Munpreet Sohal

Facing Forward – Co-producing 2023!

Co-production group members attending a zoom meeting

As the complexity of problems and crisis management in adult social care continues, so too do the efforts of those working across all sectors to do their bit to effect change. Change does not happen quickly or magically. There is no wand. The crisis in health pushes adult social care further down the agenda. A growing and resilient social movement for change such as #SocialCareFuture across the UK is helping to bring it back to the forefront. So too is IMPACT, an implementation centre enabling practical improvements on the ground and making a crucial contribution to longer-term cultural change. Karen, our Lived Experience Engagement Lead, shares how IMPACT’s co-production work was shaped in 2022 and the upcoming plans for co-producing in 2023.

Our co-production approach

IMPACT projects, or sites as they are known, take a co-production approach. They span many areas of adult social care, such as direct payments, decision aids in end-of-life dementia care, and technology-enabling care. Expressions of interest are now open for organisations wishing to work on change projects in partnership with IMPACT in 2023-2024.

IMPACT’s co-production advisory group ensures the voice of those with lived experience is equally represented across IMPACT’s work. As will be reflected in our first annual report when it is published.

Co-production group members attending a zoom meeting

Learning from 2022 and co-producing into 2023

Looking back, co-producing our own work plan in 2022 was challenging and sometimes frustrating, but hugely rewarding. Relationships, time, and space were key themes. Time was well spent laying the foundations of our working relationships. We also acknowledged that co-production requires more space than we often afford – or can afford it. That will be a key lesson facing our work for 2023 – more space. A safe space to keep building trust, airing opinions freely, and listening to the voices of experience. We want to improve how we communicate this experience across IMPACT teams and beyond, by engaging further with like-minded groups.

In 2023, we begin to learn about the evidence emerging from existing sites and how IMPACT is practically working. We will continue with our flexible and responsive approach to our work. Our approach will continue to adapt based on what we hear. We also aim for many of our contributions to continue being implemented across IMPACT. We will draw on the strengths of our group members to inform, guide, and ensure that those who have lived experience of drawing on social care support are central to our work.

As we scale our projects, we want to ensure that co-production remains a core approach throughout all of IMPACT’s work. We want to ensure that this is consistent and transparent. Thankfully, the IMPACT team is traveling in that same direction and is listening with open ears. And listening to hear – prepared to act upon the feedback, and committed to effecting change. Each positive change in social care, however small it may seem, can lead to another, and another. Perhaps not from a magic wand, but from these tiny ripples come great waves.

Black History, Forgiveness and Adult Social Care

Our Digital Communications Officer, Munpreet, does a few things in her spare time, from volunteering at her Gurudwara, to working on both educational books and community-led building sites. Recently, as part of her volunteer work, she travelled to Ghana as part of a delegation launching the Peace Charter for Forgiveness and Reconciliation in Africa. The group she travelled with also visited Cape Coast Castle, near Accra, Ghana. This castle historically held thousands of African men, women, and children in captivity before sending them across the ocean to become slaves in the western world. 

As October is Black History Month, Munpreet has shared some of the things she learnt from this visit and how it relates to our approach within the adult social care sector. 

What has this visit taught me about forgiveness and care?

When I visited the castle, I didn’t know what to expect. The guide walked us through the dungeons and cellars in which our group of 40 felt confined, uncomfortable and at times scared; only to learn that previously these same walls had been home to over 200 individuals at any one time. 

As we were a delegation for peace, we asked the guide how the Ghanaian people have addressed forgiveness for the atrocities that occurred. He responded, “If we do not forgive, we will still be stuck within our own pain and suffering. Forgiveness is the only way we can heal.” He also shared that the local Chiefs of the time had been responsible for some of the harm that was done, as they had willingly handed over their prisoners of war without questioning the circumstances they were going into. As an acknowledgement of this complicit behaviour within the local history, our guide pointed out a plaque which the current Chiefs had placed on the castle walls, pledging to never let such injustices occur again. 

