Tackling domestic abuse by challenging perpetrators – rolling out Drive. Domestic violence: Changing the conversation from asking ‘Why doesn’t she leave?’ to start asking ‘Why doesn’t he stop?’

By RedQuadrant consultant, Claire Bethel

RedQuadrant has successfully worked with two police forces in the last year to carry out feasibility studies into the roll-out of DRIVE[1], an intensive intervention for perpetrators of high risk high harm domestic abuse. The Home Office announced £10 million of funding in the Budget this year for interventions working with perpetrators of domestic abuse. This includes £1.1 million for implementation of the Drive project to expand it into new areas. Any Police and Crime Commissioner in England and Wales can apply.

Domestic abuse is thought to cost in the region of £66 billion a year in England and Wales[2]. Although both men and women experience abuse, it remains a gendered crime, more commonly inflicted on women by men, with at least 27% of all women experiencing partner abuse since the age of 16[3]. Traditional approaches to tackling domestic abuse in this country have for years focused on providing support to victim-survivors and their children. This has changed in recent years with recognition that, if we are to stop domestic abuse in its tracks, we have to do something to challenge the behaviour of perpetrators of high risk or serial abuse. Failing to do so allows them to move from one relationship to another, wreaking havoc until the victim-survivor manages to get away or the authorities take action.

Support is frequently provided by local agencies in the form of refuges; providing sanctuary in the victim-survivor’s home (eg: strengthening locks, installing stronger doors); a range of criminal justice measures and helping victims to seek safety. Much of the caseload of a Children’s Services Department is taken up with addressing the consequences of domestic abuse – frequently leading to child protection plans or, in extreme cases, children being taken into care.

It was recognised that criminal justice interventions punished the offender but did little to change their behaviour which is frequently entrenched, stemming from adverse childhood experiences, including witnessing domestic abuse in childhood. Evaluation of traditional perpetrator programmes has been inconclusive, with high rates of recidivism by participants. Concern that this approach, whilst both worthy and necessary, didn’t help to address the behaviour and mindset of the perpetrator led to greater efforts to find a longer term solution.

In response, a number of programmes have been developed to tackle the root cause of domestic abuse perpetrators’ behaviour. DRIVE, developed by a consortium of voluntary sector organisations[4], aims to tackle high harm and serial perpetrators by challenging behaviour and preventing abuse. This is a truly multi-agency approach, relying on collaboration between police, voluntary and community sector, local authority, housing, probation and many other agencies. An evaluation of a pilot project found that it has led to the number of participating service users reducing their use of each type of domestic violence and abuse behaviour – for example, physical abuse reduced by 82% and sexual abuse by 88%[5]. It is a three-pronged approach consisting of engaging with the perpetrator, supporting the victim and using disruption to penalise any ongoing abusive behaviour.

A RedQuadrant team, with a range of expertise on domestic abuse and interventions to address it, has worked with two Police and Crime Commissioners – one urban and one in a more rural area – to evaluate the effectiveness of their DRIVE pilot and to examine the feasibility of rolling it out across the whole police force area. Taking both a quantitative and a qualitative approach, our work has involved interviewing a wide range of stakeholders to find out their views on what difference a pilot of DRIVE has made in their area; an economic analysis into the costs and benefits of the scheme and potential ways of rolling it out, and an analysis of their initial findings to see if these were likely to match those produced by the original pilot being evaluated by the University of Bristol (spoiler: it does).   

[1] http://driveproject.org.uk/

[2] Oliver R, Alexander B, Roe S et al, The economic and social costs of domestic abuse, Research Report 107, Home Office, January 2019.

[3] Smith et al, 2012, cited in NICE guideline, Domestic abuse and violence: multi-agency working, page 28.

[4] Respect, SafeLives and Social Finance.

[5] Hester M, Eisenstadt N, et al, Evaluation of the Drive Project – a three-year pilot to address high-risk high- harm perpetrators of domestic abuse, University of Bristol, Executive Summary, January 2020, page 2.

Call for action – build on trust in adult social care

By RedQuadrant consultant Charley Maher

In my blog in April I discussed how, because of COVID-19, local authorities have experienced a significant increase in demand for packages of support and an increase in people requiring support in the community as they lost access to their informal networks of families, friends and communities.  To enable local authorities to respond to the most urgent and serious cases, volunteers, charities and third sector organisations have come together to respond to the crisis; food banks, befriending services, distributing packages, sharing creative ideas to reduce social isolation, etc.  Organisations unified as we started trusting one another, and relationships between sectors are strengthening.  This newfound trust has resulted in quicker and smoother solutions to immediate need as we see conversations between individuals and those who know them best. We can see communities, volunteers and third sector organisations being trusted to engage and respond with people they know.

