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Critical review tool for social care leaders

This critical review tool is for leaders and practitioners working in local authorities and partner organisations and people who draw on support to assess their ambitions, strengths, and development areas in relation to developing strengths-based care and support across a local place.

This tool is free to use, although we recommend that you ask our experts at SCIE to support you to complete it. We will facilitate workshops and produce a report on practical actions to ultimately get the best outcomes for your organisation and local people who draw on support. We recommend that the tool and workshops involve people who draw on support and carers; a process we call co-production.

It focuses on nine critical domains to help leaders and people working in adult care and support to understand where they are now and what they need to consider if they are to make progress. Good practice examples and links to helpful tools and resources are also provided.

Introduction

This critical review tool is designed to support leaders and practitioners in local authorities and partners with responsibilities for adult care and support, working with people who draw on support to critically assess their ambitions, strengths, and areas for improvement in relation to developing a whole-place approach to strengths-based working.

This tool can be used by anyone who is leading or managing adult social care services or who works for a partner that is seeking to develop strengths-based approaches, such as housing, the NHS and the voluntary and community services and social enterprises. We recommend that it is used by directors of adult social care, lead members for adult social care, assistant directors, heads of service, principal social workers and team leaders and senior leaders from other system partners, e.g. NHS, housing and the voluntary, community and social enterprise sector. We strongly encourage those using the tool to involve people who draw on support and co-produce any actions which result, a process called co-production.

This is not an audit tool or a method for scoring progress on strengths-based ways of working. Its aim is to support reflection and discussion about where the local place or system is and where it needs to go next.

Recent evidence, along with our experience of supporting dozens of councils, shows that strengths-based ways of working are only successful when you adopt a whole-place or whole system approach, involving not just adult social care, but also the NHS, housing, community organisations and local people. This is why this tool asks leaders to think through what needs to change across the whole service and the wider public sector and community.

It focuses on nine critical domains, with associated characteristics of good practice, which need to be considered if we are to make progress towards developing strengths-based working across the whole local place, helping leaders and practitioners understand where they are now and what they need to focus on if they are to make progress. Good practice examples and links to helpful tools and resources are provided throughout.

This tool draws from many evidence sources and good practice resources. These include SCIE’s Care Act strengths-based resources, the Department of Health and Social Care: Practice Framework and Practice Handbook, which SCIE co-authored; the evidence underpinning SCIE and the University of Birmingham’s Strengths-based Practice Leadership programme. It also draws on SCIE’s research on leadership of strengths-based practice and the work of the Social Care Innovation Network, which SCIE delivers in partnership with Think Local Act Personal and Shared Lives Plus, and particularly the publication The Asset Based Area 2.0.

This is why this tool asks leaders to think through what needs to change across the whole service and the wider public sector and community.

What is a strengths-based approach?

Strengths-based ways of working, also called strengths-based approaches, focus on identifying the strengths, or assets, and the needs and difficulties of people who draw on services, their carers and families as well as communities in which people live.

The Care Act 2014 requires local authorities to specifically ‘consider the person’s own strengths and capabilities, and what support might be available from their wider support network or within the community’.

A strengths-based approach to care, support and inclusion says let’s look first at what people can do with their skills and their resources – and what can the people around them do in their relationships and their communities. People need to be seen as more than just their care needs – they need to be experts and in charge of their own lives.

Sitting under the banner of strengths-based ways of working are a broad range of specific strengths-based models or approaches, as highlighted in Figure 1. For more on strengths-based practice, and specific tools and models, please go to Strengths-based approaches.

Fully implemented and invested in across a whole local health and care system, strengths-based ways of working can:

  • enhance health, wellbeing and resilience
  • reduce long-term pressures on higher-cost health, care and support services
  • enable people to participate in and benefit from community resources and activities.

To ensure that any specific model or approach to strengths-based approaches achieves the desired outcomes, you need to create the right conditions across the whole service and the wider system. This tool deliberately focuses on how organisations and systems are progressing on creating the conditions which foster strengths-based practice, rather than on how to implement a particular approach. Evidence suggests that only when you take a whole-place approach, can you achieve the outcomes intended through strengths-based ways of working.

