One of the best things about the work I am doing these days is the fantastic range of passionate people I meet, mainly directly in the health and social care field but sometimes more indirectly. Recently I met Michael Bunney at a ”brain-friendly learning” event (organised by our excellent business associates, First Class Training) in Stratford. Michael is Chair of Warwickshire Wildlife Trust so we immediately had a shared interest. Michael told me about a fantastic programme called Let nature feed your senses.

Let Nature Feed Your Senses is an exciting new partnership, between LEAF (Linking Environment And Farming) and The Sensory Trust aiming to “connect disengaged groups and individuals with nature and the countryside” through a programme of activities and events.  The project sets out to get “young people, disabled groups and older people out onto farms, nature reserves, education centres and city farms, to experience everyday nature and the countryside in their everyday life”.

I was particularly interested in learning about opportunities for people with sensory impairments and learning disabilities, and people with dementia or living in care homes. I know how much I enjoyed my visit so it is not hard to imagine the huge benefits a “back to nature” outing can bring to potentially disadvantaged or isolated people, bringing alive senses and refreshing spirits. Just take a look at this video of a group of residents from a care home visiting a farm in Buckinghamshire.

I am hoping to visit one of the projects in March with my friend and business associate Maria Rankin who has a real passion for wildlife and nature… I am sure we will both learn a lot and similarly gain much well-being through this wonderful opportunity to leave the Twitter of the 21st century  behind for a few hours….

And, for those of you who want to share the experience, here we have…the original tweeter…

The film includes the wonderful graphics by Anna Geyer, New Possibilities. Anna used the headings of TLAP’s “Making It Real” document as a framework to map the issues and we had some interesting findings…but more of that anon…

In the meantime, we are planning to compile a powerful case study from all the material gathered …

What is happening… and what still needs to happen to “make it (personalisation) real” for these individuals and this user-led group in Leicestershire?

In true Whose Shoes? style, I am starting a series of posts looking at issues of personalisation from different people’s perspectives within health and social care, focusing on “Making it Real”….

An excellent starting point is the exciting Whose Shoes? workshop we held with user-led organisation Force 4 Change in Leicestershire last Saturday. On a snowy afternoon, the room buzzed as service users used Whose Shoes? to help them tease through the key issues of personalisation – what is really working well and what more needs to happen to “make it real” for them?

We were joined by a wide range of people who had all volunteered to come along to participate, listen and learn:

• Helen Turner, Community Catalysts, is running the Empowering People Innovation Challenge with Leicestershire County Council
• Frankie Hine-Hughes is Project Manager for co-production enablers Governance International
• Dorothy Hall is a highly experienced independent social worker and skilled facilitator
• Anna Geyer, New Possibilities,  records conversations in her unique, wonderful graphics
•      and me… Gill Phillips, well I live and breathe Whose Shoes? ….

Anna captures the issues raised

We also had sincere apologies from the Programme Manager, Commissioning and Engagement, at LCC who was unable to attend on the day but is following events with keen interest….

All of these people and more are invited to submit “guest blogs” to make it a really lively series, building the whole picture as we go.

So, first up, we have an interview with Karen Kidd, Chair of the group filmed immediately after the session. It was totally unrehearsed – indeed, as you will see, it was “snatched” as Karen’s taxi was waiting, but the eloquence comes through in the palpable fact that these issues are the lived experience of real people and the response comes from the heart…

Karen Kidd – Chair of Force 4 Change  VIDEO INTERVIEW

“Elderly people should be encouraged to go back to work and move into smaller homes, one of David Cameron’s key advisers said last night”. There is apparently a “nudge” unit a.k.a No.10 Behavioural Insight Team… Do you see shades of Orwellian 1984 or a sensible approach to addressing real problems in society?

The “nudge unit” is a “government team which has the task of developing ways to change people’s behaviour that do not require legislation” a.k.a “apply social pressure…”
But how much damage will be done by people looking at disabled people askance to see if they REALLY deserve that benefit or looking at older people to see if they REALLY need to stay in that big house, after the children have left…

And incidentally, this is an article about loneliness…. Perhaps the older people will be less lonely if the grown-up children and their families can come and visit once in a while!

