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Slides for day long conversation with social workers at Huddersfield University on personalisation and its impact on the social work role.

Slides for day long conversation with social workers at Huddersfield University on personalisation and its impact on the social work role.

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    Personalisation & Social Work Personalisation & Social Work Presentation Transcript

    • Personalisation & Social Work Dr Simon Duffy Talk for University of Huddersfield, 2011Monday, 23 January 12 1
    • 9.20 What is ‘Personalisation’ 10.30 Opportunities & Concerns - tables 11.00 Break 11.15 Debate 12.00 Social Work Rescript Agenda 12.45 Lunch 2.15 Applications - tables 3.00 Feedback 3.30 Break 4.00 Polling Questions 4.30 Final Questions 5.15 FinishMonday, 23 January 12 2
    • Dr Simon Duffy • Invented Individual Budgets and Self-Directed Support • Founded Inclusion Glasgow, In Control, Shop4Support and many other charities and social enterprises • Honorary Senior Research Fellow at University of Birmingham’s Health Service Management Centre • Director of The Centre for Welfare Reform • Policy advisor to The Campaign for a Fair Society • Based in SheffieldMonday, 23 January 12 3
    • The Centre for Welfare Reform • Research & development network • Independent - no government or private backing • Founded upon belief in human equality and diversity • A community of 60 voluntary Fellows... • ...people who created person centred planning, individual budgets, self-directed support, support planning etc... • 200+ publications at www.centreforwelfarereform.orgMonday, 23 January 12 4
    • The welfare state is goodMonday, 23 January 12 5
    • The welfare state is good it’s just designed wrongMonday, 23 January 12 5
    • The welfare state is good it’s just designed wrongMonday, 23 January 12 5
    • 4 Thoughts • Personalisation is not defined by government • Personalisation is about social justice • Good ideas don’t just happen • The challenge is to make it work for youMonday, 23 January 12 6
    • What is the meaning of personalisation?Monday, 23 January 12 7
    • Monday, 23 January 12 8
    • Photos from “Christmas in Purgatory”Monday, 23 January 12 9
    • Institutions don’t just come with walls... They start in the mind... And can be hidden in systems of power, education, funding and cultureMonday, 23 January 12 10
    • Great language... ‘inclusion’ ‘normalisation’ ‘individualised’ ‘community’ ‘empowerment’ ...shame about realityMonday, 23 January 12 11
    • 44 women with complex needsMonday, 23 January 12 12
    • Of 44 women working with WomenCentre: Managing a serious health condition 64% Finding a safer place to live 27% Living with childhood abuse 51% Didn’t nish their education 76% Recent experience of domestic violence 85% Fractured family (for those with young families) 66% Children have experienced abuse (for those with children) 55% Living with a severe level of mental illness 55% Living with some mental illness 91% History of drug or alcohol misuse 52% Victim of crime 41% Perpetrator of crimes 39% Worried by debt or lack of money 65%Monday, 23 January 12 13
    • Monday, 23 January 12 14
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    • Service label N Urgent problem N Real need N Victim of domestic 55 Debt 50 Better self-esteem 64 violence To overcome past Mentally Ill 39 Housing 48 54 trauma To manage Criminal 35 Benefits 46 51 current trauma To stop being Poor Mother 33 Health 37 50 bullied Misuses Alcohol 24 Rent 32 Guidance 50 Criminal Justice Uses Drugs 22 24 Relationship skills 45 Advocate Violent 19 Dentistry 8 Mothering skills 26 Chronic Health 16 Others 3 Others 1 ConditionMonday, 23 January 12 18
    • is there a different way?Monday, 23 January 12 19
    • is there a different way?Monday, 23 January 12 19
    • in practice, this meansMonday, 23 January 12 20
    • personalisation in practice • Smith family story • Reforming care management • Self-directed support • Personalised support • Personalised transition • WomenCentre • And many more innovations...Monday, 23 January 12 21
    • Monday, 23 January 12 22