Figure 1: Strengths-based approaches

Adapted from Romeo, L (DHSC, 2018), Social work with adults: strengths-based approaches

  • Asset-based community development
  • Solutions-focused
  • Local area coordination
  • Appreciative inquiry
  • Making safeguarding personal
  • Shared Lives
  • Community catalysts
  • Restorative practice
  • Family group conferencing
  • Cognitive behavioural therapy
  • Signs of safety
  • Systemic social work
  • Three conversations framework
  • Using self as instrument of change
  • Person-centred approaches
  • Narrative approaches

How to use this tool

This tool is designed to help both individuals, but preferably leadership or management teams working with people who draw on support and carers, think through where they are on developing whole-place, strengths-based ways of working and creating the conditions in which strengths-based practice can thrive.

Four statements dig deeper into each domain and what it covers to help you assess how present it is in your organisation or place. Read each statement and mark how strongly you agree or disagree with it overall. Then think through and try to describe why you have given that rating.

Of course, there is always a challenge in plotting in many cases behavioural and cultural changes on a scale, so these scores serve as an indicator only; the value of the process is largely in asking the question and inviting colleagues to reflect on them.

The tool is likely to have greater benefit by working through it in collaborative facilitated sessions, with other managers, staff (such as social workers and occupational therapists), partner organisations and people who draw on services and carers.

The tool sets out nine domains to work through. Under each domain it describes:

  • What good practice looks like
  • Why it is important
  • Key questions to consider
  • Examples of good practice
  • Useful resources – other helpful tools

You need to think about what each domain means to your local care and support system. We would then ask you to reflect broadly on where the organisation and its partners are compared to the description of good practice. We would then ask you to consider each key question, and note down where you are in relation to this.

At the end of the tool, we provide a simple action plan we would urge you to complete, with colleagues, setting out how you intend to make progress in relation to the domains.

SCIE can help you use this tool with your local leadership team. We can help by gathering evidence of your local area’s starting point, facilitating workshops to apply the tool, and co-produce an action plan. Find out more

Domains

There are nine main domains that cover a range of areas which evidence shows need to be considered to facilitate progress towards strengths-based ways of working.

Which version?

Complete the tool to rate your organisation on each of the nine domains to facilitate progress towards strengths-based ways of working.

You can use either:

  • Non interactive version: This allows you to review the tool before completion, also includes case studies and further reading links.
  • Interactive personalised version (Recommended): This allows you to assess your organisation against a series of questions, save your progress, and once completed, you will be able to download a personalised version of your report which can be shared. This personalised downloadable report will also include case studies and further reading links. We recommend you complete it individually then pass on to your colleagues for them to complete to compile a final organisation score.
  • Downloadable version: Obtain a non-personalised PDF version of this review tool

Develop a strengths-based vision and framework

What does good look like?

Local places which are making progress on strengths-based ways of working have a clear, co-produced, narrative which explains what we are trying to achieve and how we will achieve it. It should describe what needs to change and how the future of care and support will be different. This should focus on how strengths-based ways of working will transform care and support across a whole place, including care provision, but also housing, mental health, primary care, social prescribing, VCSE and community-based support. Often this narrative comes in the form of a strengths-based framework, which is designed to support practitioners and partners to understand what we mean by strengths- and outcomes-based approaches, the key principles informing practice, and the behaviours that are expected.

Why is this important?

There is value in creating a compelling vision and narrative for change in language that people can relate to in order to inspire ‘coalitions of the willing’ made up of local people and practitioners. Many local authorities we work with have co-produced a vision for a strengths- or asset-based place that resonates and unites local people.

In The asset-based area 2.0, having a ‘clear, shared story about how we work and what we want to change’ is one of the 10 commitments that are needed to create an asset-based area. Doncaster, which aims to develop a much more strengths-based approach to support, has recently adopted a new vision based on the Social Care Future, which provides a good example of a compelling vision for change:

We want every person in Doncaster to live in the place they call home with the people and things they love, in communities where they look out for one another, doing things that matter to them.

Social Care Future

Key questions

  • Leaders engage and involve people who draw on support, carers, practitioners, and managers in early conversations about change and value their vision, ideas and opinions when developing plans to transform social care and support.
  • We have a single practice framework and everyone understands the core principles, values and behaviours that underpin how we work with people.
  • The workforce understands what is expected of them on strengths-based ways of working and what good looks like.
  • We have a clear articulation that everyone understands of the process of change, what this will mean for practitioners, partners and communities, and what will need to change for this to be delivered.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Leading a strengths-based approach

What does good look like?

