Research and analysis within the book Women at the Centre - a model offering holistic and powerful support to the whole community

1. Slides from launch
of
Women at the
Centre
Dr Simon Duffy
Angela Everson
Clare Hyde
© Simon Duffy. Rights Reserved.
The author must be cited if images
or slides are used

2. 1. Complex Needs
2. Complex Responses
3. WomenCentre Model
4. Impact
5. Investment Case
6. Welfare Reform

3. Complex needs seem...
really complicated

4. Complex needs are
really complicated
12 possible needs
Range of responses:
1 to 10
Mean response: 6
Varied patterns
Real complexity

5. 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 finish their education 76%
Recent experience of domestic violence 85%
Fractured family (for those with young families) 66%
Children have experienced abuse (for those with 55%
children) a severe level of mental illness
Living with 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%

6. Domestic Violence
85% of the women in the whole group were recent
victims of domestic violence with 55% of women
experiencing frequent domestic violence from their
partner:
• 46% had their partner steal from them
• 65% were physically attacked
• 18% were raped
• 16% saw their children hurt
• 31% felt like killing their partner
• 68% were scared of their partner

7. Victim of Crime
41% of all women reported being a victim of crime in
the last year and there were 43 incidents of crime:
• 17 cases of criminal damage
• 12 cases of domestic violence
• 5 cases of the (non-vehicle)
• 2 cases of burglary
• 3 cases of serious wounding
• 2 cases of wounding
• 1 sexual offence
• 1 mugging
Note that domestic violence is oen not called a crime
by its victims - so these figures are an under-estimate.

8. Perpetrating Crime
39% of women had committed a crime at some time in
their lives. e number of women committing
particular crimes was:
• 11 common assaults
• 3 thes (not vehicle)
• 3 thes from a shop
• 2 drug offences
• 1 the from a commercial vehicle
• 3 burglaries in a dwelling
• 3 acts of fraud or forgery
• 2 other woundings
• 2 thes from a commercial property
• 1 serious wounding

9. Using Drugs and
In the sample 52% of all women said that drugs
or alcohol was an important part of their life
now or in the past:
• 32% had used cannabis
• 10% had used prescription drugs
• 15% had used cocaine
• 22% had used amphetamines
• 7% had used heroin
• 13% had used crack

10. Chronic Health
64% of all women were managing complex and
significant medical conditions including
women with (in descending order of
frequency):
• depression
• asthma
• anxiety or stress related illnesses
• heart or blood pressure problems
• illnesses of the bowels or stomach
• diabetes

11. Mental Health
Severity Score 0 1 2 3
Feel slowed down 9 21 12 2
Feel tense or wound up 2 25 7 6
Don’t enjoy things I used to 13 14 7 6
Get frightened and anxious 4 22 9 5
Expect something awful to happen 6 8 13 12
Lose interest in my appearance 18 10 10 5
Can’t laugh or see the funny side 23 9 5 2
Feel like I need to be on the move 7 15 14 7
Worrying thoughts on my mind 7 11 17 7
Don’t look forward to things 19 11 5 6
Don’t feel cheerful 21 17 3 2
Get sudden feelings of panic 7 15 18 2
Can’t relax 8 22 9 4
Can’t enjoy books or TV 23 17 2 2

12. Housing
Type of home Before After
Home owner 8 7
Renting from private 10 16
landlord
Friends or relatives floor or 6 1
sofa
Renting from council 8 9
Renting from a HA 4 6
Living with Parents or 3 2
Guardian
A guest in someone else's 3 1
house
Refuge 1 0
Total 43 42

13. Victim of Child Abuse
• 36% had an unhappy childhood
• 44% experienced emotional abuse
• 26% experienced neglect
• 51% experienced some kind of abuse
• 33% experienced physical abuse
• 16% experienced sexual abuse
• 42% said that how they were treated as a child has made it
more difficult for them in their lives today
• 78% of those who said they had an unhappy childhood and
52% of those who were abused felt badly affected by those
childhood experiences today

14. Child Abuse Now
For those mothers with children now 54% of
those who replied said that their children had
been abused and a further three women said they
were not sure. Abuse was across the full range:
• 39% experiencing emotional abuse
• 12% experiencing sexual abuse
• 12% experiencing physical abuse
• 12% experiencing neglect

15. Education
Within our sample we found that the women working
with WomenCentre have varied educational
backgrounds:
• 23 had O-levels, GCSE’s or NVQs.
• Some also had A-Levels, degrees or other forms of
higher education.
• 76% of women didn’t feel they had finished their
education
• 58% said school didn’t work for them
• 33% said they had not gone to school regularly

16. Income
79% of women were living alone or just with children
under 18 (40% of total).
All relied upon some form of community-based income
security.
e poorest woman in the sample, living on income
support alone, her annual income is £2696 or £51.85 per
week.
is is just 10% of the average annual salary in the UK
and less than 2% of the salary of the Prime Minister.