There is the question of how councils will cope in the post-COVID world of adult social care, with the increase in demand, in business as usual community reviews and in people who use services? My suggested answer is to build on these new approaches of trusting providers, trusting care agencies and third sectors who have existing relationships with people.  If we can trust them in a crisis, can we extend this trust into the future thereby extending and continuing this sense of community and togetherness we see now?  As we utilise the resources and knowledge these organisations and providers have to respond to the crisis, can we see this as a new approach to implement in our services and practice? Can we simplify processes and remove some of the formalities and structures that serve as time-consuming and potential blockers to true conversation-based approaches?

Before the Covid crisis, we did some work with a London borough to research, coproduce and test a model whereby the third sector was able to carry out some of the statutory functions of adult social care. A public consultation with people who used services, carers and families were open to the concept, with reassurances around training and quality assurance with the local authority maintaining oversight and responsibility.  Ongoing consultation with the third sector demonstrated an appetite for providers and voluntary organisations to be more involved in the statutory functions and the belief that doing so would improve outcomes for individuals that use services. Piloting, with high levels of face to face training, ongoing support, point of contacts for advice and training,  provided evidence of the capabilities of the third sector to produce person centred, strengths based assessments and reviews with individuals which resulted in creative support plans and increased use of community resources as opposed to the default approach of formal services.

Public consultation and provider engagement and piloting shows us it is possible to develop and build on trusting relationships with care agencies and the third sector.  The COVID – 19 crisis has shown that local authorities have turned to providers and the third sector to support them and it has been this joined-up approach which has helped meet the increased needs.  Yet we can still see some hesitation around continuing with these trusting relationships.  Why?  Assessments and reviews are statutory functions.  They are important pieces of work with individuals which require skilled conversations and person-centred interactions, a broad knowledge base to encompass,  direct payments and financial considerations. And ultimately Local authorities remain responsible for these functions therefore it is understandable there may be hesitations around using providers and the third sector to complete them. The question then became; how do we reduce these uncertainties and support the development of these relationships with providers and the third sector?

As we suggested in the previous blog, this would require training and upskilling of voluntary and third sectors: the Care Act is clear that those undertaking assessments and reviews should have the skills to do so.  We have created a qualification specification with clear learning outcomes and training modules to as part of an accredited qualification to upskill providers, care agencies, and the third sector across adult social care. Before we progress this any further, we would like to engage with local authorities, providers, commissioners who are potentially interested in making greater use of the third sector for assessments and reviews: we are interested in working in a couple of areas to refine and develop the work we have undertaken to date on qualifications in this space.

What kind of leadership is needed in public services and how localised will it need to become? Stephen Moss

Output from groupwork at the second ‘build back better in the days after’ virtual round table.

The days after – a learning community to build back better – join now: www.publicservicetransformation.org/2020/04/the-days-after-a-learning-community-to-build-back-better

Reflections of the ideas expressed: Stephen Moss, Senior Consultant, RedQuadrant

In our second build back better in the days after session as part of an online gathering using ‘open space’ methodology, an interest group formed around this question:

What kind of leadership is needed in public services and how localised will it need to become?

A complementary question was merged with the first to stimulate the discussion:

What future culture, leadership attributes and governance is going to be required for local authorities where large scale remote working is a new reality?

example Jamboard – brightly coloured post-it notes on a white background

The discussion was conducted online via zoom in a breakout room with participants with a range of perspectives on public services. The main points were captured on a ‘jamboard’ – a virtual whiteboard set up to support the group discussion (sidebar). This blog builds on the discussion.

Four broad themes of leadership capability emerged:

  • System leadership of place
  • (Leaders) willing to work with community empowerment and sustainability
  • Relationship-based leadership
  • Safe working: psychological and physical

This blog expands on the post-its (highlighted in italics) to define a place-based, relational leadership approach emerging from the lockdown.

System leadership of place

Street level support networks eg Wigan What does this mean for how we lead? How do we lead on a strengths-based model?

empowering communities and families to support parents and children

Public service leaders need to create a different relationship with communities in the places they serve. This suggests greater emphasis on asset-based approaches to development and building capacity in local communities to strengthen local support networks and economies. Assets include people, physical natural and build environments, knowledge, businesses and goodwill. Studies such as ‘Born in Bradford’ point towards the need to create ‘community readiness’ to tackle local social issues impacting safety, health and well-being.

In places like Wigan, this is also about re-defining the social contract between local authority and communities it serves and how decision-making and power are distributed. We have seen during Covid many examples of people and their communities creating new support networks for more vulnerable people. We also cannot yet measure the impact of lockdown on health outcomes in local populations; we have seen health inequalities cruelly exposed, and the collapse of many SMEs and increases in unemployment on the economic horizon. In this time of transition then, public service leaders have little choice but to let go of power, regroup to ensure the safety of the most vulnerable and look at how to work with each other and their communities in new ways.

(Leaders) willing to work with community empowerment and sustainability

The discussion here focused on local authority leadership however the principles apply to public services in general, as the focus moves on to what is needed in a locality.