DSC00044

How does this apply to the UK today? 

During the Coronavirus pandemic, I volunteered at a vaccination centre. I saw many individuals from the African community arrive to be vaccinated, most of whom shared that within their communities there was a fear that the vaccine was designed to harm them. 

At the time I couldn’t understand this feeling of persecution and mistrust. However, having visited the castle it is now as clear as day. I understand that there are deep-rooted traumas that have been passed down within these communities that may not be overtly apparent to us. Yet, it is this history that can influence the way in which these same communities engage with larger health and social care services. 

It, therefore, becomes the responsibility of those delivering care to ensure they listen attentively, build trust, and create safety and security for those they are supporting. 

How can we use this knowledge within IMPACT? 

IMPACT is currently conducting a facilitator project on Direct Payments within the BME community. The project came as a result of IMPACT assembly discussions and is based on the recognition that those from BME communities do not access the support that is offered to them. I discussed my trip with the project Facilitator, Marie, to understand how this learning could be applied to the project going forward. 

The take-away points from the conversation were: 

  • We need to take time to understand the personal/familial or community history that might be influencing someone’s behaviour 
  • We need to make an active effort to build trust with all communities so that they feel valued, heard, and supported. 

Within IMPACT we understand that there are many issues that cannot be solved overnight. However, discussions and sharing of knowledge such as this gives us the opportunity to broaden our horizons and become aware of perspectives we may not have previously considered. 

Examining Choice and Control in Care

Choice and Control Pro and Con Brainstorm

6-week reflection by Amber Cagney, Networks Manager

I’m Amber Cagney – I work part-time with Kate Hamblin (Networks Lead) and Maria Teresa Ferazzoli (Project Officer) on the IMPACT Networks. My role is UK Networks Manager, which includes recruiting Local Network Coordinators in across the four nations, supporting them to run their Local Networks and meeting them in between each one to debrief and decide together how to run their next meeting. We’re currently running our first pilot network on choice and control and recruiting sites for the second network pilot on values-based recruitment and retention.

I worked in the anti-slavery sector for almost 10 years after starting out as a volunteer! My previous job with West Midlands Anti-Slavery Network was as the development manager where I set up a safe house project for male survivors of modern slavery in a multi-agency partnership. I still work within the sector part-time, and I’m a trustee for a charity delivering long-term support to survivors of modern slavery and human trafficking.

I’ve been with IMPACT for six weeks and am reflecting on the work we’ve done so far.

Equality, Diversity, and Inclusion

Equality, diversity, and inclusion are at the centre of IMPACT’s values. Having come from a human rights background, I believe the Universal Declaration of Human Rights should be central to any work or research into the care and support of people. The Declaration states “All human beings are born free and equal in dignity and rights”, it also states the rights to equal access to public services, the freedom of movement, and many others; these are core principles and it’s essential that our work is grounded in the pursuit of equality for all people to have a good life and the ability to thrive.

Equality is about ensuring that every individual has an equal opportunity to make the most of their lives and talents. It is also the belief that no one should have poorer life chances because of the way they were born, where they come from, what they believe, or whether they have a disability. Equality recognises that historically certain groups of people with protected characteristics, such as race, disability, sex, and sexual orientation, have experienced discrimination.

Multi-agency Interactions

IMPACT’s Networks are a good example of inclusive multi-agency interactions that are exploring the issues related to choice and control and values-based recruitment with a range of individuals who either draw upon care and support or help deliver it. Our first pilot is underway, tasked with exploring mechanisms, systems, and behaviours in adult social care that enable choice and control.

Initial Feedback

The feedback from our first Local Network meetings across England, Scotland, and Wales has been really interesting to read and reflect on so far. The definition of care is “the process of protecting someone and providing what that person needs”. The feedback strongly suggests the shift needs to be in the “process” and ensuring that the person being cared for has a voice, choice, and control in what their care looks like, with the recognition that every person is unique and has their own wants and needs. All individuals who access public services for care have the right to be protected from harm, and the right to be supported to live with as much autonomy and freedom as possible.