Anyway, the debate is raging. Already 450 comments posted on the Telegraph website. I have posted a similar discussion in our LinkedIn group (the personalisation group to integrate social care, health and housing), as well as in the Big Society group.

As one commentator has said already, this government is certainly sparking some interesting conversations over the breakfast table…

Pollyanna explains: “When we walk, we have to talk. Everyone comes with a list of four or five people with whom they need to talk to resolve an issue – usually people who hadn’t replied to their emails or phone calls or people with whom they are working on a particularly tricky issue. It is a really productive process – 50 managers having five conversations each, which if you converted into meetings and missed calls would take many days rather than three hours”.

Refreshing (literally) to see such an imaginative but simple approach and surprising in these days of “austerity” to risk the adverse publicity of “staff walking up hills instead of getting on with their important paperwork!”. Yes, these staff are being encouraged to leave the emails and the in-tray, to forgo the agenda-driven meetings and (shock, horror, probe) TALK to each other, one-to-one.

Face-to-face discussions can often achieve empathy and understanding of the real issues in a way that does not necessarily happen through emails or “standard” meetings.

Similarly, I am finding that it is the forward-thinking local authorities who are still prioritising creative approaches and making time for staff to get away from the day job and engage with peer support networks, experiment with social media etc.

When I first developed Whose Shoes? – a discussion tool to help people engage with the personalisation agenda in health and social care – I thought it would be the less “advanced” local authorities and care providers who would use this resource. I was wrong.

The leading organisations are the ones who embrace change and empower their staff to think through the issues in a way that genuinely “wins hearts and minds”. The ones who are not afraid to use imaginative approaches – a walk, a creative discussion tool – to help people relax and feel empowered to discuss the REAL issues.

By exchanging anecdotes and good practice, having time to tease through tricky issues, people build relationships and co-produce sustainable solutions.

A breath of fresh air!

Today “David Cameron orders merging of health and social care … Integration of services will save money says prime minister” (Guardian – 5 January 2012)

At the start of the New Year, Philippa Codd and I announced the re-branding of our LinkedIn group to focus on integration – perhaps Mr Cameron noticed and liked the idea…?

Our group was previously called “The personalisation group to revolutionise social care”. It has grown steadily and now, with over 1000 members, is known for its lively discussions and action-focused approach – constantly sharing best practice, challenging poor practice. It has come alive with more and more people meeting up and working collaboratively, not just on the net.

But the title no longer reflected what we were doing or the way forward. We re-named our group: “The Personalisation Group to Integrate Social Care, Health and Housing”. Housing seems to be omitted from Mr Cameron’s announcement?

Why did we do this? During 2011, we had worked increasingly across health and social care …AND housing. It became very obvious that for a truly person-centred approach, ALL sectors need to work very closely together. After all, if you needed support for a long-term health condition, would you want to struggle to understand the boundaries between different agencies and departments or would you want a joined-up service?

Would you want the nightmare that my family had with health and social care fighting over funding for our relative’s care through a Continuing Care Assessment (ie trying to pass the buck, NOT fighting to pick up the tab!) I remember long meetings with piles of paperwork and five people sitting round the table discussing humiliating “domains” to establish exactly HOW bad this woman, who was clearly dying, was under each category. I remember the anger and frustration, thinking the system had lost the plot somewhere and how much better it would be if these resources were directed at providing the actual care.

Philippa has a strong background in housing and has always seen very clearly the central role of  housing in promoting well-being and a personalised approach. We had some very informative meetings with Vic Rayner, CEO of SITRA. This culminated in us being invited to deliver Whose Shoes? workshops as part of SITRA / Box of Frogs wonderful “Festival of Ideas and Possibilities” for personalisation in Birmingham, Leeds and London. We used Whose Shoes? to tease out the key opportunities and challenges and are following up the issues raised with SITRA and with the East Midlands Housing Association.