Willingness for LAs to do things differently and focus on empowering communities – Need right skills and values to do this

Understanding communities and building relationships

Local authorities as facilitators of services not delivering services

Leadership capabilities across the system/place – values based

Developing leadership across the locality – in the community as well as public services – means identifying with the needs and aspirations of that locality. This can be an essential part of building capacity in the community to care and to resolve important issues locally – care for the elders, dementia-friendly places, sustainable local economies and climate emergency responses, resolving anti-social behaviours. As leadership capabilities are developed everywhere, creating a coherent shared view of the priorities for that locality becomes central to community development, the role of commissioning and the coproduction of services that are relevant for the population there.

Focus on relationships at all levels – trumps structure

This means collaborating to make change and improvement happen irrespective of formal organization structures. Good relationships between all parties at a local level will drive better outcomes than formalized structures created  to ‘leverage coordination’ but where relationships misfire or lack trust and incentive to collaborate in innovative ways. Much time, energy and resources can be spent on ‘form’ – structuring coordination and complex governance – but the key point here is to pay attention to behaviours and interactions between people as the driver of alignment and cooperation to work effectively on complex local needs. Inevitably this will also lean into changing power dynamics implied by structure and organization boundaries and who decides on how funding is used locally.

Relationship-based leadership

A consequence of this approach is that public service leaders take a more relationship-based approach to leadership. To do this, Public Services leaders, often leading as ‘expert’ leaders in their field, need to shift their own locus more to the wider needs of the local system. Essential to this shift, they need

Reflection time needed to step back from crisis management

the psychological and mental pressures of complexity and the syndrome of ‘over responsibility’ felt by public service leaders is exacerbated by a funding and professional expertise operating model that leans into crisis management as a default setting. Reflection time as a leadership practice, creates the mental and emotional space to change the leadership approach to one that is more relational:

Move from ‘fixing’ to enabling – leaders have to believe in doing things differently and (be more) relationship based

this represents a shift to a non-hierarchical/non-patriarchal model of leadership, moving away from the dynamic of control and rescuing – moving towards enabling the strengths and capabilities of others to be seeded, nurtured and grown. Leadership is distributed through the local system and decision making is far more localized.

Managing by outcomes not presenteeism

represents a change in the ‘psychological contract’ with staff – focusing on helping people to succeed at what they do, wherever they may be working from (at home, in hubs and local places, as well as in the office). This assumes a maturity in relationship based on an adult’s responsibility to organise their time, priorities and schedules in ways they see fit; they are supported to do this if needed, but it is what is achieved – the outcomes of their endeavours that is important; working from home undermines habitual ‘presenteeism’ – and for that matter absenteeism, but this also requires a clear assessment of what people are trying to achieve and how that works in a ‘blended’ work place (home-based – office based – and place based working).

Developing leadership at all levels

creating agency and adult-adult working where anyone working in a local system can be supported to lead – essentially facilitating initiative, trust around a shared purpose, values and set of local conditions that support the aspirations of local residents and businesses. Investing in leadership development becomes place-based not organizational and is designed to meet local needs and solve local problems; participants come from all parts of the system.

Compassionate and emotionally intelligent leadership is essential

underlines the importance of  the reflection time needed to step back from crisis management – to make sense of what is going on and to ensure that the leader is not overwhelmed by feelings or the emotions of people they are leading in creating the conditions for recovery. As we recover from Covid 19 emergency responses and aim to build back better, creating the right conditions for working in new ways is an essential leadership role. The group discussion discussed what this means in practice:

Safe working: psychological and physical

Distribute leadership to ‘front-line’ and decision making – supported by new processes with governance

Less risk averse, innovative, citizen focused – how to safeguard staff in trying things. Leadership support is needed.

‘Experience strategy’ and leaders have to engage and ‘walk the talk’ with more staff working away from the office

Recognise and celebrate right values and behaviours in context

There are a number of trends influencing psychological and physical safety. If we take as a starting point the possibility that Covid 19 and lockdown has been psychologically impactful and possibly traumatic over time for staff and key leaders in local systems, then organization and place-based development need to be psychologically (and trauma)-informed. Reported increases in domestic violence and therefore adverse childhood experiences during lockdown, illustrates the tensions experienced by families which can of course also include employees of public services. We have known for many decades that any shift to remote working can shatter social networks that contribute to happiness, productivity and coping at work. Working in more relational ways is a trend in public services – children’s social care, education, homelessness and police services in particular are embracing ‘psychologically informed environments’ and ‘trauma-informed practices’. This requires organization and leadership practices that create the right conditions for this work to be done.

These two factors (recovery from the impacts of Covid and working in relational ways with more vulnerable members of society) require psychologically and physically safe environments to be created for all staff. Overlaying the points on the post-its above, we can see this is a critical dimension too in how leadership is developed to support these new ways of working.