Effective leadership is critical to developing strengths-based ways of working across local services and the local place. This relates in part to those in more senior roles who can provide an official endorsement, develop an authorising organisational environment, identify the necessary resources, and champion the cause of strengths-based practice to other stakeholders. But successful implementation requires leadership from others. This includes leadership from across the organisation who can create a culture of collaboration with partners and providers, operational managers who coordinate services at a local level, and professionals who work directly with people. Meaningful and sustained implementation of strengths-based practice also requires those who draw on support to shape the vision and determine what success will look like. This requires individuals and communities being given the support and opportunity to demonstrate their leadership too.

A strengths-based approach requires a new kind of leadership, which draws strength from many more sources: the whole team, voluntary sector and other partners, and most importantly, from citizens themselves. Leaders practising strengths-based approaches will not try to effect change by themselves. They will share rather than hoard power, which in turn will enable them to ask more of those around them. The key measure of success is not their own strength, but the combined strength and capacity of the whole system.

Alex Fox, CEO Shared Lives

Why is this important?

Effective leadership is critical to developing strengths-based ways of working across local services and the local place. This relates in part to those in more senior roles who can provide an official endorsement, develop an authorising organisational environment, develop and promote a single, widely shared and understood strengths-based vision and practice framework or model, identify the necessary resources, and champion the cause of strengths-based practice to other stakeholders. But successful implementation requires leadership from others. This includes leadership from across the organisation who can create a culture of collaboration with partners and providers, operational managers who coordinate services at a local level, and professionals who work directly with people. Meaningful and sustained implementation of strengths-based practice also requires those who draw on support to shape the vision and determine what success will look like. This requires individuals and communities being given the support and opportunity to demonstrate their leadership too.

Key questions

  • Leaders at all levels need to model strengths-based approaches with the workforce and take care to use language which communicates this.
  • Staff at all levels have permission to resolve the issues they encounter, including through collective problem solving.
  • We recognise that we can only create the outcomes we seek by working in partnership with the wider system.
  • We celebrate and disseminate ‘success stories’ across multiple forums, for example, newsletters, multi-agency meetings, and other events.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Developing a strengths-based approach to commissioning

What does good look like?

To develop a place-based approach to strengths-based working, you need to develop commissioning which is able to invest in services and forms of support which recognise, and enhance people’s strengths and assets within the local community. Strengths-based or asset-based commissioning is based on developing a detailed understanding of the actual strengths and needs of adults within the local place at both an individual and population level, and working with people and organisations to design and invest in different forms of services and support. Strengths-based commissioning:

  • focuses on outcomes – like wellbeing and independence – rather than ‘time and task’ (how much carers spend with people and what they do) or episodes or care
  • is co-developed with people who draw on services, providers and the voluntary and community sector so that they help shape outcomes, priorities and preferred models of care
  • encourages more commissioning to take place at the neighbourhood level and ‘micro commissioning’ (people using personal budgets and direct payments to purchase services)
  • encourages smaller, innovative providers to enter the market, and encourages strengths-based practice in organisations which are supporting people.

Why is this important?

Without changing commissioning or planning as it is increasingly referred to in the NHS, we will not be able to shift large areas of care provision – including commissioned home care and residential care – towards strengths-based, person-centred ways of working. Commissioners have some of the most critical resources and levers, to encourage providers and more practitioners to adopt strengths-based ways of working.

Key questions

  • We have a clear strategy and plans for how we will commission for strengths-based care and support.
  • We go beyond just consulting with current providers, people and practitioners to engage in a process of co-design, where these stakeholders are actively involved and engaged in the process.
  • Our approach to commissioning is based on a detailed understanding of the strengths, needs and aspirations of the local population, and we develop commissioning plans which clearly set out how to build on these.
  • We seek out opportunities to commission innovative, asset-based models of care, such as Shared Lives, local area coordination and Wellbeing Teams.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Working in partnership

What does good look like?

Strengths-based ways of working can only be achieved through partnership working and collaboration with a wider range of statutory partners and other organisations. This ensures that there is strong commitment to strengths-based ways of working across the local place, and that people are supported to access a broad range of community-based resources and don’t experience lots of bureaucracy or are handed from one person to the next.

In areas with strong levels of partnership working, all of the key leaders are signed up to this way of working and have trained their staff in strengths-based practice.

Leaders engage in systems leadership which is a form of leadership which acknowledges that many issues of mutual concern in public services cannot be solved by any one person or institution, and require leaders to collaborate across organisational boundaries.

Why is this important?

People who draw on support often have a range of needs and strengths, many of which cannot be met by adult social care alone. People increasingly need partners – be they housing, the NHS or local community centres – to work together to meet their needs and aspirations. A strengths-based way of working, relies on drawing on the broad range of resources which exist in the community, and connecting people to these. This can only happen if partners work closely together on the design, commissioning and delivery of local services and support within the community.