    • individual (or personal) budgetsMonday, 23 January 12 23
    • 7 steps of self-directed supportMonday, 23 January 12 24
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    • Personalised Support flexible & creative supportMonday, 23 January 12 28
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    • Personalised Transition control: health, education & supportMonday, 23 January 12 32
    • Monday, 23 January 12 33
    • Jonathan’s health needs are complex.In the 3 years before leaving school Jonathan spent 150 days in hospital - responding to problems with breathing. In the 3 years since leaving hospital he has spent only 2 nights in hospital - for elective dental treatments. Jonathan’s family have overseen the development of a personalised package of support for Jonathan with flexibility, employment and learning - but not learning in college - but learning on the job. Over the last 3 years, Jonathan has acquired two City & Guilds Qualifications and is now learning new independent living skills. Over the last 3 years, the individual budget system has enabled Jonathan and his family to make significant efficiencies in the costs of his care and support and save the NHS: •Over £100,000 in hospital stays •Over £300,000 in residential care costs •Over £100,000 of funding contributed by the LSCMonday, 23 January 12 34
    • A couple of weeks ago in Sheffield, I met a wonderful woman called Katrina. Shes got three disabled sons. e oldest is Jonathan, a charming, warm hearted young man of 19. He cant walk or talk clearly, or feed himself alone. Hes had a breathing tube in his neck since he was a toddler. Under a scheme the new Liberal Democrat council in Sheffield is extending, Jonathans just got his own individual budget and care plan. Now hes doing work with a local charity, attending a music group, has his own personal assistant - a child whose potential seemed so limited. Finally as a young man, engaged in life in a way he and his mother never thought possible. Katrina told me with the biggest smile Ive ever seen, she said: Weve gone from having nothing to having everything. I wish every childs needs would be taken this seriously. (Nick Clegg, 17 September 2008).Monday, 23 January 12 35
    • WomenCentre a creative and positive communityMonday, 23 January 12 36
    • Monday, 23 January 12 37
    • Monday, 23 January 12 38
    • What are the opportunities? • What benefits are in personalisation? • What threats are in personalisation?Monday, 23 January 12 39
    • time for debateMonday, 23 January 12 40
    • good ideas don’t just happenMonday, 23 January 12 41
    • Monday, 23 January 12 42
    • Monday, 23 January 12 43
    • social  work  is  the  art  of  helping   people  be  active  citizensMonday, 23 January 12 43
    • social  work  is  the  art  of  helping   people  be  active  citizens in  practice  citizenship  means...Monday, 23 January 12 43
    • Monday, 23 January 12 44
    • 1. being in control 2. with direction 3. enough money 4. your own home 5. enough help, and 6. being active in communityMonday, 23 January 12 44
    • Monday, 23 January 12 45
    • but  citizenship  isn’t  easyMonday, 23 January 12 45
    • Monday, 23 January 12 46
    • poverty  attacks  citizenshipMonday, 23 January 12 46
    • Monday, 23 January 12 47
    • and  poverty  comes  in  many  formsMonday, 23 January 12 47
    • and  poverty  comes  in  many  forms • loss of hope • no power or control • disadvantage • exclusion & prejudice • isolation & abuseMonday, 23 January 12 47
    • Monday, 23 January 12 48
    •  so  social  workers challenge povertyMonday, 23 January 12 48
    • Monday, 23 January 12 48
    • Monday, 23 January 12 49
    • and  social  workers  do  this  byMonday, 23 January 12 49
    • and  social  workers  do  this  by ★ inspiring - hope and recoveryMonday, 23 January 12 49
    • and  social  workers  do  this  by ★ inspiring - hope and recovery ★ empowering - individuals & familiesMonday, 23 January 12 49
    • and  social  workers  do  this  by ★ inspiring - hope and recovery ★ empowering - individuals & families ★ strengthening - personal developmentMonday, 23 January 12 49
