Agenda item

In attendance for this item were:

Worcestershire County Council:

Richard Keble, Assistant Director of Adult Services

Kerry McCrossan, Operations and Integration Manager

The Assistant Director gave a presentation, which provided an overview of the Council's switch to a strengths-based approach to social work with adults, based on the 'Three Conversation' model. Essentially the new approach would move away from social workers going in and asking questions about the problems, to asking someone 'what can you do?' and using a person's strengths to build on, in providing support.

The Panel was shown two slides which had been used to explain the new approach to staff involved, which put forward what social workers should be doing, based on the British Association of Social Workers Code of Ethics (2012):-

·         Promote social change, problem solving in human relationships and empowerment and liberation of people to enhance well-being

·         Address the multiple, complex transactions between people and their environments

·         Enable all people to develop their full potential, promote and enhance independence and enrich their lives

The second slide depicted the current system nationally, which unintentionally had become focused on processes, referrals, cost reductions and aversion to risks. Staff immediately identified with these points.

The Three Conversations approach would replace the status quo operating model in social care, with one based on assets and strengths, and collaboration. It was a new way of working, not an additional one. Experiences from other local authorities, their service users and staff, provided compelling evidence that it worked, improved well-being, and could significantly improve staff satisfaction and productivity. It also worked in integrated environments to improve both health and well-being, as well as consuming less resources.

The Three Conversations involved in the new straight-forward approach were:

·         Listen and connect – really understand what matters, connect to resources and support

·         Work intensively with people in crisis – look at what needs to change urgently for the person to regain control, put into a plan, stick like glue to help make the most important things happen

·         Build a good life – what resources, connections and support will enable the person to live that chosen life? How do they need to be organised?

The numbers of conversation 3 would significantly reduce as staff mastered conversations 1 and 2.

Staff would need to know people's communities and neighbourhoods to be able to work in this way, and learn a new way of recording work, with no hand-offs, no referrals, no triage or waiting lists – and lots more accountability and seeing things through to the finish.

This represented a significant cultural and behavioural change for all staff, but one which was completely in line with core values, principles and reasons for being in social care jobs.

The evidence base and lessons from elsewhere

The new approach was very much based on reflective practice; the approach worked with all people and represented the most effective financial sustainability strategy, since the evidence showed a significant reduction in contacts that become ongoing packages of care.  There was potential for a major impact on long-term spend, and particular opportunities for integration with the NHS.

Improving partnerships with health professionals and other key partners would be very important.

Changing the conversation with people would mean social workers would often end up helping people to happily spend some of their own money well, rather than the Council's, which would build on their assets and strengths.

The answers to a person's needs were often very individual and unexpected. By sticking with and collaborating with the person in need, families would be much more likely to collaborate with social workers.

Risk would be viewed differently, by taking more risks but always collectively with reflection and discussion. The approach did not feel easier, but more interesting, flexible and people-centred.

Timeline

The new approach would be introduced with two teams from 24 April, with evaluation and innovation sites to learn new ways of working from May to July. It was planned to have the model working across the county from February 2018.

It was ambitious and a massive cultural change, but the feedback from staff was that everyone supported the new way of working and was ready for it. The Operations and Integration Manager also pointed out that the importance of staff retention and recruitment, which would be helped by increased job satisfaction.

Main discussion points

·         Panel members agreed the new approach was a very good idea and could see that staff would benefit from more 'doing' and less 'processing'.

·         The officers advised that although the changes would be substantial, the evidence showed that the speed of the positive impact helped staff to see the benefits of the new approach early on. There were always some people who may not like change, but this was the right way forward for Worcestershire and in truth the concepts behind the approach should ring true to anyone in social or care work.

·         The new model was not a reaction to the recent Ofsted report of Children's Services, although it would help address some of its concerns.

·         The Cabinet Member for Adult Social Care agreed that links with the community would be very important, and that a community model was needed to avoid acute (hospital) care being the default option.  She particularly liked the fact that the new approach gave people a named contact to work with and kept in mind the fact that people can get better and regain independence.

·         It was essential that health and social care came together, especially links between GPs and social workers – the Kidderminster area was particularly progressive in this respect. Officers advised that multi-disciplinary teams would mean partnership working.

·         The new approach would be a big change and was not without risks, but it was acknowledged that a change was needed to facilitate more independence.

The Healthwatch Worcestershire Chair was invited to comment, and welcomed this as a significant but challenging change for Worcestershire, which could not be achieved alone and community links would be important. Healthwatch were involved and would want to engage with service users and carers.

In thanking the officers for their information, the Panel agreed it would be helpful to be updated on progress with the new approach and the Assistant Director suggested Autumn 2017.

The Chairman paid particular tribute to Cllr Blagg, who was not standing for re-election, as an exemplar portfolio holder for adult social care. The Panel had been hugely impressed by her knowledge, commitment and involvement in scrutiny meetings.

A Panel member also paid tribute to Cllr Wells for his chairmanship of the Panel.