Personalisation & Social Work

Personalisation & Social Work
Dr Simon Duffy
Talk for University of Huddersfield, 2011

Monday, 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 Finish


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 Sheffield


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.org


The welfare state is good


The welfare state is good

it’s just designed wrong

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 you


What is the
meaning of
personalisation?

Photos from “Christmas in
Purgatory”


Institutions don’t
just come with
walls...

They start in the
mind...

And can be hidden
in systems of
power, education,
funding and culture


Great language...

‘inclusion’
‘normalisation’
‘individualised’
‘community’
‘empowerment’

...shame about reality


44 women with complex needs


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%

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
Condition

is there a different way?


in practice, this means


personalisation in practice

• Smith family story
• Reforming care management
• Self-directed support
• Personalised support
• Personalised transition
• WomenCentre
• And many more innovations...


individual (or personal) budgets


7 steps of self-directed support


Personalised Support
flexible & creative
support


Personalised
Transition
control: health,
education & support


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 LSC

A couple of weeks ago in Sheﬃeld, I met a wonderful woman
called Katrina. She's got three disabled sons. e oldest is
Jonathan, a charming, warm hearted young man of 19. He can't
walk or talk clearly, or feed himself alone. He's had a breathing
tube in his neck since he was a toddler. Under a scheme the new
Liberal Democrat council in Sheﬃeld is extending, Jonathan's
just got his own individual budget and care plan.
Now he's 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 I've ever seen, she said: We've gone from
having nothing to having everything. I wish every child's needs
would be taken this seriously. (Nick Clegg, 17 September 2008).


WomenCentre
a creative and positive
community


What are the opportunities?

• What benefits are in personalisation?

• What threats are in personalisation?


time for debate


good ideas don’t just happen


social
work
is
the
art
of
helping

people
be
active
citizens


social
work
is
the
art
of
helping

people
be
active
citizens

in
practice
citizenship
means...

1. being in control

2. with direction

3. enough money

4. your own home

5. enough help, and

6. being active in community

but
citizenship
isn’t
easy


poverty
attacks
citizenship


and
poverty
comes
in
many
forms


and
poverty
comes
in
many
forms

• loss of hope
• no power or control
• disadvantage
• exclusion & prejudice
• isolation & abuse


so
social
workers

challenge poverty


and
social
workers
do
this
by


and
social
workers
do
this
by

★ inspiring - hope and recovery


and
social
workers
do
this
by

★ empowering - individuals & families


and
social
workers
do
this
by

★ strengthening - personal development


and
social
workers
do
this
by

★ connecting - to community


and
social
workers
do
this
by

★ connecting - to community
★ building - safer networks


but
social
workers

cannot
do
this
on
their
own


these
are
not
things

you
can
do
for
people


these
are
things
you

have
to
do
with
people


it
is
people
themselves

who
make
a
change
building
on
their
own


resilience = hopeful human spirit


control = money and the power to use it


strengths = gifts, skills & knowledge


community = opportunities to join in


community = opportunities to join in
relationships = safe and loving networks


personalisation
=
social
work

so
what’s
the
big
problem?

the
big
problem

for
social
workers
is...


the
old system

gets
in
the
way


the
old
care
management
system


the
old
care
management
system

makes
it
hard
to
do
social
work

it’s
really
hard
to


it’s
really
hard
to
• empower people - without entitlements


it’s
really
hard
to
• strengthen capacity - focusing only on needs


it’s
really
hard
to
• connect to community - inside segregated services


it’s
really
hard
to
• connect to community - inside segregated services
• build safe networks - without family, friends and love


replace
care
management


replace
care
management

with
self-‐directed
support

this
means
social
workers
can


this
means
social
workers
can
1. empower people - tell people their budget


this
means
social
workers
can

2. strengthen capacity - focus on personal outcomes


this
means
social
workers
can


3. access community - use funding flexibly


this
means
social
workers
can


3. access community - use funding flexibly

4. build safe networks - work with family, friends & others


systems
sit
on
systems
-‐
like
sedimentary
rock


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 Adults

We’re
all
still

working
in
the

old system


we’ve
changed
words


added
new
complexities


But
the
system is still the same


social
workers
sometimes
even
feel

personalisation

has
made
things

worse

we
must
simplify


and

redesign

the
whole
system


we
need
a
New
Script

for
social
work


the New Script looks like this...