Creating conditions for working in this way

Creating a ‘secure base’ for staff involves organization design and development that is based on the key elements of early development; that is creating a ‘holding space’ – where individual and collective anxiety is effectively ‘held’ and supported to differentiate the personal from the professional. In developmental terms, this is moving from dependence (working to instruction/prescribed standards) to independence (expert leadership based on what I have learned and trained in) to interdependence (working across boundaries in the system to achieve outcomes for the local population and service users). Without this progression we get co-dependence (and remote working can create this, and the crisis system described earlier encourages this) – which fuels demand, escalation and reactive strategies in a state of constant anxiety, over-dependence on fixing or being fixed and sometimes, constant engagement with ‘the authorities’ over a lifetime.

One outcome of co-dependence is conflict and/or avoidance across boundaries. Conflict can be both interpersonal and inter-institutional (often one reflecting the other) and leaders will need to develop the practices needed to work across personal and institutional boundaries to support collaboration whilst acknowledging the need to refresh and reboot relationships at every level.   Our highlighted points above can be a source of both liberation and anxiety, innovation and exploitation. Letting go and holding to account in adult ways are fundamental components of creating these conditions, in which feelings can be validated, the strengths of people nurtured, learning is valued and accountabilities are held from a place of integrity, without blame or shame.

Join us to build further: https://www.publicservicetransformation.org/2020/04/the-days-after-a-learning-community-to-build-back-better/

Process, Place and Relationships – The purposeful Smart City – by Jane Eckford, public servant and industry mentor

In preparing for the Wind Up and dissolution of Scotland’s first New Town, East Kilbride, the chair, Mr J Allan Denholm, reflected on the achievements of the New Town Development Corporations, with words that have much resonance today. 

‘The measure of a mature and successful community is its ability to sustain growth and support the aspirations of its people throughout periods of change and challenge as well as in times of stability and prosperity …

‘…It is people in every part of this community who have created East Kilbride’s success and whose hands its future will lie’.

The New Town model had been based on land and property development to meet housing needs over-spilling from Glasgow but more than this, to provide community infrastructure, social cohesion and employment opportunities through inward investment.

 It provided places for people and business to thrive – a platform of place based and harmonious participation from a wide variety of stakeholders with the purpose of building ‘good’ and sustainable growth. It was a model of working, using many different levers and capabilities, skills and viewpoints, to marry lofty policy with the practical, physical delivery of a new town which served the common good. It influenced many of us officers who were embarking on our own public service careers. And it certainly remains part of the local government policy through to delivery model of local place shaping governance.

It was those final words about people which seemed the most poignant and important for people like me, a corporation employee, and and who also part of the community we were serving.  Our work felt personal ….and it was personal.

That annual report of 1994 certainly captured all the big, high-profile economic development successes of EKDC but the real yardstick of success was really how the people of East Kilbride felt about each other and the place.  

Since that point I have been, and will remain, a flag bearer for ‘emotional connectedness’ we learned as part of that journey – and for designing people ‘in’ and not ‘out’ in increasingly digital or technology enabled service or policy solutions.

Now, following the trauma following  the Covid-19 pandemic, we see the need to create community platforms of a different kind.  The emergence of Smart City solutions for urban spaces, a next generation on from the green field development corporations, provides new possibilities to improve how we live – but only if we take great care not to export across into the new future, all the old biases, injustices, prejudices and labels, that the algorithms might project from our past and flawed structures.

And only if we take great care not to use digital capability to govern by remote control without real, sincere, empathetic human engagement to negotiate ongoing change.

The past is no longer a good indicator of what will come.  Patriarchal organisational strategies based on past performance will not readily accommodate emerging questions.

A definition of Smart Cities is currently  ‘an urban area that uses different types of electronic data collection sensors to supply information which is used to manage assets and resources efficiently. 

Key dimensions of current Smart City capabilities focus on Smart Energy, Smart Transport, Smart data, Smart infrastructure, Smart mobility and Smart IoT with sensing and reporting devices being attached to existing urban infrastructure. 

Using anonymised data there are some wholescale insights which can be made about behaviour and use.  Indeed the current narratives supporting Smart Cities centre around driving more efficient use of resources and reducing cost in comparison with current behaviours. 

The current narratives around design of Smart technologies to understand homelessness, as an example, are really interesting in this regard with rationales ranging from reducing demand on hospitals, social care and other services to being able to track individuals movements to providing help at park benches, to connecting homeless people with hostels and help via mobile and smartphone technology.  

But whilst we are demonstrating ‘capability’ it might be a good time to discuss ‘purpose’.

Referencing the Scottish New Town model of community connectedness I would ask how kindness, dignity and compassion can characterise our decision making and actions – some key values to underpin a just, inclusive and fair society.

In my mind there are some key questions which might be usefully debated including;

  1. Can technology platforms include the capability to develop emotional intelligence, empathy and connectedness of people?
  2. Is  our emotional connectedness to place important or necessary for thriving communities?
  3. Who owns data and insight in a democratic environment, and how do we all ensure it is deployed for the common good.
  4. What degree of empathy and interpersonal skill do we need to see in those developing new technology to reduce the level of marginalisation of people across society

The EKDC Chair observed over 30 years ago that ‘…there is a danger that high profile, international and national flagship projects will become the yardstick by which community success is measured’.  This seems to be a highly prescient challenge for us all now.

