By Aisling Duffy
Arranging homecare when mums’s dementia made life at home very difficult brought starkly into focus for me the role of the provider from a very personal perspective. We experienced a transactional, needs led process focussed largely on the tasks that mum and dad would need help with, the hours, payment arrangements etc. Important of course to get these right but the far more important questions about who would support mum, would they be able to chat with her and dad about things that mattered to them, would they be happy to wear casual clothes not a uniform (no said the provider – yes said the staff!) had to come from me not the provider. In practice we had some wonderful carers and Angela, in particular, became an important part of the family sharing in the everyday highs and lows, laughter and tears, texting me to reassure, encouraging Dad to have time out for himself. A style and approach that to be honest seemed despite and not because of the provider. And so, I was reminded yet again as CEO of a provider organisation of the important part our organisations can play in ensuring care and support is focused on living life to the full, filled with optimism, opportunity, affection and connections – the default not the exception.
This #socialcarefutures series of blogs is an opportunity to think positively and imaginatively about the part providers can and in my view should play in the lives of the communities we support. I write from the perspective of a not for profit provider. Here are my top 5 examples!
- Partnership of Equals – working alongside and in genuine partnership with people and families is at the core of great support and the common strength of good providers. When providers fail to fully recognise this, lives are put at risk. Too often adult social care has focussed on the needs of the person, sometimes to the exclusion of anyone else in their life. People have rich histories and family relationships that are part of defining who they are. Supporting staff teams to appreciate and engage with each person’s family in a way that respects their personal history is so important. It’s not always straight forward or predictable. Every family, my own included, has their own very personal dynamics and different ways of rubbing along together that while filled with love may not be easily understood by others. I fear that often no more than lip-service is awarded to these relationships. Providers are very well placed to develop and nurture holistic support that respects the joy, trials and tribulations being part of a family brings.
- Living Life to the full – outcomes not tasks! Providers are still too often contracted to deliver tasks and hours not outcomes and happy, healthy lives! The Alliance contract I mention below includes a set of outcome measures that were developed in partnership between people using services, providers and commissioners. Delivering on these shared outcomes will result in financial reward ‘gainshare’ for all parties and failure to deliver will mean shared financial penalty ‘painshare’. And while money is only one driver in my experience it can help focus a partnership!
- Community Connecting – from Street Parties to Community Choirs to supporting entrepreneurs in social businesses, providers can use capacity and resource to support grass roots community development. The role of providers in providing great support to people is to support and strengthen the communities people are part of not to replace them. Certitude’s Community Choirs in different parts of London bring people from all walks of life together over one shared interest – singing! We fund the Choirmasters and negotiate the venues and each Choir takes it from there – new friendships and relationships are the natural outcomes. Microbreweries are shooting up and for some beer loving people we support in south London a partnership with Gypsy Hill Brewery has led to them developing and now marketing their own beer and learning new business [and beer tasting] skills. In my experience successful and sustainable community connecting requires the provider to be skilled and astute in assessing when to step forward and use its capacity and resources to develop community connections and when to step back and let the community take the initiative forward.
- Systems Leadership – Providers support people who are at the receiving end of our health and social care system – who know first-hand what works and what doesn’t. This experience and knowledge is too often lost. One of the most innovative and exciting opportunities I am involved in is the Lambeth Living Well Network Alliance, which is a formal partnership between Certitude, South London and Maudsley NHS Foundation Trust (SLaM), homelessness charity Thames Reach, Lambeth Council and Lambeth NHS Clinical Commissioning Group, working together to design and deliver mental health services for adults in Lambeth. We are responsible for the entire adult mental health budget and the delivery of a co-produced business plan that is intended to transform mental health services over the next 7-10 years [the length of contract]. Progressive commissioning and strong provider leadership ensure this collaboration draws on the strengths and insights of the whole community with success measured against outcomes developed with people using services. Too often third sector providers are at the periphery of systems design – in Lambeth we are at its very heart with an enormous opportunity to do things differently. Providers need to positively grab the mantel to get involved in system design and not sit back waiting to be invited to the table!
- From competition to collaboration: At times of austerity the natural tendency can be to batten down the hatches, cut back on partnering, keep a steady ship and hope for the best! In such challenging and austere times, we need more not less collaboration. Effective alliances can lead to more innovative solutions, shared risk taking and better outcomes for people supported and colleagues. Certitude’s experiences of partnerships with the likes of the Brit School, the Tate, and Slaughterhouse have led to a range of collaborative creative ventures. Collaboration with statutory and charity partners is resulting in less use of residential and hospital care and more community and personalised support for people with serious mental illness in Lambeth. Collaboration requires openness to understanding each other’s differences, finding common ground and a shared drive and accountability to deliver change. It’s about recognising that our system is full of challenges and complexity which makes life more difficult for people we support and no one organisation has all the answers. Alignment with our values is without doubt the most important factor when developing the partnerships and collaborations that are right for Certitude. Not only do we seek great partnerships, but we aim to be a great partner too!
While none of this is rocket science, it isn’t how many people experience providers. Providers are in a unique position to be part of creating social care support that enables people to live happy, healthy lives both now and in the future. Making sure my ‘Mum test’ – care focussed on living life to the full, filled with opportunity, affection and connection is the expected default experience of anyone using social care.
Aisling Duffy is Chief Executive of Certitude www.certitude.org.uk.
Aisling tweets at @AislingDuffy_
Aisling is also Vice Chair of VODG and a board member of the National Development Team for Inclusion.