Choice and Control Pro and Con Brainstorm from the Scotland IMPACT Local Network Meeting

Choice and Control in Care

The networks discussed enablers for choice and control in care, which included:

  • Being asked – sometimes decisions can be made for people. True choice and control means asking, then asking again in the future – not assuming one answer stands forever – and also considering the person’s communication needs.
  • Being supported to make decisions – decision making can happen at lots of different levels, and people should be supported to make as many decisions as they can, and at every level possible.
  • Good information – being able to access information on providers, activities, or groups, that is up to date and free from jargon, but also accessible.
  • Good relationships – there are power dynamics in relationships, about how one person could be seen as being quite influential and pushing a decision in a particular way. Facilitating open conversations is important, potentially using advocacy.
  • Transparent systems and clarity over budgets– clear understanding of the eligibility criteria for different monies and knowing what they could be spent on

The local network attendees also acknowledged hindrances and barriers to choice and control, including both systemic and human decisions such as:

  • Risk – people should be supported to take risks and try new things, but attitudes – from the person, their family, support provider, or social worker – can be a hindrance. Proactive risk management with the supported person and mitigating risks together can be positive.
  • Relationships – sometimes the “family knows best” perspective can be a hindrance to the individual making progress. Also relationships between different partners- care providers feel like they are consulted to a lesser degree than a social worker, for example.
  • Rigid systems and processes
  • Time  – time to review support plans is not seen as a priority, and choices should be revisited, not taken as permanent.
  • Location and availability of services – very rural locations mean choices can be limited.
  • Disconnect between social care and health – health paying directly for some services rather than putting it into the budget so the individual can choose.
  • Covid-19 – many projects and activities were paused during the COVID-19 pandemic.

Next Steps

The next steps of the Local Networks are to explore what an effective mechanism to enable choice and control with finances and support plans looks like, and to share best practice amongst the different regions

We are currently facing the ongoing challenges of the COVID-19 pandemic, in a complex adult social care environment that is systemically underfunded, undervalued, and neglected in policy; we are very aware of the challenges of creating change, however, to progress and move forward to a more equal society and nation, these are exactly the types of conversations we urgently need to have, and there is no better time than now.

Thinking about 2023

In 2022, we’ve been getting up and running as a national centre and testing our four delivery models via a series of pilot projects across different parts of the UK.  In 2023, we want to work in even more places and cover a broader range of topics.  We’re still working on the detail of this, but we hope to be able to go out to the sector in late 2022 with an ‘expression of interest’ – looking for partner organisations who might be interested in hosting future projects. 

Topics for 2023

The topics for 2023 would be based on the priorities which came out of our national survey and from our Assemblies.  In particular, we’ll focus on topics which:

  1. Make a real difference
  2. Tackle inequalities
  3. Make good use of scarce resources
  4. Have enough evidence for us to work with (where there isn’t enough evidence we’re trying to make sure that we feed this back to partner organisations so that they can try to fill these gaps as quickly as possible)

This is likely to include topics such as:

  • Prevention and well-being
  • Assets-based and person-centred care
  • Carers’ health and well-being
  • Support for people who work in social care

Identifying Partner Organisations

When we identify sites that might want to work with us, we want to get a real mix (e.g. in terms of geography, and the nature and needs of the local population).  We also want to make sure that we don’t just work with organisations that usually volunteer for these opportunities – but with a wide range of people.  This might include small, innovative community organisations; user- and carer-led organisations; and services that are really struggling and wouldn’t usually be able to think about taking part in something like this.

To help people plan, we’ll be clear about the funding and support we can provide, but also about the things we’ll need in return (for example, we’ll want sites that are committed to co-production and to sharing learning with others). 

Expressing interest

There will be more information later in the year – but please start thinking about whether your organisation might be interested in expressing an interest. You can sign up to our newsletter and follow us on social media (Twitter, LinkedIn) to be among the first to find out more.