    • and  social  workers  do  this  by ★ inspiring - hope and recovery ★ empowering - individuals & families ★ strengthening - personal development ★ connecting - to communityMonday, 23 January 12 49
    • and  social  workers  do  this  by ★ inspiring - hope and recovery ★ empowering - individuals & families ★ strengthening - personal development ★ connecting - to community ★ building - safer networksMonday, 23 January 12 49
    • but  social  workers   cannot  do  this on  their  ownMonday, 23 January 12 50
    • these  are  not  things   you  can  do  for  peopleMonday, 23 January 12 51
    • these  are  things  you   have  to  do  with  peopleMonday, 23 January 12 52
    • it  is  people  themselves   who  make  a  change building  on  their  ownMonday, 23 January 12 53
    • Monday, 23 January 12 54
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    • Monday, 23 January 12 55
    • resilience = hopeful human spiritMonday, 23 January 12 55
    • resilience = hopeful human spirit control = money and the power to use itMonday, 23 January 12 55
    • resilience = hopeful human spirit control = money and the power to use it strengths = gifts, skills & knowledgeMonday, 23 January 12 55
    • resilience = hopeful human spirit control = money and the power to use it strengths = gifts, skills & knowledge community = opportunities to join inMonday, 23 January 12 55
    • resilience = hopeful human spirit control = money and the power to use it strengths = gifts, skills & knowledge community = opportunities to join in relationships = safe and loving networksMonday, 23 January 12 55
    • Monday, 23 January 12 56
    • Monday, 23 January 12 56
    • Monday, 23 January 12 57
    • Monday, 23 January 12 57
    • Monday, 23 January 12 58
    • personalisation  =  social  work so  what’s  the  big  problem?Monday, 23 January 12 58
    • the  big  problem   for  social  workers  is...Monday, 23 January 12 59
    • the  old system   gets  in  the  wayMonday, 23 January 12 60
    • the  old  care  management  systemMonday, 23 January 12 61
    • the  old  care  management  system makes  it  hard  to  do  social  workMonday, 23 January 12 61
    • it’s  really  hard  toMonday, 23 January 12 62
    • it’s  really  hard  to • empower people - without entitlementsMonday, 23 January 12 62
    • it’s  really  hard  to • empower people - without entitlements • strengthen capacity - focusing only on needsMonday, 23 January 12 62
    • it’s  really  hard  to • empower people - without entitlements • strengthen capacity - focusing only on needs • connect to community - inside segregated servicesMonday, 23 January 12 62
    • it’s  really  hard  to • empower people - without entitlements • strengthen capacity - focusing only on needs • connect to community - inside segregated services • build safe networks - without family, friends and loveMonday, 23 January 12 62
    • replace  care  managementMonday, 23 January 12 63
    • replace  care  management with  self-­‐directed  supportMonday, 23 January 12 63
    • this  means  social  workers  canMonday, 23 January 12 64
    • this  means  social  workers  can 1. empower people - tell people their budgetMonday, 23 January 12 64
    • this  means  social  workers  can 1. empower people - tell people their budget 2. strengthen capacity - focus on personal outcomesMonday, 23 January 12 64
    • this  means  social  workers  can 1. empower people - tell people their budget 2. strengthen capacity - focus on personal outcomes 3. access community - use funding flexiblyMonday, 23 January 12 64
    • this  means  social  workers  can 1. empower people - tell people their budget 2. strengthen capacity - focus on personal outcomes 3. access community - use funding flexibly 4. build safe networks - work with family, friends & othersMonday, 23 January 12 64
    • systems  sit  on  systems  -­‐  like  sedimentary  rockMonday, 23 January 12 65
    • Personalisation Care Management Protection/Safeguarding Responsibilities Annual Reviews Joint Assessment Processes Eligibility Criteria & Resource Panels Care Planning Monitoring Systems Comprehensive Assessments Mental Capacity Law Social Care Law for Children and AdultsMonday, 23 January 12 65
    • We’re  all  still   working in  the   old system  Monday, 23 January 12 66