“34 doughnuts”: what the world (well, Twitter), wants to tell the UK government about recovery

Responses to @JACattell tweet re: United Kingdom’s ‘renewal’

Article by RedQuadrant finance lead Joanne Peters, with assistance from Benjamin Taylor and Vinay Débrou.

On 15 April, James Cattell (a pioneer in #oneteamgov) and part of the Systems Unit in the UK Cabinet Office (https://www.gov.uk/government/groups/systems-unit) – posted this tweet: https://twitter.com/jaCattell/status/1250357135428521984

The tweet, which was sent entirely in a personal and unofficial capacity, read:

I work in a central government team that’s helping build a strategy for the United Kingdom’s renewal after we’ve recovered from #coronavirus.
Who should we be listening to?
What questions should we be asking?
Where has this approach (not) worked well before?
Please share!
This received 1,800 retweets, 1,600 likes and over 1,500 replies.

Vinay Débrou (https://vinaydebrou.com/), a member of the PSTA’s learning community, https://www.publicservicetransformation.org/2020/04/the-days-after-a-learning-community-to-build-back-better/, and the Yak Collective (https://www.yakcollective.org/projects/dont-waste-the-covid19-reboot/), volunteered to parse the replies into excel we have been able to do some analysis of the replies. The raw scraped data from this analysis (public data scraped end April and cleaned 10 May) is available here: (https://www.dropbox.com/s/n3iikj0lt8q4gzv/2020-06-02%20Replies%20Data%20to%20JaCattell%20Tweet%20JP%20analysis%20v0.5BT.xlsx?dl=0)

“>at this link (Excel format).

Here are some key points and thoughts from the analysis:

• The most-cited single theory, approach, or recommendation is around Kate Raworth’s Doughnut Economics (https://www.kateraworth.com/), centred around ‘humanity’s 21st century challenge… to meet the needs of all within the means of the planet’, with a total of 34 references.

• Many of the tweets are from special interest and lobby groups promoting their causes in this context. Not all will be relevant but rather a chance to pressure where a door into Whitehall might be thought to have been opened. Does this indicate that there is not much opportunity for people to have their say and for these groups to get heard at the moment in what is a centrally led response and the focus is on crisis management?

• This along with politically motivated responses and an element of abuse limits the overall analysis.

• There are many links to research, think-pieces, agendas and blogs and it is apparent that so much thinking is already out there or being done at the moment which is relevant to the current situation which can be harnessed. This could be grouped into themes for further research. In particular, Kate Raworth features in the wordcloud with over 20 mentions and also in the analysis of most-liked tweets, suggesting that there is breadth and depth of support for Doughnut Economics as a lens or framework for renewal.

• This Wordcloud analysis of key words with over 20 mentions is useful and emphasises where the sentiment is.

JACattel tweet wordcloud

• ‘People’ has the highest number of mentions followed by ‘listen’ suggesting that there is a call to focus on developing policy and ideas with consultation and involvement of people. ‘Ask’ is also a similar trend.

• ‘Communities’, ‘economy’ and ‘government’ all present equally in the response, interesting as it indicates a balance in perspective and also ties in with the varying theme of a systemic transformation (covering environment, climate, economy, society, finance, business etc.)

• ‘Local’ also features, perhaps reflecting the recognition in local networks that have proved critical in the response so far.

• If the replies which got more than 20 likes are analysed into themes, the overwhelming area of interest and support is sustainability and wellbeing. This has 3 times as many likes compared to the second most popular, ‘listening to people’.

jacattell tweet top issues

There are some key points arising from this:
• There is a strong feeling that people from across society need to be at the heart of the next steps.
• There is broad support for a more sustainable model generally underpinned by economic reform (though the theories and approach vary).
• A focus on interdependencies and transforming the system as a whole, particularly linked back to varying approaches to ‘sustainability’.
Alongside these, ‘listen to people’ and ‘ask for help’ seem to be the key recommendations for renewal.

We will leave it to the reader to determine whether anything from this input in response to an unofficial, personal tweet. made it through to the UK Government’s plan to rebuild, published on 26 May.

What it has been like working through the crisis in local government

A RedQuadrant consultant writes

Lots of different experiences of the current lockdown, even in the same LA! I thought I’d share mine.

Thank God for ICT software being hosted in the cloud. Without this, contact centre staff would probably have had to come in to keep essential services going. With this, the majority of the council can work from home.