Assess
people’s

ELIGIBILITY
for:


Assess
people’s

ELIGIBILITY
for:

• guidance


Assess
people’s

ELIGIBILITY
for:

• guidance

• rehab
or


Assess
people’s

ELIGIBILITY
for:

• guidance

• rehab
or

• a
budget


Assess

CAPACITY
&

clarify
where
the

leadership
is:


Assess

CAPACITY
&

clarify
where
the

leadership
is:

• the
individual


Assess

CAPACITY
&

clarify
where
the

leadership
is:

• the
individual
• a
representative


Assess

CAPACITY
&

clarify
where
the

leadership
is:

• the
individual
• a
representative
• or
a
professional

Don’t
plan
for

people
-‐
instead

ENABLE
other

people
to
plan


Don’t
plan
for

people
-‐
instead

ENABLE
other

people
to
plan

But
always
make
sure
that
you...


is is Community Brokerage


OR

Plan
with
people

DIRECTLY

yourself,

especially
when:


Plan
with
people

DIRECTLY

yourself,

especially
when:

• it’s
a
critical
situation


Plan
with
people

DIRECTLY

yourself,

especially
when:

• it’s
a
critical
situation
• the
solution
is
obvious,
or


Plan
with
people

DIRECTLY

yourself,

especially
when:

• it’s
a
critical
situation
• the
solution
is
obvious,
or
• nobody
else
can
help

AGREE
plans
as

soon
as
possible

if
they
are:


AGREE
plans
as

soon
as
possible

if
they
are:

• sensible


AGREE
plans
as

soon
as
possible

if
they
are:

• sensible
• safe


AGREE
plans
as

soon
as
possible

if
they
are:

• sensible
• safe
• and
in
budget


AGREE
plans
as

soon
as
possible

if
they
are:

• sensible
• safe
• and
in
budget
Plans
should
NOT
be
perfect!

If
people
need

help
to
set

things
up
then

DIRECT
them
to

the
right
people

and
places


It
is
the
REVIEW

that
is
central
to

really
learning

what
is
working

and
to
helping

people
be
in

control
of
their

own
life.


This
is
a
New
Script
for
Social
Work


What
the
New
Script
means
is


What
the
New
Script
means
is
★ things speed up


What
the
New
Script
means
is
★ things speed up
★ bureaucracy goes down


What
the
New
Script
means
is
★ things speed up
★ social workers use their best skills


What
the
New
Script
means
is
★ things speed up
★ people connect to community


What
the
New
Script
means
is
★ things speed up
★ people connect to community
★ but most importantly...

lives
are
transformed


e New Script
helps us to...


1. empower people -
e New Script people and families in
helps us to... control of their own lives


1. empower people -

2. strengthen capacity -
people living positive
lives, achieving, growing


1. empower people -


3. access community -
people as active
citizens


1. empower people -


3. access community -
people as active
citizens

4. build safe networks -
reducing abuse and
isolation


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 27.2

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?

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?

Personalisation
should
be
eﬃcient

but
it
can
easily
be
made
wasteful

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 £212.76

how
do
you
make
a

‘good
idea’
really
useful


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 Gracian


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?

www.campaignforafairsociety.org

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 Finish


Personalisation & Social Work

Recommandé

Recommandé

Contenu connexe

Similaire à Personalisation & Social Work

Similaire à Personalisation & Social Work (20)

Plus de Citizen Network

Plus de Citizen Network (20)

Dernier

Dernier (20)

Personalisation & Social Work