It's the quality of conversations that matter to social care reform

Featured article - 31 October 2017
By Martin Farran, Corporate Director of Health, Housing and Adult Social Care, City of York Council

Most good relationships start with a conversation. We use conversations to find out about people. What do they think? What do they like? What are they good at? We find out what makes people tick through conversations.

Shouldn't this be the way we start relationships between those who provide access to social care and people who use services? Wouldn't that be a good what to find out about a person; not just about what help they need, but also what skills, resources and ideas they can bring to bear?

• Asset-based places: a model for development (SCIE Future of Care)

This is what City of York has tried to do, making the shift from what was sometimes deemed to be an overly paternalistic, needs-led approach, towards one that is focused on people's strengths and community networks.

Under the banner of Future Focus, York has redesigned its approach to assessment and case management. This has involved moving away from a traditional assessment based model which often led to people receiving costly care packages which didn't necessarily deliver good outcomes, towards a model based on having conversations with people that let them define their desired outcomes and how they can best be supported.

Accessing local community resources is not straightforward

That's the case if you don't know where to look, so the other key strand to these changes is the provision of better information and advice, co-designed with users so that it is much more intuitive and accessible.

And these changes are showing early promise. Since the new approach was piloted, 38% people who received a home visit from the Intensive Support Service did not go on to need a service and 100% of respondents said the advice and information had a positive impact.

This is not to suggest that York expects the community to step in unaided into the spaces left behind by traditional services. Aware of the impacts of service cuts on communities, and the pressures on the voluntary sector, York is finding ways to invest in voluntary sector and support community led initiatives like Ways To Wellbeing and Local Area Coordination, both of which are led and delivered within the community sector.

• Ways to wellbeing

York is making a good start, but with a fast ageing population and a challenged NHS system, deeper change will be required. Focused initially on adult social care, this asset based, preventative approach, needs to underpin the way all services are provided. It needs to be sustainable to, with the culture of conversations and an asset based approaches become business as usual, with communities and statutory agencies working together to find solutions.