We have never been so busy, and this is in an already fast-paced council. From setting up Covid-19 assistance packages in partnership with the voluntary sector, to weekend working. From thousands of new benefit claims to working hard but sensitively on collecting business rates and council tax money owed so people don’t get into avoidable debt. To organising all of the payments of grants to businesses, under a political spotlight. From government directives changing twice daily on the above. From huge local and national political scrutiny on how we are supporting people to stay safe – both colleagues and customers – nothing matters more. Reviewing transformation work and deciding it should all still go ahead, and working hard to meet the timescales. From seeing colleagues’ spare bedrooms, kitchens and children, and cuddly toys from the most unexpected of people! Daily briefings to be delivered early each morning on the impacts on customers and residents. Increased productivity from homeworking. Benefit claims paid on the same day. Contact centre volumes up but answering times down. Everyone pulling together for their council and place. Server and software issues, timelags on video calls between speech and face showing colleagues laughing while you’re delivering bad news.

I honestly can’t think of anything anyone has been asked to do that they have refused. No wondering where someone may be and if they can make your meeting – we are all at home working with shared diaries. Wonderful team working and across services. Job roles, employment status and hierarchies less important than making things happen and removing barriers. Compassion and humanity for bereaved colleagues. Sickness down, annual leave down – all hands on deck.

We have never been so busy.

Building on newfound trust – The future of Adult social care – by Charley Maher

The social care workforce is amazing.  It is responding to the current challenges with passion and selfless dedication.  As hospitals are stretched beyond capacity and every single bed is needed, the social care workers are supporting with rapid discharges whilst ensuring the safety of individuals.  Discharge to assess and hospital social work teams are working constantly to ensure beds are available to support the fight against the Coronavirus. Local authorities are mobilising their social care work force to respond to these challenges and are supported with the changes in the Coronavirus Act 2020 which are intended to enable authorities to prioritise resources.

To enable local authorities to respond to the most urgent and serious cases, most of the duties contained in the Care Act 2014 have been temporarily suspended during the COVID-19 pandemic, under changes to adult social care which are contained in Schedule 12 of the Coronavirus Act 2020.  Local authorities are already experiencing an increase in demand from vulnerable people and whilst battling the challenges of hospital social work and discharges to support an overwhelmed NHS, councils are being proactive with the early identification of people potentially most at risk and looking to create prevention and early intervention strategies to avoid further crisis.  Many local authorities are using targeted support models and identification tools to help them identify and engage with people to provide information, advice and support.  We can see volunteers, charities and third sector organisations coming together to respond to the crisis; food banks, befriending services, distributing packages, sharing creative ideas to reduce social isolation, etc.  People are uniting to battle the crisis.  Organisations are unifying.  We are trusting one another and relationships between sectors are strengthening.  The third sector are proving, beyond doubt, the massive value they add to the community. 

The extent of the impact of COVID-19 is not limited to the more obvious hospital crisis but extends to the community as peoples’ mental health and the impact of social isolation is being recognised as a major risk to people.  Many councils have identified that, as a result of the restrictions imposed due to COVID-19, there is risk of social isolation for vulnerable people who would normally access community-based support to meet their personal outcomes. It has long been acknowledged that ‘community life, social connections, and having a voice in local decisions are all factors that have a vital contribution to make to health and wellbeing’ (gov.uk) Much work has been undertaken over the years to develop community based support, ensure integration with people who use services and the local community, personalisation and breaking down barriers to those with disabilities, much of which has been halted by this unprecedented challenge. Support plans which have been codesigned with people who use services and include daily use of community resources have been placed on hold due to the new rules around social distancing and only accessing the local community for essential purposes. 

One of my first thoughts was for people with learning disabilities and the often-complex packages of support which blend formal services with community resources. By the very nature of some disabilities, routine and structure are everything.  These suddenly imposed changes to routine support to access the community, participation in social activities and attending volunteering and learning opportunities could be difficult for some people who use services to understand and may result in changes to behaviours. 

Let’s meet Fred.  Fred is 49 years old and lives in a shared living scheme with 3 other people who use services.  One of Fred’s personal outcomes is that he requires support to access community resources for physical exercise and mental stimulation. Once a week he goes to see his parents, both of whom are in their 70s with underlying health conditions.  Fred is currently supported to access the community with 1:1 support due to risks around road safety and a history of behaviours of concern.  The care and support provider receives contact from the local authority who provide information and guidance around community support for shopping, medication, how to stay safe, contact information in the event of an emergency etc.

The implications of COVID-19 mean that Fred can only go out once a day for exercise. He is unable to access cafes or see his parents.  Fred is unsettled and is displaying behaviours of concern which has made accessing the community difficult. Fred is spending more time at home and there are difficulties in his relationships with the other people he lives with as everyone is forced to socialise within the home environment for long periods each day. Fred now requires 2:1 support both in and outside the home. This becomes an urgent and serious case for which social worker support is required; a new assessment due to significant change in need, an increased package of support etc, etc. It is here that we find our new wave of crisis.  Because Fred isn’t alone.  There will be many, many people with complex needs who will struggle to adjust to these sudden changes and severe restrictions to their everyday life.  Social Care is faced with increasing demand due to COVID-19 so how are councils responding to these situations? TRUST!  Providers are contacting social care and reporting these changes in need and workers are trusting their knowledge and insight, they are trusting their existing relationships with people and that they know the individuals and what support is needed. Councils are implementing the changes to the support over the phone, recording the outcomes and trusting the providers to arrange and amend the support package to ensure the wellbeing of individuals.