IMPACT Network is officially live

We’re mid-way through our 2022 Establishment phase, and deep in the middle of setting up pilot projects to test our four delivery models. We are delighted to share that our first IMPACT Network has been set up.

IMPACT Networks are one of the four delivery models IMPACT is piloting to achieve change in adult social care. Our first network is looking at choice and control for people with learning disabilities and/or mental health issues in supported living. Our Network Coordinators are:

What are IMPACT Networks?

Networks are being piloted across the UK, with local networks in Scotland, Wales, Northern Ireland, and England, all focusing on the same issues. The aims are:

  • To improve practice and outcomes in adult social care at the local level and solve common, yet complex challenges.
  • To bring together practical solutions at the community level to create solutions that can be scaled up to help inspire and inform change across the UK.

Each local network, made up of 8-10 people – people with experience of care and support, carers, front-line staff, funders/decision-makers, and relevant service providers – will meet four times over a period of six months. They will discuss a particular issue using materials provided in advance, such as findings from research, practice knowledge, and lived experience. Members will share their experiences and learning and suggest practical solutions.

They will feedback to the Networks Lead, Kate Hamblin, and Networks Manager Amber Cagney, and learning will be shared with the other local groups working on the same issues, creating a network of networks. The aim is to produce an action plan to take a particular issue forward and enact change.

The inspiration

IMPACT Networks were inspired by one of our Critical Friends: Nka, the Swedish Family Care Competence Centre. For many years, Nka has worked with ‘Blended Learning Networks’ – a method where people with a common interest and from various backgrounds work towards a common goal. They learn from each other and share experiences and convert research results into practice and policy. The networks always focus on carers, but each local network is based on a specific theme of interest to key stakeholder groups, including informal carers and their organisations

A local network consists of 10-15 people – carers, health and social care practitioners, decision-makers, local politicians – led by one or two members. The leaders of the local networks in turn have meetings with staff from Nka, forming a national network.

We were also inspired by Etienne Wenger, who in the field of education, developed the concept of communities of practice in organisations to solve common issues they were facing. Communities of practice are formed by people who engage in a process of collective learning – they share a concern or passion for something they do and learn how to do it better through regular interaction.

Next step for our Network

The first Network meetings will take place in late July.

Amber Cagney has recently been appointed as the Networks Manager, and will be working closely with Kate. Maria Teresa Ferazzoli has also joined the team in Sheffield recently as the Project Officer. We will update our project page with updates from Kate and the team.

A Co-production Charter

The beginning of the journey of the Co-Production Advisory Group

A key element of IMPACT, the UK evidence centre for adult social care, is the commitment to co-production in all aspects of its work. The first step towards this commitment involved the Co-Production Advisory Group, and their group Charter.

The Co-Production Advisory Group’s role is to develop, support, monitor and review IMPACT’s co-production activity, producing an annual report for the Leadership Team on progress made during the year, areas of good practice and areas for further development. This work is supported by the Lived Experience Engagement Lead, Karen McCormick.

“Quite often when new groups come together for the very first time, it can be a challenge to gel. We are all a little bit nervous and perhaps unsure of each other’s circumstances. However, this was not the case with IMPACT’s new Co-Production Advisory Group. They are an animated, confident and lively bunch – this bodes well for us as a group.” Karen explained.

Creating a Charter

A charter is a nice way to document how we intend to collaborate together and our guiding principles.  It’s a way of acknowledging the work we have to do, such as project objectives and the parameters we have to work within, but also allowing space for members of the group to have their say on how we approach it and work together.  

“My approach to starting a charter is to include the knowns, leaving space for the unknowns and being open to the aspirations.” Karen tells us.

“The knowns are the practical things such as structures, definitions, the fact that we need to have 3 meetings this year and produce and annual report. The unknowns are things like the topics we are going to discuss and the schedule for this. Unknowns are also things like the shared vision for the work of the group, the strengths and assets of the group and the language we use and barriers to participation.  Suggestions around practical tips for working together online, communicating and engaging are also included in the early version.

