21st century a modern version of mutualism in a renewed civil society, This means multilateral co-operative methods of working and the re-introduction of co-production into the operating structure of third and public sector agencies: citizens and agencies in MUTUAL CONTROL actively working together to collectively CO-PRODUCE mutually agreed outcomes.

Co-production goes well beyond the idea of ‘citizen engagement, or ‘service user involvement’ to foster the principle of equal partnership. Co-production dissolves the distinction between providers and consumers of services. It offers to transform the dynamic between citizens and public service workers, putting an end to ‘them and us’. Instead people pool different kinds of resources, knowledge and talents, capabilities ideas and relationships to co-produce well being for all.  Co-production is about making the best use of all resources – building locality by helping the core economy to grow; moving from a welfare state to a civic state of well being.

Professor Michael Sandel in the recent Reith lectures reminds us that agencies must prioritise working with citizens to rebuild the architecture of civic life, suggesting that the virtues of democratic life – community, solidarity, trust, civic friendship – are not like commodities that are depleted with use. They are rather like muscles that develop and grow stronger with exercise.

As William Beveridge said more than 60 years ago, now is ‘a time for revolution, not for patching’.

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