17. Income Source N Child Tax Credit 18
Money from Council Tax
1 14
Partner or Family Allowance
Wage 3 Incapacity Benefit 6
Disability Living
Income Support 23 10
Allowance
Begging 0 Pension or Pension 5
Credit
Invalid Carers
Maintenance 2 1
Allowance
Job Seekers
7 Individual Budget 1
Allowance
Housing Benefit 18 Other Earnings 1

18. Debt
65% of women were worried by debt or had other
money worries. e predominant forms of debt were:
• Bank or credit union -6
• Loan sharks - 3
• Bills - 3
• Catalogue - 1
• Family - 4
• Stores and credit cards - 3
• Companies - 2
• Student loan - 1
• Tax and benefits - 3
• Housing - 3
• Private loan - 1

19. Public service responses
to complex needs are

20. Public service responses
to complex needs are
even more complicated

21. Public service Used last % Helpful Unhelpful
Job Centre year
26 59% 1 4
Benefits Agency 27 61% 2 2
Housing Services 20 45% 2 1
Police & Victim Support 18 41% 1 0
(victim)
Police (criminal) 13 30% 1 0
Prison 0 0% 0 0
Probation 9 20% 1 2
Children’s School 15 34% 1 1
Acute Mental Health Services 4 9% 0 0
Community Mental Health 6 14% 0 1
Services
GP Surgery 36 82% 3 1
Community Health 11 25% 1 0
Adult Social Work 2 5% 0 0
Children Social Work 14 32% 1 4
Adult Education 10 23% 0 0
Citizen Advice Bureau 8 18% 4 2
Children Centre 2 5% 1 0
Sure Start 2 5% 2 0
Carers Project 2 5% 2 0
Age Concern 2 5% 2 0
Counselling 3 7% 3 0
Park Initiative (Community) 2 5% 2 0

22. An alternative hypothesis - ‘complex needs’
are not really so complicated...
‘complex needs’ is code for real poverty - the
multiple and reinforcing erosion of personal

23. WomenCentre’s response to
1. Start with the whole woman - gendered and
holistic
2. Offer a positive and comprehensive model of
support - every woman is a one-stop-shop
3. Build a bond of trust - create the means for
woman to do real work together
4. Be a new kind of community - women,
working together, to improve lives and
communities.

24. in other words...
personalised
support through
collective action

25. A positive model of service...
...5 and half levels of

26. Us Per
Service Cost
e Cap.
Level 1 - Information £50,000 13,520£3.70
Level 2 - Advice & £200,000 1,000 £200
counselling
Level 3 - Case work £500,000 500 £1,000
Level 3.5 - Intensive case £575,000 115 £5,000
work
Level 4 - Training £200,000 268 £746.27
Total £1,525,000

27. Knitting together the bond of

28. “Working with” - real wealth

29. Urgent
Service label N N Real need N
problem
Victim of Better self-
domestic 55 Debt 50 64
esteem
violence
To overcome
Mentally Ill 39 Housing 48 54
past trauma
To manage
Criminal 35 Benefits 46 51
current trauma
To stop being
Poor Mother 33 Health 37 50
bullied
Misuses 24 Rent 32 Guidance 50
Alcohol
Criminal Justice Relationship
Uses Drugs 22 24 45
Advocate skills
Violent 19 Dentistry 8 Mothering skills 26
Chronic Health
16 Others 3 Others 1
Condition

30. Focusing where the risk is...
© Simon Du y. All Rights Reserved.
INFORMATION SHARING IDENTIFYING FAMILIES @ RISK
Info Police Risk Factor 1 Risk
Sharing Management
Protocol Strategy
NHS Risk Factor 2
Top 50
Families
Social Service in
Risk Factor 3
Crisis & Chaos
WomenCentre Risk Factor 4
Focused Feedback & learn
Assumed Support
Consent
to
Referral +
£

31. 108 women on any one day...
...5,000 different women in one year

32. The WomenCentre

33. Total impact
• Typical time in intensive case work - over 1 year
• Our sample focused on women who were in the
middle of their intensive of work
• 100% of women said life has improved since
working with WomenCentre; 100% said
WomenCentre helped

35. Life area score N of sample impact
Life as a whole 42 95% 50%
Relationships 28 64% 45%
Work 15 34% 51%
Leisure 33 75% 41%
Housing 24 55% 48%
Neighbourhood 15 34% 44%
Money 30 68% 37%
Physical health 21 48% 40%
Mental health 36 82% 42%
Children’s wellbeing 19 43% 36%

36. Transformational
86% of women felt more positive about their own future. 93%
said WomenCentre had helped them with their attitude to their
future. 74% of women said they felt their life was worthwhile,
while 72% said they had positive dreams for the future, these
included:
• 68% wanted to be a good mother
• 68% wanted to be a good friend
• 46% wanted to be a helpful neighbour
• 55% wanted to help in the community as a volunteer
• 6% wanted to play a bigger role in their faith community
• 42% wanted to be a good employee
• 24% wanted to run their own business

37. changed behaviour [for women offenders] 100%
better able to manage their relationships [for victims of 78%
domestic violence]
need to use drugs & alcohol reduced 73%
health improved 95%
management of health improved 89%
felt better 93%
had improved education 40%
managing money better 51%
found a new place to live 29%
housing had improved 50%
helped to feel safer at home 64%
children were safer [where abuse suspected] 43%
feel safer in their neighbourhood 53%

38. Quotes - key themes
• Supportive & responsive - “Very
supportive, if you can’t get hold of
anyone someone always calls you back
quickly.”
• Transformational - “It made my life
worth living.”
• Secure - “If I needed help or anyone to
talk to there was always someone there
to help and it’s also confidential.”
• Social - “It’s a safe place where women
can come together to socialise and learn
to promote their own well being.”

