On November 1st, 2016 we hosted our first workshop of the SEEDS group. Standing for sharing experiences, evidence, discoveries and successes - we met at the historic Grand Central Hotel to do just that. SEEDS builds on the work of the Iriss champion network, an approach to engaging with people who work in the social services workforce that ran from 2009 - 2016.
Although this was a new group coming together for the first time, we welcomed some familiar faces of people who were part of our champion network. We were also joined by Sarah Ahmad from Something Meaningful who visualised some of our group conversations.
It’s getting personal
We started off by doing a ‘personal profile’ exercise - a simple template that asks some big questions including:
- What people like and admire about me
- What’s important to me
- What drives me about my work
This really got people reflecting and talking. We uncovered stories about what initially brought people into working in the social services sector and how they felt about the work they do. People talked about being ‘humbled’ by their work and having a passion for making things better for people who access support, promoting social justice and equality.
Success
Once people were warmed up and knew a bit more about each other we moved on to focus on successes. Sometimes it can seem like there’s a knee jerk move towards focussing on the challenges, the bits that are broken and need fixing. When designing the day, we really wanted to give some space and attention to people’s successes, the things they were proud of and to unpacking the mechanisms of these. Discussions began with what actually constitutes ‘a success’. Some felt that it implied a completed ‘thing’ so we agreed successes could also be works in progress. A range of examples was given - no two were the same. The similarities were in the enablers which ranged from processes to values and attitudes:
- working together
- co-production
- doing things differently
- positive attitudes, positive culture
- belief in the abilities of others
- time
- non-judgemental approach
- openness
- empathy
- enthusiasm
- determination
- patience
- shared values
- hard work
Other comments suggested that fresh thinking, being more open to risk and taking a strengths-based approach were useful enablers of success:
- ‘Willingness and interest of others to engage’
- ‘Something fresh and different that isn’t ‘mandatory training’
- ‘Partnerships - staff supporting and talking to the people who would benefit / people being open to working in different ways’
- ‘Learning - taking a chance!’
- ‘People - knowledge of ‘how to’ and local knowledge / contacts’
- ‘Can do’ attitude, belief in families and each other
- ‘The right people, compatibility, skills - matching effectively.’
- ‘Developed from where we were at in practice, not a set series ‘imposed’
It was also great to hear some Iriss tools noted as enablers too!
Evidence, learning and sharing
Part of the successes activity involved asking participants to reflect on the role of evidence in their successes. For some, it was a lack of evidence which prompted some new work, for others it was an integral part of the process or an output produced to share learning. Several different kinds of evidence were highlighted - practice wisdom and experience, theory, research, lived experience/feedback from families, examples from other parts of UK, evaluation.
The final part of the activity was about learning - what was captured and how was it shared. Several lessons that were learned from the successes were detailed including:
- reinforcing change can be difficult
- being realistic about the time it takes for change to happen
- taking staff with you through change and find out what they need to know
- the importance of involving whole families in interventions
- the impact of staff values on action plans
- the importance of supervision and mentoring
- seeing the opportunity in opposition
People shared their learning with a range of stakeholders including partner organisations, families, teams and other organisations (eg other Health and Social Care Partnerships, Scottish Government, health colleagues). Mechanisms for sharing included conversations with partner organisations, practice forums, regular network meetings, learner journeys, dissertation, mentoring, presentations (internal and external) and good news stories.
Improvement
In the afternoon we asked people to tell us about the areas of improvement they were focussing on. Topics included:
- evaluation
- retention and recruitment
- co-production
- service redesign in the face of budget cuts
- sharing good practice
- differentiating training from learning
- time for reflection
- transitions for young people
- developing and sustaining outcomes-focused practice
- commissioning
- monitoring
- day services and day centres
These were themed and groups gathered in an unconference style session to explore. Given the diversity of the topics, this session was challenging and each group did things a bit differently, but overall, people said they valued the opportunity to talk, listen and reflect. Some ideas for projects were also generated and taken back to the wider Iriss team to discuss as part of our business planning.
A good start
So, as the first workshop of a new group, the energy was positive and the discussion productive, with some people swapping details and making connections between shared interests. The group said they valued:
- ‘Meeting new people, time out of work to think / ask questions’
- ‘Making new connections, sharing discussion, comparing practice, services’
- ‘Opportunities to re-focus upon broader themes of learning and be part of a learning community ‘
- ‘Good conversations’
- ‘Being able to work on my own issues while being in group discussion’
- ‘Opportunities to hear other’s perspectives and ideas’
People said they were inspired by the passion, creativity, commitment and shared goals across the group. All the feedback backed up what we know from our experience - that people need and value opportunities to share experiences, evidence, discoveries and successes.
