The summary report highlights key messages from Phase II of the Social Care Innovation Network, and the outputs of the three learning groups. Describes the challenges, identifies key learning themes from each of the groups and makes recommendations for future work.
For those wishing to develop an asset-based approach to care and support, commissioners interested in alternative approaches to commissioning and people who access or wish to access care and support through a direct payment, individual service fund or personal budget.
The Social Care Innovation Network, of which I am a member, is offering the sector a great opportunity to generate more clarity around innovation, so that we scratch beneath the surface of a buzz word and apply a theory with big feet right from the start.
What is the social innovation network?
The Social Care Innovation Network (SCIN) is a partnership between SCIE, TLAP and Shared Lives Plus, funded by the Department of Health and Social Care. Its purpose is to examine and promote ways that innovative approaches to social care can flourish and develop. The network has brought together councils and organisations which provide care and support to people, citizens and national bodies to work collaboratively and creatively, in order to push the boundaries of what is possible in growing innovation.
The values of the work are in line with TLAP’s Making It Real approach, such as the ‘I’ statement which describes how social care support should be about supporting a person’s life not the services being provided. ‘I can live the life I want and do the things that are important to me as independently as possible.’
Phase I of the project focused on exploration – to explore in depth the challenges and barriers to sharing and scaling up innovation across the adult social care sector. The outcomes were summarised in a report Getting under the skin of it.
What did the network focus on in phase II?
Phase II of the project moved onto a discovery phase – to develop, through learning groups, practical lessons on how we can develop the conditions in which innovations can flourish or proliferate. Three learning groups were set up in late 2019 with the intention of meeting three times in January, March and May 2020. Due to Covid-19 the third round of meetings did not take place.
The three groups focused on:
- Developing the asset-based areas model in more depth. We describe what we mean by asset-based areas later in this report.
- Re-designing commissioning so that it supports innovation by becoming more citizen led. Commissioning is a process that public sector organisations use to plan, procure, deliver and evaluate services for local residents.
- Taking self-directed support back to its roots so it affords authentic choice and control and enables people to connect and contribute. Self-directed support is an approach that puts people at the centre of the support planning process and enables them to make choices to about the services they receive.
The leads for each of the learning groups were supported by people with lived experience, from either the National Co-production Advisory Group or the Coalition for Collaborative Care.
In total, phase II involved 24 organisations which consisted of local authorities, innovative organisations and locally engaged citizens of people with lived experience. All the providers involved in the work are featured in the TLAP directory of innovations in community-centred support, colloquially known as the ‘rainbow’.
The learning groups were asked to work on:
- Describing the challenge clearly and draft a theory of change for participants to try, offer support and peer support. A theory of change is a visual picture which describes how we believe a policy, programme or initiative makes a difference to outcomes.
- Identifying useful, practical, tangible activities for participants to try.
- Capturing what people do, what worked well and what didn’t work so well.
- Creating recommendations and identifying unmet needs and future work required.
From the outset the three main themes – asset-based areas, commissioning and self-directed support have been viewed as intrinsically linked and mutually reinforcing. In short, you cannot achieve the outcome of more people benefitting from innovative models of care without considering all three themes together:
- asset-based areas are the overarching vision for a citizen-led, person-centred and relational approach to care and support which improves wellbeing.
- citizen-led and asset-based commissioning is one of the mechanisms through which this vision is translated into investment in the right models of care and ways of working.
- self-directed support ensures that citizens have influence and power to ensure that the vision of an area works for them and is truly reflected in outcomes and experience of care.
What were the drivers for change?
Asset-based approaches were a core theme for each of the learning groups. As described in the TLAP paper The asset-based area, the approach has two core aims:
- to make visible and value the skills, knowledge, connections and potential in the community
- to redress the balance between meeting needs and nurturing the strengths and resources of people.
All groups thought it was important to value a compelling vision of an asset-based area in language which people can relate to in order to inspire ‘coalitions of the willing’ to emerge and turn the vision into a reality. There was acceptance that an asset-based area requires many changes, including bold and brave decisions. Statutory partners need to be willing to let go and take some risks by ceding more autonomy to individuals, communities and local organisations, some of which provide services.
We live in an unequal society. We must be alert to the risk that innovation might benefit some more than others and risk widening existing inequalities.
Whilst the overarching vision for change was the vision of the asset-based areas, four other areas were particularly highlighted for being important drivers for change:
- digitally enabled care
The issue of equalities has underpinned many of the discussions in the learning groups. There was agreement that this must become a much more prominent objective in future innovation work.
These themes were considered throughout phase II of the project, as well as ensuring the use of plain language in communicating the work of the network.
What were the challenges during COVID-19?
The learning groups were due to meet face to face in April/May but this was not possible due to Covid-19. We have continued to communicate via other methods to ensure thoughts and ideas were taken into consideration in developing the final outputs.
During the COVID-19 pandemic, TLAP has collated information from organisations on the directory of innovations in community-centred support to explore how they are working differently to adapt and respond to Covid-19. Provider responses to COVID-19
A bid has been submitted to the Department of Health and Social Care for a three-year programme of work following on from phases I and II. Phase III will focus on in-depth work in local areas to test and scale up innovations in a number of local areas, and evaluate their impact on outcomes. We also want phase III to provide early learning to inform DHSC’s plans for social care reform. It will involve on-site peer-to-peer support from experts in the field.
Phase III has four main areas to explore:
- Identify and encourage local areas to create the conditions in which the best of social care can thrive.
- Build the evidence base further to support the impact of innovation delivered at scale.
- Develop practical solutions to support a step change in scaling of innovation in social care.
- Identify areas which assist the Government long-term plan for adult social care.
Now, more than any other time, learning from Covid-19 is key. There is recognition that we should learn from the positive changes and approaches across the sector to ensure these can be absorbed and sustained in the future. The first stage of the work will be to kick start with this.