One of the key concepts of Whose Shoes? is to encourage people to “walk in the shoes” of service users and carers and give everyone a voice. We encourage service users and carers – “experts by experience” to apply to join the LinkedIn group. Please get involved to help us work towards a truly integrated, co-production approach.

It is early days but the re-branding of the group looks to be very timely. Indeed, our experiences of talking in-depth to many service users and carers in 2011, particularly older people, have highlighted the need for integration across not just Social Care, Health and Housing …but also… local services, retailers, bus drivers, leisure facilities…. the wider community!

We are hoping that the new focus – and renewed impetus – really help to build a positive future,  improving the lives of vulnerable people in 2012 and beyond.

So, yes, let’s start 2012 with a bang. Happy New Year everyone!

Huge thanks to my co-presenters Philippa Codd and Dorothy Hall, who generously gave their time and shared their experiences of using Whose Shoes? in a wide range of settings, supported by their vast knowledge of the care and housing sectors.

The Festival was billed as “an opportunity for clients, commissioners and providers of housing, care and support to share and contribute new and innovative ways in which services can be personalised in their communities” It deliberately set out to be a creative, informal environment – and certainly succeeded. My brain-friendly learning group (Hi Mel and Stella!) would certainly have approved: we had Box of Frogs drama, Question Time, Secret Millionaire, Dragon’s Den, Speed Dating and much more…..

Each event was hugely rewarding but in different ways.  So which did I enjoy most…?

The marks are… Birmingham – our best workshop (we had to turn people away!); Leeds – the best “buzz” in the marketplace; London – fab networking, including meeting Robin Johnson, Joint Editor, Housing Care and Support journal, who invited me to write a feature. They were all really great events!

Best outcome for me?…meeting lots of people passionate about personalisation, but particularly Sally Taylor and staff from East Midlands Housing Association. We have since co-presented a lively one-day workshop looking at how Whose Shoes? can be used specifically to explore the opportunities and challenges of personalisation within the housing sector.

Most impressed by?… Box of Frogs – very powerful drama about mental health issues. AND they are great people – we had almost as much drama trying to catch a taxi together, but that’s another story…

And the overall winner?….….hopefully, service users and carers!

With such a concentration of people who really care about supporting people and personalisation and so much exchange of good practice, these events must surely lead to better outcomes. It’s up to all of us now to build on these foundations and continue to work together to embed the personalisation ethos throughout social care, healthcare and housing.

I am sure the facilitators will do a great job in collating all the feedback but I was struck by how powerful some of the comments / stories were to hear first hand and the fact that inevitably some of this impact is lost in the usual “summaries of key points”. Also sometimes I could see individual voices being lost as more dominant people had their (sometimes repeated!) say.

I am privileged, through my Whose Shoes? work, to attend a lot of service user engagement events and to be able to listen to people’s stories. I pitch up and chat to people and unearth different perspectives.

This was a predominantly “older people” audience and I was struck by how different the issues were for a young girl with physical disabilities who struggled a little to be heard and to make it onto the facilitator’s summary.

I liked the way that, in addition to the table discussions, the organisers also posted the questions on sheets at the back of the room so that people could add their own post-it notes if they wanted to write down a particular point. This seemed a good way to ensure that individual points were recorded faithfully and not “lost in translation” (or, at least, not until the “summary” stage!)

Copyright Nutshell Communications Ltd 2011

It would have been good to have government reps there today hearing FIRST HAND what people were saying… I wonder how often this happens…

We have gathered information about how older people can be supported to maintain or regain independence and enjoy the best possible quality of life. We have used creative methods which supplement the Whose Shoes? approach, including the excellent graphic facilitation services of New Possibilities inBirmingham.

Through the relaxed environment of the Whose Shoes? sessions, people have told us what is important to them and, together with their carers, have highlighted where things so often go wrong.

