22 January 2026
By Gerard Crofton–Martin, Director of Transformation and Improvement, SCIE
Time spent in care services has a way of cutting through assumptions. It brings you back to what matters, challenges your thinking, and sharpens your sense of what good care and support really looks like. That was certainly my experience at Greenlands View, a residential service in Birmingham, part of Lifeways.
What I encountered there was a strong sense of purpose, an openness to learning, and a clear commitment to putting people at the centre of everyday decisions. It was also a reminder that, even in the current climate—with its very real pressures on workforce, capacity and resources—there are places where thoughtful leadership and a culture of listening are making a meaningful difference to people’s lives.
A culture of personalisation that listens and acts
What struck me most was the service’s listening and learning culture of personalisation, embodied by the registered manager, Emma. With encouragement and licence from regional and national executive teams, Emma continues to take Greenlands View on a journey of empowerment—right the way through everyone involved in the care and support provided.
You could not help but smile hearing the story of this journey so far. It was not a tale of grand redesigns or shiny innovations, but of small, thoughtful decisions that shifted power towards people and, in doing so, changed outcomes.
One example stayed with me. Anthony*, a resident who is non-verbal, was experiencing distress and behaviour that challenged when new staff joined the team. Rather than seeing this as something to be ‘managed’, Emma reframed the problem: how might we help Anthony feel safer and more in control? The solution was both simple and profound—Anthony became part of the recruitment process for new staff. Reasonable adjustments were made, including the use of a communication pad. By the time new colleagues arrived for shadow shifts, Anthony already knew them. The result? A marked reduction in recorded incidents and a more confident, connected team.
This was not an isolated story. Another resident, Mindy*, is diabetic and previously had to return home every day between 4pm and 6pm for an insulin injection from the district nurse. Even when out enjoying time with family or staff, Mindy’s day was interrupted—often waiting in, sometimes for hours. Emma noticed that distress increased around this time, not because of the medication itself, but because of the restriction it placed on Mindy’s life. Following consultation with Mindy, their family, the district nurse and other professionals, the service moved to tablet-based medication. The impact was immediate: fewer restrictions, more choice and a noticeable reduction in distress.
Redefining what a ‘good day’ means
Emma put it simply: a good day is when people are enabled to do what they want, no matter how small it might seem. Posting three letters. Putting a load of laundry on. These moments matter because they speak to autonomy, dignity and control.
What this reinforced for me is that improving lives is not always about the latest technology or equipment, though this can offer huge potential when it is designed with people who draw on care and support. Often, it is about culture—about putting people first, trusting colleagues, and being brave enough to share power.
Leadership that enables, not constrains
Importantly, this culture is not happening in spite of the organisation. Members of the Lifeways Quality Team, who joined me on the visit, were clear that they never want to ‘clip the wings’ of registered managers. Their role is to enable positive risk-taking and creativity—providing tools, frameworks and organisational approaches that support, rather than stifle, local leadership.
This aligns with Lifeways’ guiding principle of ‘Nothing about me—without me’: engaging and including people in everything that affects them. Initiatives such as Our Voices and the co-produced Quality Checkers approach—where people drawing on care and support help define, assess and celebrate what good support looks like—show how co-production can shape organisational culture, not just individual care plans.
The Lifeways team is passionate about co-production, engagement and continuous improvement, and the Lifeways Executive Advisory Panel, a team of experts by experience, is central to that mission. They advise and support the Executive Team to ensure the people they support are heard and drive meaningful change. The Family Advisory Panel also contribute to key strategic decisions and initiatives, ensuring family members are involved in decisions that will affect their loved ones.
Holding on to what matters
There is no escaping the reality of the challenges facing adult social care. Pressures on workforce, funding and capacity are felt everywhere, and services like Greenlands View are not immune. What stood out during my visit, however, was a quiet confidence that even in difficult conditions, it is possible to hold on to what matters most.
For SCIE, staying close to these everyday realities is essential. It helps us test our thinking, refine our work, and stay attuned to the voices of people who live in and work within services. More importantly, it reminds us that good care is built through relationships, trust and shared purpose—and that these foundations remain as relevant, and as powerful, as ever.
Notes
*Pseudonyms are used
As a not-for-profit charity, SCIE supports the development of innovative solutions to address challenges faced by children and families, helping ensure high quality, co-produced, ethical and evidence-based practice.