“These were collated into a draft charter (a working document) and presented as suggestions to get us started at the induction meeting – the first coming together of the co-production advisory group – all subject to change through engagement and agreement among members of the group. Ideally with more time, we would come with a blank page but we have a lot of work to do in a short space of time.”

A Living Document

It is intended that the charter will be a living document. Just like charting any course, it will need revision – the group will have waypoints, needing to check where they are and if they are heading in the intended direction. It is hoped that by the end of the first working year together all members of the co-production advisory group respect the journey, and recognise each other and themselves as valued members of the crew.

Demonstrator is officially live

In this blog, IMPACT’s Robin Miller and Sarah McLaughlin celebrate the set up of the first IMPACT Demonstrator

We’re mid-way through our Establishment phase, and deep in the middle of setting up our initial pilot projects to test our four delivery models. We are delighted to share that our first IMPACT Demonstrator has been set up.

Demonstrator background

This Demonstrator will be based in Mid & East Antrim, where a successful asset-based project is already in place. IMPACTAgewell® was introduced in 2017 by the Mid & East Antrim Agewell Partnership (MEAAP) in partnership with local health and social care organisations through funding from the Dunhill Medical Trust (a member of the IMPACT consortium). Its innovative model includes linking people to community resources, multi-disciplinary locality hubs to bring together professionals in a locality on a regular basis and ‘funded’ social prescriptions which enable resources to flow to voluntary and community organisations.

IMPACT Demonstrators will explore how we can use evidence to address major strategic issues for adult social care. Improvement ‘coaches’, including people with lived and/or practice experience) will work in local services to facilitate an evidence-informed change, support evaluation and work with national policy and practice to embed any lessons learned.

Asset-based approaches

The first Demonstrator will be focused on ‘asset-based approaches’ and in particular how older people can have a better life via health and social services working in new ways with them and with the community and voluntary sector.

As well as learning from their success to date, the Demonstrator will work with IMPACTAgewell® to ensure that this approach is available to all older people in the local area. At present most, but not all, general practices participate, and therefore some older people are not able to benefit from the opportunity. Partial implementation is a common issue when introducing an innovation. The local community and voluntary-led partnership would like to examine how the engagement process can develop, and how they can encourage and support the engagement of all the services and professionals in the area. Doing so could ultimately lead to the scale and spread of the model to other areas.

Sarah has been appointed as the first improvement coach and the second post will shortly be advertised by the University of Ulster – we will share vacancies when they are made live. We will update our project page with updates from Robin, Sarah and the MEAAP team.

IMPACT on the Care Matters Podcast

We are pleased to bring you a two-part episode of the Care Matters Podcast, produced by the ESRC Centre for Care and CIRCLE, and focussing on the work of IMPACT (IMProving Adult Care Together), the new UK centre for implementing evidence in adult social care. IMPACT is funded by the ESRC and the Health Foundation, with £15m over nearly 7 years.

Improving Adult Care Together: Part 1
Improving Adult Care Together: Part 2

“We believe that good care isn’t about services, but about having a life – and that evidence can play a key part in achieving this vision.”

However, for this to be meaningful, ‘evidence’ has to include insights from different types of research, from the lived experience of people who draw on care and support and carers, and from the practice knowledge of people working in adult social care.  As IMPACT gets up and running, people from across social care have told us that they don’t really need ‘more evidence’ – but that they are crying out for practical support on the ground to make a difference in the realities of front-line services, support to fund the participation of people whose voices are seldom heard, and shared spaces/facilitation to come together to work on shared problems and shared solutions.

We’ll be building all these principles into a series of delivery models and projects which we’ll be piloting from 2022, and then rolling out across the UK from 2023.  As we start this work, these two linked podcasts involve conversations between people from different parts of the UK and from different parts of the social care ‘system’, exploring some of the key challenges and opportunities, and reflecting on what these mean for our work together to bring about positive changes on the ground.  You can find out more about how to get involved, but please listen to and share these podcasts as a way of continuing the conversation about how we get better care and support for all of us, how we see social care as a form of social and economic investment that we make in ourselves as a society, and how we work together to make a difference.