    • we’ve  changed  wordsMonday, 23 January 12 67
    • added  new  complexitiesMonday, 23 January 12 68
    • But  the system is still the sameMonday, 23 January 12 69
    • social  workers sometimes  even  feel   personalisation   has  made  things   worseMonday, 23 January 12 70
    • we  must  simplifyMonday, 23 January 12 71
    • and   redesign   the  whole  systemMonday, 23 January 12 72
    • we  need  a  New  Script   for  social  workMonday, 23 January 12 73
    • the New Script looks like this...Monday, 23 January 12 74
    • the New Script looks like this...Monday, 23 January 12 74
    • Assess  people’s   ELIGIBILITY  for:Monday, 23 January 12 75
    • Assess  people’s   ELIGIBILITY  for: • guidanceMonday, 23 January 12 75
    • Assess  people’s   ELIGIBILITY  for: • guidance • rehab  orMonday, 23 January 12 75
    • Assess  people’s   ELIGIBILITY  for: • guidance • rehab  or • a  budgetMonday, 23 January 12 75
    • Assess   CAPACITY  &   clarify  where  the   leadership  is:Monday, 23 January 12 76
    • Assess   CAPACITY  &   clarify  where  the   leadership  is: • the  individualMonday, 23 January 12 76
    • Assess   CAPACITY  &   clarify  where  the   leadership  is: • the  individual • a  representativeMonday, 23 January 12 76
    • Assess   CAPACITY  &   clarify  where  the   leadership  is: • the  individual • a  representative • or  a  professionalMonday, 23 January 12 76
    • Don’t  plan  for   people  -­‐  instead   ENABLE  other   people  to  planMonday, 23 January 12 77
    • Don’t  plan  for   people  -­‐  instead   ENABLE  other   people  to  plan But  always  make  sure  that  you...Monday, 23 January 12 77
    • Monday, 23 January 12 78
    • is is Community BrokerageMonday, 23 January 12 78
    • ORMonday, 23 January 12 79
    • Plan  with  people   DIRECTLY   yourself,   especially  when:Monday, 23 January 12 80
    • Plan  with  people   DIRECTLY   yourself,   especially  when: • it’s  a  critical  situationMonday, 23 January 12 80
    • Plan  with  people   DIRECTLY   yourself,   especially  when: • it’s  a  critical  situation • the  solution  is  obvious,  orMonday, 23 January 12 80
    • Plan  with  people   DIRECTLY   yourself,   especially  when: • it’s  a  critical  situation • the  solution  is  obvious,  or • nobody  else  can  helpMonday, 23 January 12 80
    • AGREE  plans  as   soon  as  possible   if  they  are:Monday, 23 January 12 81
    • AGREE  plans  as   soon  as  possible   if  they  are: • sensibleMonday, 23 January 12 81
    • AGREE  plans  as   soon  as  possible   if  they  are: • sensible • safeMonday, 23 January 12 81
    • AGREE  plans  as   soon  as  possible   if  they  are: • sensible • safe • and  in  budgetMonday, 23 January 12 81
    • AGREE  plans  as   soon  as  possible   if  they  are: • sensible • safe • and  in  budget Plans  should  NOT  be  perfect!Monday, 23 January 12 81
    • If  people  need   help  to  set   things  up  then   DIRECT  them  to   the  right  people   and  placesMonday, 23 January 12 82
    • It  is  the  REVIEW   that  is  central  to   really  learning   what  is  working   and  to  helping   people  be  in   control  of  their   own  life.Monday, 23 January 12 83
    • This  is  a  New  Script  for  Social  WorkMonday, 23 January 12 84
    • What  the  New  Script  means  isMonday, 23 January 12 85
    • What  the  New  Script  means  is ★ things speed upMonday, 23 January 12 85
    • What  the  New  Script  means  is ★ things speed up ★ bureaucracy goes downMonday, 23 January 12 85
    • What  the  New  Script  means  is ★ things speed up ★ bureaucracy goes down ★ social workers use their best skillsMonday, 23 January 12 85
    • What  the  New  Script  means  is ★ things speed up ★ bureaucracy goes down ★ social workers use their best skills ★ people connect to communityMonday, 23 January 12 85
    • What  the  New  Script  means  is ★ things speed up ★ bureaucracy goes down ★ social workers use their best skills ★ people connect to community ★ but most importantly...Monday, 23 January 12 85
    • lives  are  transformedMonday, 23 January 12 86
    • e New Script helps us to...Monday, 23 January 12 87
