adult

Build a Collaborative Future Using Evidence

On Monday 3 October, IMPACT hosted a Conservative Party Conference fringe event in Birmingham city centre: ‘Utilising the Evidence to Build a Collaborative Future for Adult Social Care’.

The panel was made up of:

  • Jon Glasby, Director of IMPACT and Professor of Health and Social Care at the University of Birmingham
  • Damian Green MP, Co-Chair of the APPG on adult social care and MP for Ashford
  • Sarah McClinton, ADASS President and Director of Health and Adult Services and Deputy Chief Executive for the Royal Borough of Greenwich
  • Ruch Amos, self-described “average guy who has a passion for reducing inequalities for disabled people”
  • David Brindle (Chair), senior commentator and ex-Guardian Public Services Editor

Learning from lived experience

The panel was focused on how we can promote good practice, scale up, aid innovation and remove the barriers. The discussion started with Rich’s lived experience of adult social care, emphasising the importance of having a network of friends and the effect of changes to funding – after moving into local authority accommodation, individual care budgets were replaced by collective ones.

“Funding was only available for us to exist.”

Rich Amos

He reflected that there was a real lack of attention to individual support needs and was told his housemates should be his source of social interaction. He and his housemates were treated as one unit, not individuals. Rich has now moved to a different local authority, where he was reassessed and it was recognised he needed one to one support, which he now receives through PAs supporting him 24 hours a day.

The challenges

“The overwhelming barrier is the lack of capacity.”

Damian Green

Damian Green emphasised workforce provision and a lack of smooth planning as significant issues – constituents have told him that care home space is available, but it’s very hard to get domiciliary care. He said a lack of organisation, paired with a need for more funding, means innovation in social care is hampered.

Sarah McClinton said it’s important to reflect on the breadth of care, with over half a million people waiting for social care right now. She also said crises feed into short-termism, and longer-term planning is challenging.

Jon Glasby called for adult social care to be reframed nationally, with care seen as able to change lives. At the moment, there’s a lack of visibility: challenges are not well-understood by the public and policy-makers, and social care is portrayed as a burden. He added that people feel policy claims what they should be doing but the question is how do we do this for real? IMPACT’s co-design survey found people want more practical support, rather than evidence.

Rich Amos emphasised the external factors that are playing a part in challenges finding accessible accommodation, from Covid to the lack of accessible new build properties. He said the system needs to be more flexible and adaptable, and that we’ll keep having these conversations unless learnings are shared and the system changes.

Opportunities for change

Damian Green said we need to change planning rules, so a percentage is set aside for accessible housing/housing for those drawing on social care. He said it could make a radical difference, challenging the crisis narrative if care was embedded in people’s lives and routines. He also emphasised the possibilities an imaginative use of assistive technology could open up.

Sarah McClinton agreed, emphasising the control these changes could give people. She said we will all need housing that lets us be independent for the longer. Discussing the future of the sector, she highlighted: broader housing standards and more flexible approaches. She also suggested more integrated care systems, with more focus on recovery and building independence, as well as learning from COVID (data on support needs/vulnerability presents the possibility to do preventative work).

“Good support isn’t just about ‘services’ – it’s about having a life.”

Jon Glasby

Jon Glasby said you have to start with the person and the life they want to lead, and build back from that – a person-first approach. He added that community navigators and local area coordinators are really valuable, so we need to have creative conversations about what support people need & from whom.

David Brindle asked a quick-fire question. What would you prioritise, to improve adult social care?

  • Rich Amos: Co-production is key, the benefits are clear. We need a national, universal approach to this instead of pockets of excellence and of fragmentation.
  • Damian Green: Ending the conception that social care is funded by council tax. It must be funded nationally. We also need a proper workforce plan.
  • Sarah McClinton: Making the sector more attractive to work in: better pay for the social care workforce, parity with NHS staff, the workforce needs to feel truly valued and that there are career development opportunities
  • Jon Glasby: Organising care well relies on relationships – building relationships locally with partners, and between central and local partners.

Rich Amos said people must be involved at every step of the journey when designing services, with equal relationships and power dynamics removed to create better outcomes for everyone involved.

Jon Glasby said good leadership is needed at all levels but there’s currently an ambivalent attitude towards leadership across the sector – need to create routes where people can keep doing what they love in their jobs as they move up the career ladder. He added there’s no shared approach and united sense of what success looks like in social care so we end up arguing with ourselves & presenting varied messaging to policymakers.

Sarah McClinton emphasised that work is needed to improve staffing and resourcing, through a workforce plan.

“Adult social care can be very scary for individuals, but we all need to remember the impact it has. We get so focused on policies, agendas, but adult social care comes down to humans supporting each other and if that works well it enables people who draw on care to live fulfilling lives.”

Rich Amos
Attendees talk before the event
Jon Glasby, David Brindle and Rich Amos sit on the panel chatting before the session had started
Attendees talk before the event
A woman in the audience taking notes
The audience, sitting around round tables
Sarah McClinton holding a microphone with the panel looking at her
Someone in the audience asks a question
The audience claps
Sarah McClinton and Rich Amos chat after the event was over
Attendees and Rich Amos sitting on sofas and chatting after the event

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.

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