Community-led care and support: a new paradigm

Report from SCIE Roundtable held on 12 February 2015

SCIE Report 71

Published: May 2015

The move towards genuine community-led support is about challenging the accepted wisdom of delivery of services – including statutory services. It’s a huge shift.

Lord Michael Bichard, Chair, SCIE

The aim of the Social Care Institute for Excellence (SCIE) roundtable discussion was to identify, celebrate, support and learn from community-led activity. We aimed to identify practical steps stakeholders can take to support community-led services and share that knowledge with the sector including policy-makers.

The challenges facing care and support cannot be met in the traditional way by traditional services. Statutory services can sometimes fail to provide what people want and need, but community-led services are often closer to the client, more trusted and can release the real potential in our communities. We need to reignite that potential.

Statutory services can sometimes be reluctant to cede power. On the other hand, as communities are expected to take on additional responsibilities – such as youth work and libraries – do they have the capacity and capability to do this? Statutory services need to rethink their role and focus on commissioning outcomes, rather than protecting the traditional system.

Key messages

Positive impact of community-led services

  1. Community-led services help to break down the differences between people who need, and people who provide, care and support.

Challenges and barriers

  1. Community entrepreneurs always expect to face barriers – such as the complexity of regulations and funding regimes.
  2. Communities with greatest need are at the most risk of losing support.
  3. We need to challenge whether or not commissioners are best placed to understand the mix of community needs. Local communities really understand the context in which care and support services work.
  4. Many professionals feel restricted by current practice and would welcome the opportunity to engage more directly with people and communities
  5. While the rhetoric increasingly talks about the need for local communities to define their needs and local solutions, we still see distrusting relationships between statutory organisations and professional groups and local communities. We need to generate trust amongst commissioners and statutory services in small, local organisations.

There is a deficit of candour as well as a deficit of funds. How we develop relationships and trust really plays into this. If people can understand their rights and responsibilities, you can begin to build relationships, trust and a concept of what’s possible.’

Rich Watts, Programme Lead, Mental Health, National Development Team for Inclusion

Building and sustaining community-led services

  1. When it comes to community-led support, it is about spreading out, not scaling up. These types of services are likely to remain small and local – but they can be numerous.
  2. The move towards genuine community-led support is about challenging the accepted wisdom of delivery of services – including statutory services. It’s a huge shift.
  3. We need practice-based evidence, not evidence-based practice to really understand what is going on and what works – and does not work.
  4. Passion is impossible to replicate. What works is to be able to provide support to individual passionate, courageous individuals, e.g. through providing coaching, leadership development and networks.
  5. It is important that local organisations measure the impact of their work, especially on wellbeing. We need to provide support to local organisations and consistent and simple to use evaluation frameworks to help them to measure impact.

It is important that community-led care and support services are supported to become sustainable. Failure damages not just the people delivering the service but the people using it. People with good ideas who want to provide a care service for other local people need the right kind of advice and mentoring tailored to them. Quick-fix initiatives, such as seed-fund grants and some training, don’t help to build sustainable services. Most of these little ventures will stay small and local and individual. Passion is impossible to replicate.

Sian Lockwood, Chief Executive, Community Catalysts

Enabling community-led services to thrive

  1. Local community enterprises need support to connect and share with each other. Larger voluntary sector organisations could play a role in facilitating this.
  2. Most care and support is provided by family and friends – not by official services. Carers are often part of ‘virtual’ communities – not just geographical communities. Need to consider this when supporting concept of community-led care and support.
  3. Commissioners do need some level of evidence of impact, but if community organisation can demonstrate that they are identifying, engaging and benefitting people at risk or in need of support, that is sufficient.

We need to consider what is the productive system that can develop and support local learning of what works to promote community actions that can benefit from more older people and second can help support more older people? What ingredients and recipes appear to be most effective in producing useful, innovative, risky activity that can then be tested? It is about learning models that are not just centralised national models but about getting into a locality and learning alongside that locality for a number of years. It’s about having an ongoing programme of learning that is also credible to others, and generates evidence of what works to others including commissioners.

Lord Filkin, Chair, Centre for Better Ageing

As a commissioner I am satisfied if community-led groups can demonstrate that they are identifying, engaging and benefiting people at risk. That’s enough for me – that’s sufficient evidence to support a commissioning decision.

Joe Fowler, Director of Commissioning, Sheffield City Council