Changing social care: an inclusive approach

SCIE Guide 29

Published April 2009

About this guide

Adult social care is changing, to ensure that the people who use services are at the heart of their own care and support. This change, outlined in 'Our health, our care, our say' (Department of Health 2006) and confirmed in 'Putting people first' (Her Majesty's Government 2007), will result in greater choice and control for individuals and better support for carers and families. To achieve this, the social care workforce will need to change its approach.

This guide is based on the messages from two SCIE knowledge reviews, which looked at the evidence from both literature and practice.

• Knowledge review 16: Improving social and health care services
• Knowledge review 17: Developing social care: service users driving culture change

The first identifies the actions crucial to successful change and improvement, and the second explores the experience of people using services who are trying to achieve cultural change. Together, they conclude that culture change led by the people who use services, and underpinned by strong leadership and the full participation of the workforce and wider stakeholders, will begin to deliver the vision of modern, inclusive social care.

What is this guide for?

This guide seeks to give readers some ideas about how to successfully change services in order to place people at the centre of their own care and support. It begins with a brief overview of the policy context and then moves on to a series of ‘how to’ sections. It will look in turn at the importance of good leadership, and the full involvement of both the workforce and all stakeholders in achieving change. It will also explore in more detail how to involve the people who use services in order to positively drive and influence change. The examples and resources are not intended to be exhaustive, but should give some indication of what can be achieved.

The ‘how to’ sections will all follow the same format:

• What needs to be done – suggestions and examples from practice.
• How we know this – messages from the literature.
• How are you doing? To check progress in your organisation.
• Checklists – from practice and literature.

Who is this guide for?

This guide is for everyone who is interested in how to achieve positive change in social care services. This includes a wide range of people, such as user-led organisations, those working in the third sector, councillors and managers, and the workforce from both the statutory and independent sectors. The guide does not tell you how to ‘do personalisation’ and people working in different sectors will find some sections more relevant than others. The central messages – the importance of good leadership and the full involvement of the workforce and all stakeholders – will, however, be relevant to all, whatever improvement you are trying to make.

How were the examples and case studies selected?

The guide is illustrated throughout with quotes, examples and case studies. These are all drawn from the content of the two knowledge reviews on which this guide is based. More detail can be found in the respective knowledge reviews.Knowledge review 16 includes detailed case studies from four organisations:

• Willowbank Community Resource Centre, Dungannon, Northern Ireland – a rights-based service user-led community resource centre.
• Age Concern Sheffield, Sheffield, England – an independent, local organisation dedicated to supporting older people in Sheffield.
• Disability Wales, Caerphilly, Wales – an independent, not-for-profit membership organisation of disability groups and allies from across Wales.
• Children and Family Court Advisory and Support Service (CAFCASS), England – working with children and their families involved in court proceedings, to advise courts on what is considered to be in the children’s best interests.
• BrendonCare Alton Alton, England – a charity with 10 care centres across the south of England

These are available as separate resources in the Case studies section, together with further case studies.

How to use this guide

The guide has been structured to enable the reader to pick and choose the sections they are most interested in. This introduction includes an overview of the policy context, setting the changes in social care against the backdrop of wider public service reform. There are then four main chapters, focusing on the key areas to consider:

• Leadership for change and improvement – outlines the steps leaders can take to facilitate change in service delivery.
• Workforce involvement and participation – why the involvement of the workforce is important and how to facilitate it.
• Stakeholder involvement and participation – why the involvement of all stakeholders is important and how to facilitate this.
• Service users driving culture change – how to facilitate genuine participation that will drive improvements in services.

For readers interested in the changes needed to achieve personalised services, this guide can usefully be read in conjunction with two additional resources:

• Personalisation: a rough guide (Carr 2008). This SCIE guide aims to tell the story so far about the personalisation of adult social care services. It sets out our current understanding of personalisation at what is a very early stage of implementation, and explores what personalisation is and where the idea came from.
• Common core principles to support self-care: a guide to support implementation (Skills for Care and Skills for Health 2008) Skills for Health and Skills for Care have worked with key stakeholders, including people who use services and carers, to develop a set of common, unifying principles. The aim of these is to identify best practice, in order to support service reform and promote choice, control, independence and participation.