Our host and guests

Host

Jon Glasby

Jon is a qualified social worker by background and works as a Professor of Health and Social Care at the University of Birmingham.  He is the Director of IMPACT.

Jon Glasby Profile

Part 1

Karen McCormick 

Karen is a parent to a young adult with an intellectual disability who draws on social care. In order to give her daughter more choice and control over her life, they have opted for a personal budget. The process of establishing her daughter’s self-direction arrangement to employ her own personal assistants motivated Karen to found inCharge Ltd in 2020.  She believes that technology can play an enabling role in the self-directed care process.  Karen contributed to the work of the Northern Ireland IMPACT assembly in the design phase through her lived experience contributions to the temporary co-production advisory panel and is now Lived Experience Engagement Lead for IMPACT. 

inCharge HQ Website
inCharge Twitter
Karen’s Linkedin
Karen’s Twitter

Terry Davies 

Terry is an IMPACT Assembly member for Wales and is a person of lived experience, employed by West Wales Action for Mental Health.

West Wales Action for Mental Health Website

Obert Tawodzera 

Obert is a Research Fellow at the University of Birmingham and IMPACT’s Project Officer. He completed his PhD at Sheffield University and was part of the Sustainable Care programme led by Professor Sue Yeandle. Prior to doing his PhD, Obert worked as a care worker for adults with learning difficulties. His desire and passion to see change which is underpinned by inclusion and equality is what drives his commitment to research in adult social care.

Professor Sue Yeandle Profile

Part 2

Clenton Farquharson MBE

Clenton is a disabled person with lived experience who draws upon health and social care. Clenton employs his own Personal Assistance, and he looks after his mum’s personal budget which his mum uses for her own personal assistance.

He is Chair of the Think Local Act Personal (click here to learn more) programme board, and a member of the Coalition for Personalised Care. He is also a member of the Social Care Sector COVID-19 Stakeholder Group which will ensure that concerted and determined action continues to be taken to reduce the risk of transmission of COVID-19 in the sector, both for those who rely on care and support and the social care workforce.

Clenton was named in Disability News Services’ list of influential disabled people and listed in the top 50 of HSJ’s most influential Black, Asian and minority ethnic people in health. He was also voted top social care leader in the recent Social Care Top 30 awards hosted by Care Talk magazine.

Visit Think Local Act Personal
Social Care Top 30 Awards

Karen Hedge

As National Director for Scottish Care (click here to learn more), Karen is working to shape the future of social care but is frustrated by the failure of traditional research to move beyond the ‘proof of concept’ stage. She believes IMPACT offers an exciting opportunity to reconsider our approach to evidence implementation by recognising the value and capability of the social care sector. Creating the conditions for real collaboration, critically including those who work in and access care and support, will allow us to move not only to research implementation but embedding. She brings over 20 years of sector experience from frontline to Board level and a passion for evidencing impact in outcomes for people.

Scottish Care Website

The Care Matters Podcast

Care Matters Podcast Producer: Dan Williamson

Dan is the Digital and Communications Coordinator at the ESRC-funded Centre for Care and produces the Care Matters podcast, as well as creating animations, videos, various other digital outputs and maintaining the Centre for Care website and social media platforms. Before joining the Centre for International Research on Care, Labour and Equalities (CIRCLE) at the University of Sheffield, Dan worked for many years at a telecare company, training healthcare professionals and patients with long-term conditions how to operate state-of-the-art remote monitoring devices.

The Care Matters Podcast Series: care is a complex and important issue that affects everyone at some point in their life. The CARE MATTERS podcast welcomes experts in the field and those giving or receiving care to discuss crucial issues in social care, as we collectively attempt to make a positive difference to how care is experienced and provided.

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