Eligibility criteria and critical need - SEEDS 2
On the 15th March 2017 we were back at the Grand Central Hotel (in a bigger room, we listened to feedback!), for the second SEEDS workshop. This time we had a specific topic - eligibility criteria and critical need which was highlighted during the first SEEDS workshop in November. The workshop was co-facilitated with Robert White, Head of Social Work from Independent Living Fund Scotland.
A strong platform
The day kicked off with some scene setting from Robert.
The strong platform we have in Scotland to build from to provide enabling assessments of need was explored, including the The Social Care (Self Directed Support) (Scotland) Act 2013 and the detailed statutory guidance for practitioners.
Robert explained that the legislative underpinning of social care assessments in Scotland remains the Social Work (Scotland) Act 1968 S12A. When this Act was the delivery model of social care assessment a national framework of Eligibility Criteria was developed. This framework arguably appears focussed on older people’s care needs, however, has been used for Adult Social Care since 2009. Many partnerships who have no ‘formal’ eligibility criteria use this framework.
For comparison, we also heard about the approach taken in England. With the implementation of the Care Act 2014 authorities in England stopped using a banded eligibility criteria similar to Scotland. This consultation concluded that the four bandings of risk were too open to local variation and individual subjectivity. England’s new eligibility criteria are outcomes focussed with the key impact being a person’s well-being.
Local differences
The focus for the rest of the morning was to make space for discussions about local contexts and differences. Groups identified and shared key strengths of using eligibility criteria in their context and areas for improvement.
- Without an eligibility criteria you are more open to subjectivity and inequality
- Eligibility criteria increases accountability
- Barriers: authorising budgets, senior management scrutiny, computer systems
Discussion also covered local variations of training in using the criteria, the role of resource allocation groups and the challenges of working in an integrated context.
Outcomes
As the day progressed we talked more about what really matters to people and the tensions between using eligibility criteria while trying to be outcomes focused:
- ‘The current processes are deficit focused - start with assets’
- ‘At the moment it feels like we’re just helping people to exist’
Some key questions were surfaced through the wider group discussion:
- Can we be truly outcomes focused when we’re assessing need and risk using the criteria?
- What about social and emotional needs? Aren’t these critical, especially when thinking about prevention and early intervention to support people before they reach crisis point?
- How can we shift local authority focus from need to outcomes in order to generate budgets?
What’s critical for people we support is positive conversation - to understand and help them achieve what they want
Transitions
In the afternoon the focus shifted to eligibility criteria and transitions - from children’s to adult services, from adult to older adult services. What’s critical to people will change as they move through the phases of their life - how flexible is the criteria to this?
Mind the gap
The day finished up with a discussion about what’s missing. Overall, the group felt that there were evidence gaps, things we still need to know about the effectiveness of eligibility criteria, what the alternatives might be and how this supports an outcomes approach. People felt that the criteria needed to fit better with personal outcomes, be more robust, prevention-focused and responsive to the changing needs through the life course. There was a suggestion for ‘assertive champions for outcomes in local authorities’ and of achieving ‘a better balance between eligibility and outcomes combined with the more honest, committed implementation of outcomes-based approaches’.
The biggest gap was seen as education, communication and training. The group felt it was important to establish a common understanding and language around eligibility criteria and critical need. The consistency of understanding across local areas, organisations, and between practitioners (health & social care) and the public was seen to be missing. One person commented on the ‘need for difficult conversations at all level - services and commissioners’. Other education, communications and training needs including:
- Local authorities need to meet national guidance - support to do this
- Effective signposting and information about other resources
- Effective advocacy by workers, peers, carers and service users to shift ‘blockages’
- Education for everyone - decision makers, assessors, services users, public
- Training for all levels of social care staff on eligibility criteria and SDS
- Speak to Health NHS staff and public so they understand we have eligibility criteria
- Work to change mindset - encourage and change in what people themselves consider critical need and how to respond to those
- Identify ‘best of breed’ assessment tools and roll it out - reduce variability
- Time and freedom for staff to do their jobs, strip back the bureaucracy and admin
Again, people at this workshop as with the first, valued the opportunity of space to work through issues core to their work with others from different areas. They said they benefited from ‘great conversations’ and the ‘energy and enthusiasm around the table’. When asked what they would do differently after the event, common responses were about ‘challenging’ and ‘questioning’ the current approaches in their context and the ‘status quo’. This was really encouraging as we hope our workshops help participants to feel more confident in introducing new ways of thinking about thorny issues in their contexts and drawing inspiration from other people, areas and organisations.
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