The ‘lockdown’ rules present a risk of social isolation for many of us and as many of us will indeed struggle with isolation. For those people who require support and services, it would seem, the impact could be far worse.  However, councils are going further, by recognising the impact of social isolation to those people who are not receiving services, the people who are ‘managing’ with the support of family, friends, other informal networks or have very small packages of support.  What happens to their ability to cope when socialising is removed from their daily life? It has long been recognised that social isolation and loneliness is associated with a range of mental and physical health impacts: strokes, heart disease, weakened immune system, increased risk of falls, Alzheimer’s disease, depression, anxiety and suicide.

Now we meet April.  April is 78 years old and has been asked to self-isolate.  April would normally go to her local shops daily to buy food and get exercise. April is known in her local community and enjoys speaking to people, many of whom she has known for years.  April has reduced mobility due to osteoarthritis and has a history of falls. She has OT equipment in place to support her around the home such as a perching stool and grab rails.  April uses a walker to access the community. She likes to be as independent as possible and has a stand up wash every day and a minimal package of support for a bath and hair wash once a week.  Family help with cleaning and laundry and April goes to her daughters for a roast dinner every Sunday and to her son’s for dinner every Wednesday.  April visits her local library every Tuesday for a book club and attends a weekly coffee morning at her local church. April’s daughter takes her to church every Sunday.  Since self-isolating, April has lost her routine, her social interactions and has become depressed.  Since losing her opportunity for daily exercise, April is experiencing an increase in joint pain.  April’s community and family have rallied round, and food is delivered. Her family have provided an i-pad so she can video-call family members and see her grandchildren which April says has helped.  However, April’s carer has expressed concerns to the family and council around her mental wellbeing and some signs of self-neglect within the home. The carer describes some decline in April’s mobility, that she seems unsteady on her feet and the carer is worried that April is at an increased risk of falls.  The carer is not sure if April is eating or managing medication and she seems muddled.  The family stated they would be happy to support with personal care and would explore assist technology to support with medication however, they are unable to action this now due to self-isolation.  The council record the risks and agree to implement a daily visit to support April with her personal care and to prompt with medication.

Prior to the Covid-19 crisis, both case studies would likely have required a home visit from adult social care due to the change in need, however we can now see councils responding from a position of trust.  It is fair to say that this trust has come about from a lack of resources and a need for social care to prioritise urgent and severe cases, but the trust is there and it is resulting in quicker and smoother solutions to immediate need.  Moreover, gone are the delays in responding due to waiting lists and a need to prioritise risks.  Gone are the panels and other formal approval processes for funding.  Gone is the, often clunky, assessment and review documentation, which has been reported as a blocker to conversations and timely interventions. In their place we can see conversations between individuals and those who know them best.  We can see communities, volunteers and third sector organisations being trusted to engage and respond with people they know. We can see less demand for statutory services, formal processes and social care interventions.  Which means our skilled social care workforce can continue to respond to urgent needs within hospitals, supporting the NHS in this unprecedented crisis.

For the reasons identified above, it is likely that we will see continue to see significant increases in packages of support and an increase in people requiring support in the community as they lose their informal networks of families, friends and communities. The changes to the Care Act are reported to be in place for up to 2 and a half years, and therefore reviews and assessments are a power rather than a duty. However, reviews and assessments will need to be carried out- a function that was already stretched within adult social care.  So how will councils cope with the increase in demand, in business as usual community reviews and in people who use services? The truth is, we don’t know.  Many councils are not able to consider this as the respond to the current increasing demand. It seems the fitting answer is to build on these new approaches of trusting providers, trusting care agencies and third sectors who have existing relationships with people.  If we can trust them in crisis, can we extend this trust into the future therefore extending and continuing this sense of community and togetherness we see now?  As we utilise the resources and knowledge these organisations and providers have to respond to the crisis, can we see this as a new approach to implement in our services and practice? Can we simplify processes and remove some of the formalities and structures that serve as time consuming and potential blockers to true conversation-based approaches?

It would require training and upskilling of voluntary and third sectors as the Care Act is clear that those undertaking assessments and reviews should be skilled to do so.   It would require ongoing support and joint working.  It would require a unified approach and trust.  But we can already see that it is possible.

Author: Charley Maher, charley.maher@redquadrant.com

Charley is an experienced adult social worker who has developed into a highly effective Change and Transformation Consultant. Charley has experience of organisational change, while supporting Operational Managers to improve the quality of practice. Her most recent project involved helping a local authority design a new pathway for adult social care that incorporated third sector and voluntary organisations.

Time to wake up, listen and delegate to your people

Its day 8 of self-isolation and its starting to hit home how hard this will be; coughing child seems to be recovering energy and appetite but the number of stories of friends of friends on ventilators growing by the day and my parents and Rachel’s in isolation and its hard.