One of the areas we have explored in more detail has been around nutrition and hydration. Many problems have been raised, particularly those that have NOTHING to do with cuts or staff shortages but are simply poor and unthinking practice – eg putting drinks out of reach of hospital patients.

It was therefore with great interest that I saw that a new “code of conduct and minimum standards of training for health care assistants and care workers who look after the elderly inEngland” has been announced by the government.

According to the BBC report,  “The government said the new standards are likely to focus on communication, confidentiality, nutrition and hydration amongst other things. The announcement follows growing concerns about the training and quality of care provided by some care workers. They are often poorly paid whilst doing a difficult and demanding job.”

Next week we are working together again exploring issues of personalisation in the housing sector…. I’ll keep you posted.

We are all still buzzing from the fantastic #Cherwell (yes, we even had a #hashtag!) service user engagement event we held in Bicester on 2 June 2011. I have been working with Cherwell Care during 2011 to help the owners, Graham and Eileen, develop their home care business and make it truly reflect the needs of their service users. We are aiming for a 21st century approach, delivering support in a person-centred way, reaching out to the local community and seeing how we can work together to promote independence and help people live as long as possible in their own homes with the best possible support.

Whose Shoes? was a fantastic tool to explore the issues and get people working together. The informal atmosphere and expectations of a game meant that everyone contributed, an element that can be an insurmountable challenge for more traditional community engagement approaches which tend to favour those who are most confident or vociferous!

Well, the service users certainly told us what they thought! They told us what was working well already and what needed to improve – and since then we have concentrated on ACTION to make a difference! Carrie Lewis, graphic facilitator from New Possibilities, had captured so many important issues and we have used this artwork constantly as we have followed up the points raised over the following weeks. Firstly we divided all the points into different categories:

What can we at Cherwell Care change ourselves? - Lets’s do it! Is it quick and easy… let’s do it NOW! Keeping in touch with people … we have started a newsletter. Is it within our control, but a little longer-term …. let’s built it into action plans and set a definite goal and timescale (Example: We are now setting up gardening, cleaning and handymen services with “vetted” workers; also we are introducing more social events – all in direct response to the Growing our Community event!)

What can the Local Authority change? – Lets’s talk to them! Several very constructive meetings have been held with Oxfordshire County Council who were represented at the event. (Outcome : Cherwell Care is now recognised as a provider who listens to their service users and has an important role in shaping the market to deliver the outcomes that service users have requested; improved communication and partnership working)

What requires involvement from the wider community? – Lets’s work with the council to make it happen! And this is the stage we are at now: for example, the council is arranging meetings with the bus company (looking at how to make older people and disabilities feel safe using public transport) and Royal Mail (people want post boxes to be more convenient!)

Moving forward… NOT a one -off event! So often events like these can be a one-off event. At worst nothing actually happens. At best, good stuff happens but nobody actually thinks to tell the people themselves how they have influenced policy and what has changed. We are determined this will not happen here!

• We have sent a newsletter to service users (posted separately) keeping everyone informed of how the views they expressed are continuing to shape services and informing them of new developments as we move forward.
• We have won a new contract making us the leading home care provider in Bicester, Kidlington and Banbury. We are involving one of the service users who attended our event fully in the recruitment process. He will take part in a full-day assessment process for three new Care Co-ordinators who will manage the teams of care workers in each locality.
• We are committed to running another Whose Shoes? day checking out how people feel and what we still need to do!

In summary

Whose Shoes? is a fantastic “tool for change”. It helps people relax , have fun and discuss the real (sometimes contentious) issues in a meaningful and constructive way. Everyone has a voice and people feel encouraged to say how they really feel. It was great to test out and develop some new messages about nutrition and mobility, use of technology by older people and people staying connected in their own communities. This tool has huge potential to make a real difference to people’s lives.

We are looking forward to the next event!

By Philippa Codd, Independent Consultant, who co-manages “The personalisation group to revolutionise social care” on LinkedIn with Gill Phillips.