    • 1. empower people - e New Script people and families in helps us to... control of their own livesMonday, 23 January 12 87
    • 1. empower people - e New Script people and families in helps us to... control of their own lives 2. strengthen capacity - people living positive lives, achieving, growingMonday, 23 January 12 87
    • 1. empower people - e New Script people and families in helps us to... control of their own lives 2. strengthen capacity - people living positive lives, achieving, growing 3. access community - people as active citizensMonday, 23 January 12 87
    • 1. empower people - e New Script people and families in helps us to... control of their own lives 2. strengthen capacity - people living positive lives, achieving, growing 3. access community - people as active citizens 4. build safe networks - reducing abuse and isolationMonday, 23 January 12 87
    • Share Expenditure Cost PP Hours PP 1. First point of contact - initial sign- posting 9.5% £414,437 £63 2.6 2. Overview assessment 13.7% £599,514 £91 3.7 3. Comprehensive/full assessment 19.0% £831,038 £126 5.2 4. Basic planning 13.7% £597,272 £91 3.7 5. Intensive planning, service design or support planning 16.3% £713,343 £108 4.4 6. Problem solving & responding to crises 16.0% £700,749 £107 4.4 7. Short reviews - basic 7.5% £327,924 £50 2.0 8. Long reviews - intensive 4.3% £189,200 £29 1.2 Total £4,373,478 £665 27.2Monday, 23 January 12 88
    • Monday, 23 January 12 89
    • Monday, 23 January 12 90
    • N = 801 17% 23% 12% Individual 13% Family/Friends 34% Provider B ro k e r C are Ma n ag e r Who is the best planner?Monday, 23 January 12 91
    • N = 774 16% 9% 17% 31% Individual Family/Friends Provider 28% B ro k e r Soci al Wo r ke r Who is the best organiser?Monday, 23 January 12 92
    • Monday, 23 January 12 93
    • Personalisation  should  be  efficient but  it  can  easily  be  made  wastefulMonday, 23 January 12 94
    • Number of care managers (WTE) 111.55 Cost of care management £4,373,477.75 Number now served by authority 6465 Ratio (number of people to 1 care manager) 68.73 Total hours of care management available 185507.18 Hours available per person 27.24 Average cost per person £664.87 Time on slimmed down core functions 81623.1592 44% Time on crisis management 44521.7232 24% Residual time to reinvest 59362.2976 32% Share of residual time 32% Residual time expressed as money £1,399,512.88 Residual time per person 8.7168 Residual money per person £212.76Monday, 23 January 12 95
    • how  do  you  make  a   ‘good  idea’  really  usefulMonday, 23 January 12 96
    • Know how to take things. Never against the grain, though they’re handed to you that way. There are two sides to everything. If you grab the blade, the best thing will do you harm; the most harmful will defend you if you seize it by the hilt. Many things that caused pain could have caused pleasure if only their advantages had been considered. There are always pros and cons; the trick lies in knowing how to turn things to your advantage. Things look different when seen in a different light. So look at them in the light of happiness. Don’t confuse good and bad. This is why some people find contentment in everything, and others sorrow. This is a sure defence against the reversals of fortune, and a great rule for living, at all times and in every pursuit - Baltasar GracianMonday, 23 January 12 97
    • Monday, 23 January 12 98
    • What are the opportunities • safeguarding children and adults from abuse? • empowering disabled people? • helping people manage long-term conditions, dementia or end of life care? • allocating resources more fairly? • improving the quality of planning and support? • strengthening communities and improving connectedness? • improved family work?Monday, 23 January 12 99
    • www.campaignforafairsociety.orgMonday, 23 January 12 100
    • © Simon Duffy 2011. Rights Reserved. Full copyright details at www.centreforwelfarereform.orgMonday, 23 January 12 101
    • 9.20 What is ‘Personalisation’ 10.30 Opportunities & Concerns - tables 11.00 Break 11.15 Debate 12.00 Social Work Rescript Agenda 12.45 Lunch 2.15 Applications - tables 3.00 Feedback 3.30 Break 4.00 Polling Questions 4.30 Final Questions 5.15 FinishMonday, 23 January 12 102