• Can demonstrate better management of demand
• Has the potential to reduce longer term care and support costs (potential net savings of between £0.418m (lowest saving estimate) and £1.852m (highest saving estimate) per year)*
• Achieves improved outcomes for individuals
• Generates high levels of satisfaction and motivation amongst staff *Data based on like for like comparison of 42 cases
Drivers for Change:
• Services difficult to access
• Lack of continuity: repeated assessments and changes of social worker
• People didn’t feel properly understood and we offered standardised, ‘sticky plaster’ solutions
• Health and social care services fragmented and difficult to navigate
• Were we using our limited resources to best effect?
Growing a new model
• Systems Thinking principles
• Inside-out
• Emergent
• Practitioner-led
The Wellbeing Model Our Purpose: Help me to help myself live my life well
Our Principles:
• You fully understand me and the real problem to solve
• You help me find sustainable solutions to my problems
• You help me build my own networks of support
• If you cannot help, you pull in expertise needed • You stay with me for as long as needed
Top to toe transformation
• Five assessment, reablement and day reablement teams disbanded and reformed into 8 integrated community teams (aligned with GP practices/community health)
• Leadership development programme
• Rules out, framework for practice in.
What’s different The practice….
• Its ok to offer a relationship to people and feel responsible ‘to’
• It takes time to really understand someone – but its time very well spent
• We start from a strengths based position
• We collaborate
• We think about being helpful as opposed to ‘service criteria’
• We make ourselves accessible
What’s different The functions…
• First Contact/accessibility
• Local teams with a range of diverse talents/skills ( fully capacitated….)
• Reduced spans of control for managers
• ‘Case management’ Leadership
• ‘Upside down’
• Practice confidence
• Trust and autonomy
• Emotional intelligence
• Assurance
• Data
• Rules out – principles for practice/values ‘in’
Ethical frameworks – humanistic approach
The inherent worth and dignity of every individual
Individual autonomy and relational autonomy
Trustworthiness – a ‘new’ concept? ‘A non-possessive concern for and commitment to the wellbeing of the individual’.
Providing the conditions for growth and change
Being responsible ‘to’ but not ‘for’ (except…)
Reflective practice – competence, beneficence, maleficence, boundaries/use of self