Change Model Stage 7: Sustaining for the long-term

How to sustain for the long-term

There is always a risk that practices and processes will go back to their previous ways even after a successful initial period of change – this is why planning for sustainable change from the beginning is vital.

Being able to connect with a wider set of developments within your organisation can help to ensure engagement and investment in the longer term – you may need to communicate links clearly.

The more diverse those involved in the change are, the more likely it is to continue as there will be greater energy and capacity to do so.

Other parts of the change cycle will help us to understand what has and hasn’t worked locally. Evaluation insights can also help build the credibility of the change. Recognition from those who control funding and capacity will not only encourage people involved but will also demonstrate that the change is making a positive difference.

As local contexts change, the change approach may need to be adapted too – continuing to focus on the outcomes which matter will help to steer this.

Examples within IMPACT

The Facilitator project in Leicester aimed to understand if services at all stages in the Direct Payment process were culturally appropriate and, if no,t how/where/when changes in the service could be implemented. It was completed at the same time as wider developments on strengthening co-production within the improvement of adult social care.

The learning generated through the project was used to develop staff training to enhance local skills and capacity, and direct payment guidance was updated and translated into different languages. Twelve months following the project, the co-production group is now representative of the wider population, Leicester has changed the language they use to communicate with people who draw on care and support, and have adapted commissioning processes so direct payments are more accessible.

The Facilitator project in Glasgow supported the implementation of the ‘Care Technologist’ role, a new way of working initially developed by Scottish Care. The initial plan was to introduce a rolling programme of staff training, but this was impeded by staffing capacity issues and instead a paper-based resource was identified as being more suitable. This change was informed by feedback collected via a staff survey on training needs.

Three case studies were developed on implementing technology in care at home services that could be presented to local authorities to demonstrate what mechanisms support and hinder the use of technology. An independent evaluation found that the role fostered a more holistic approach by integrating technology with physical, emotional and social support. The Care Technologist role also delivered significant social value; from an investment of c.£77k they provided a total social value of c. £250k, providing a Social Return On Investment (SROI) ratio of over 3:1.

IMPACT worked with Neath Port Talbot council on a demonstrator project that focused on prevention, and in particular “to encourage a system influenced by the community, not a community influenced by the system.’ Part of the local community response to prevention is Pro Afan, a group of practitioners who come together to support members of the community in the Afan Valley. They work directly with individuals, often in people’s homes.

The group was formed as practitioners were frequently working in isolation, trying to tackle complex and challenging issues in a deprived area with limited statutory services. Those involved in Pro Afan recognised that by working collectively—and sharing their expertise and skills—they could achieve better outcomes, both in the short term and long term, for individuals and the wider community. By working together, practitioners also found mutual support in their roles.

Working with Pro Afan, it became evident that it would help to sustain and spread the work of the group by supporting them to develop a simple working framework. To achieve this we:

  • Interviewed all members of Pro Afan
  • Spoke with local people at various community groups and venues
  • Interviewed five local businesses
  • Interviewed 32 community members
  • Looked at data
  • Reviewed various strategies and action plans.
  • Facilitated two workshops with Pro Afan members, representatives from the local authority and colleagues from the central IMPACT team.

During the workshops we worked with Pro-Afan, to capture their vision, mission and values. This will help people to understand the aims of the group and how they work, making it easier to reach more people in the community, and potentially to transfer this way of working to other areas.

In the Leeds Network on technology, the review promoted discussion about gaps relating to effectiveness of using specialist technology and AI to help citizens and practitioners in selecting the most appropriate technologies. This resulted in the co-creation of ‘Leeds Principles for Good Technology Implementation’, which has shaped the council’s digital strategy. A community of collaborators was also established to take this work forward to embed evidence-based learning into practice.

Changes have emerged from the Personal Assistant (PA) Wellbeing Demonstrator Project at a national level in Scotland. Findings from the evidence review conducted for the project reinforced issues with poor and uncertain employment terms and conditions for PAs.

Consequently, the PA Wellbeing subgroup (part of the national PA Programme Board) negotiated a competitive deal on union membership with the Unite union to strengthen collective bargaining and representation and access to the blue light card was also extended to PAs, ensuring parity with other health and social care workers. These changes represent concrete policy shifts at a national level.

This project also made a difference to how evidence is produced on the PA workforce, through shaping questions in the national PA workforce survey. The survey is designed to track evidence on PAs in Scotland to address recognised gaps in understanding on the PA workforce