39. • WomenCentre builds a real
community through female identity
• is holistic, because its identity does
not come through ‘a specialism’
• avoids the “privileged irresponsibility”
of high status professional roles
• instead, it develops a new kind of
professionalism, with
• transformational leadership -
forgiving, supportive, mobile -
modelling its support to women

40. Success
Factors
• Stickability - no passing the buck, triage or segmentation
• Neo-professionalism - trained, committed, staff team
• Relationship building - through facing urgent problems
• Personalisation - using all of person’s real wealth
• Positive - finding the key that’s right for that person
• Pragmatic - adapting around what works
• Coherent - faith in the possibility of renewal

41. WomenCentre helps
women make it through
the maze

42. Complex funding...
• In 2009-10 turnover was just over £1,000,000
• 41 different funding streams
• average size is £25,000
• 22 distinct projects
• 33 reporting systems
• with an average length of funding of 18 months
• at best only 1 in 3 funding bids are successful
• 2011 saw a 41% cut in funding!

43. Growth brings no
coherence...
...funding streams remain
tiny

44. Constant re-
definition in terms of
centrally defined
“project’s” - what’s

45. Funding is not
Local NHS contribution to WomenCentre in 2009-10 was £38,000
- which represents 4% of WomenCentre’s budget and 0.012% of
the local NHS budget.
Calderdale Council’s direct financial commitment to
WomenCentre was approximately £165,000 - nearly 23% of
WomenCentre’s Calderdale specific funding and 0.03% of the
whole council budget.

46. Funding sources N
Local Government 13
Local NHS 5
Regional or Sub-Regional 7
Charities 13
Central Government 3
Total 41
...larger funding streams
national

47. Funding is not
but this reflects
our highly
centralised nature
of UK welfare state
- the most
centralised

48. incoherence of localism
where is the missing £0.9

49. and recent cuts
target local
government and
education reforms
further centralise
control

50. Complex funding, complex
like Penelope’s
nightly
unweaving...
...and daily
reweaving

51. A better system would
1.through relationships
2.the real WomenCentre
3.to prevent domestic
violence
4.to reduce re-offending
5.to improve health
6.to reform social work

52. 1. Relationships - not
procurement
e real questions to
ask:
• Can we trust them?
• What is their track
record?
• Will they take care?
• How can we learn
about what they do?
• How can we develop
our shared
understanding?

53. 2. Use the whole model -
stop the ‘projects’
...its the dynamics of the whole system that makes
it work

54. 3. Domestic violence
-prevent it
Research showed 87% of
women and 100% of
children were safer aer
© Simon Du y. All Rights Reserved.
work with WomenCentre. INFORMATION SHARING IDENTIFYING FAMILIES @ RISK
e event cost of domestic Info
Sharing
Protocol
Police Risk Factor 1 Risk
Management
Strategy
violence is over £29,000 per NHS
Social Service
Top 50
Families
in
Risk Factor 2
Risk Factor 3
Crisis & Chaos
incident. WomenCentre Risk Factor 4
So an investment of £10,000 Assumed
Consent
Focused
Support
Feedback & learn
to
(intensive case work for two Referral +
£
years) would create a net
saving of £16,100 - a return

55. 4. Reoffending -
Research shows reoffending
rate of less than 5%
(compared to national
average of 50%) for women
working with WomenCentre.
Event costs for mothers can
be estimated at £75,000 and
so an investment of £10,000
would produce a net saving
of £61,250 - that is a return of
over 600%

56. 5. Health - improve it!
Our research showed 73%
reduction in drug use,
95% improvement in
physical health and 98%
improvement in mental
health.
Yet health investment in
WomenCentre is
insignificant.

57. 6. Social Work - change
WomenCentre provides an effective
social work service to women and
children at 55% of the cost - calculated
on an hourly basis. It works
independently and it is embedded in a
real and mutually supportive
community that also draws in
additional resources. Staff are trained in
many disciplines and can provide a full
range of skills.
Current investment could shi from
statutory to local, non-profit-making
services like WomenCentre.

58. 7. Combined benefits -
change it
When we describe the benefits of
WomenCentre in relationship to one
target, one service, one improvement
we miss its most exciting benefit -
the same £10,000 improves life on
every dimension - deals with all
areas. e average woman with
complex needs has 6 distinct and
significant needs - WomenCentre
works on all needs at once - for the
same money...

59. potential
of
Total

60. systemic resistance to
innovation

61. The big question -
Will local leaders and
services
be able to embrace
the real innovations created
by local people?

62. The Centre for Welfare Reform
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Parkway Business Park
Sheffield, S9 4WG
T +44 114 251 1790 | M +44
7729 7729 41
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