It’s totally clear we are not alone in any of this.  The families feel in a pressure cooker, the singles feel lonely and the new couples now locked in together are about the hit the fast forward button on their relationships.

RedQuadrant has been pretty good.

Perhaps because we are used to working remotely, working to crazy deadlines and in high stress situations, Fraggle rock is a familiar place to us.  However, not everyone is so lucky and I have had a few accounts from friends and relations of people crying through exhaustion, fear and frustration on work video conference calls.

The technology will be a life saver in all this; but it’s also a danger.  It can dis-inhibit very bad behaviours including micro-management.  When we meet face to face a basic human mechanism kicks in and we start to register the emotional state of the people around us; it’s hard wired into us to do this.  Working remotely massively reduces our ability to do this as does stress.  Not being in the same room as your team can make you less included to trust they are doing their jobs.

I am also seeing many new websites being set up without anything substantive behind them; it feels like magical thinking by senior leaders to imagine new websites can save us without people behind them.  Perhaps it’s just easier than large scale engagement and delegation.

That may sound a bit luddite; it’s not.  I’m saying that technology acts as a force multiplier.  It can help deliver good ideas and help bring people together and help people do more.  But, without the good ideas and good people and delegated authority there is no force to multiply.

So if you are a leader I think it’s time to wake up, listen and trust your people enough to empower them.

You can get in touch with me to discuss via RedQuadrant at gerald.power@redquadrant.com or DM me on twitter @geraldpower happy to chat and share

It’s not about the IT it’s about exploiting the social capital

Having spent weeks setting up a community volunteer network I didn’t think I might be one of the first to use it.  But, our daughter got a headache and temperature on Sunday morning so now its home school, sick child and self-isolation for fourteen days of comfortable – if fractious and nervous- confinement.

That won’t be the case for many other people without money, food or social capital.  The people I see down the soup kitchen, or who rely on the local food bank, who for a multitude of reasons are struggling in normal times will rapidly find the situation much bleaker than mine.  Some will literally be on the streets as it has upset their mental health to the point they can no longer cope. Many of them will be going to their council for support, now or very soon.

Its undeniable part of this will be about resources and technology.  I have heard many clients saying how utterly relieved they are that they had rolled out home working before covid hit or at least had enough to allow them to work now.  However, it’s also obvious that the tools alone won’t fix this and there is a need for intelligence and insight.

Having a litre of milk arrive on the doorstep 20 min after a whatsapp request yesterday certainly make me feel better.  There are no online delivery slots in my area.  Having two bags of shopping arrive this lunchtime courtesy of a neighbour made me really realise how much this will be about ‘localism’ and local grassroots networks.

Yes we will be using tech, but it’s not really about the tech.  It’s about people, relationships and solving problems.  If local government can tap into this massive bank of social capital the road ahead will be much easier to navigate. Now is also the time to act.  The sun is shining and it feels very odd.  That reminds me of the phone footage of the Boxing Day Tsunami.  When the sea disappeared many tourists wandered down the beach to look at the funny fish; they should have considered why and what was coming next and headed for the high ground.

You can get in touch with me to discuss via RedQuadrant at gerald.power@redquadrant.com or DM me on twitter @geraldpower happy to chat and share

Covid response – It’s change but not as we know it

Its feels a bit star trek this week in supporting Local Government ‘Its life Jim, but not as we know it’. There is also a great Spock/ Kirk bromance meme going around regarding self-isolation. 

That feels pretty much where I am with clients, the priority services are still the priority services, the opportunities for channel shift are still the same and the need to manage more demand to self-service is still a priority.   Its change Jim, but not as we know it.  Now it’s far more urgent.

Within days or weeks Councils are going to have to cope with far fewer personnel and potentially big rises in demand for support and information.  Given that most of what a council does in terms of customer contact is not safety critical it should be possible to brigade resources to make sure that those in most need do get support.  Also that councils support the pandemic response looking after key workers and their kids.  The big challenge is going to be driving down all non-essential demand and moving resources to generate enough head space to make this possible. 

Having worked on the Swine Flu response in Cabinet Office I know what went on behind the scenes to muster vast capacity to do screening and prescription of Tamiflu online and by phone (remember that!) and stop GPs and A&E being overwhelmed and it worked albeit with a less deadly virus.  It was complex and it was really hard work and doing really quickly created a lot of challenges, but it was done successfully.  Perhaps because thing didn’t collapse people don’t remember it so much!

Anyway that’s what I’m working on this weekend for a large LA with my colleagues, how to re-work a contact and delivery model in a few weeks to give them the headroom to cope.  Feeling like 30% data and tech and 70% rapid change and communication. 

I just hope I can work out my own strategy on child care and looking after my parents and in-laws who are in self-isolation between now and Monday. 

If you need help on these issues contact me via RedQuadrant at gerald.power@redquadrant.com or DM me on twitter @geraldpower happy to chat and share