Key questions

  • We invest time, both formally and informally, in building productive relationships with leaders across partner agencies and organisations, developing joint priorities and plans.
  • We involve people who draw on support, carers and wider communities in developing effective partnerships.
  • We work together to support practitioners in partner services, to work in a strengths-based way and have a shared understanding of our goals and outcomes.
  • System leaders take opportunities to promote staff coming together to collaborate and problem-solve, e.g. joint away days, training and team meetings.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Effective and enabling systems, processes and information

What does good look like?

The systems, processes and forms which support practice are enabling and intuitive, freeing up practitioners to spend more time with the people they working with in the community. In areas making good progress on strengths-based ways of working, there is strong alignment between the vision and plans for strengths-based ways of working, and IT systems and kit, case management systems, processes, procedures and guidance.

Community assets, community groups and community-based services and resources are regularly mapped and the information is stored in accessible directories. Practitioners are able to find the information they need to signpost people to sources of support.

Why is this important?

Poorly designed processes, outdated IT, misaligned care pathways, and poor-quality processes and procedures, can get in the way of good strengths-based ways of working. In areas making good progress on strengths-based ways of working, case management systems and workflows are simple and intuitive to follow, and reduce the amount of unnecessary form filling, freeing up practitioners to spend more time with people who draw on adult social care.

Partners in these places also share information and are working towards having data on a single system which allows practitioners to ‘see the whole person’.

Key questions

  • Our policies, forms and procedures support staff to act in line with the vision and practice framework, rather than having to work around the system.
  • People can access information and advice in a user-friendly format to enable them to find local forms of community services, networks and support.
  • The IT, management information and systems enable and facilitate strengths-based ways of working.
  • Practitioners have a good understanding of what resources and forms of support exist in local communities.

You can rate your answers with the interactive tool.

Good practice

Delivering to a high standard and quality

What does good look like?

Those areas making progress towards strengths-based ways of working have adopted a clear framework for understanding and measuring what good looks like. This means have a set of quality standards and expectations in place which everyone is expected to work to. This is reinforced by an approach to performance management which focuses on outcomes and quality, not just outputs and episodes of support delivered. To ensure that these standards are maintained and ideally exceeded, there is a rigorous approach to audit and review in place, involving strengths-based audits of cases and evaluating impact with people who draw on support.

In a strengths-based workforce, there is a commitment to reflective and relationship-based supervision. This encourages a more reflective culture and better decisions and practice. To encourage an empowered culture, managers show a willingness to delegate financial decision-making (to certain limits) to team/service managers.

Why is this important?

Having a strong quality-assurance framework in place ensures that organisations are measuring and evaluating their practice, and promoting an organisational culture that is committed to learning, continual development and improvement. To support this continuous improvement, many local authorities have developed strengths-based practice frameworks which clearly articulate the standards, quality hallmarks and expectations placed on all practitioners.

High-quality reflective supervision is essential to building a skilled team committed to delivering a high quality of practice. High-quality supervision has many benefits including building staff resilience, informing decision-making, and supporting a culture of best practice which promotes better outcomes for people who draw on services.

Key questions

  • We have good-quality, strengths-based supervision in place for all practitioners to assure best practice, support staff wellbeing and improve outcomes for people who draw on services.
  • We have a clear understanding of what high-quality care and support looks like and take prompt action when quality slips.
  • We involve people who draw on services to evaluate the extent to which we are delivering high-quality care, and act on any feedback.
  • We have worked with partners, including providers, to ensure that their practice is high quality and aligns with the overall expectations for delivering high-quality practice.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Co-producing with people who draw on services and carers

What does good look like?

Co-production is about developing an equal relationship between people who draw on services and the people responsible for services. Where there is good co-production of care and support, people work together, from design to delivery, sharing strategic decision-making about policies as well as decisions about the best way to deliver support.

Why is this important?

Properly embraced, the insight, experience and expertise of people can make services better tailored, more sustainable, and ensure that service changes command legitimacy. Social care and support organisations should engage with, involve, and empower people who draw on support, carers and the public. People are not just experts in their own lives, conditions and care needs, they also hold vital knowledge about local services that we can harness to improve health and care. Through co-production, this knowledge can help drive improvements, including to the standards, systems, processes, forms, staff development and approaches to commissioning which underpin effective strengths-based ways of working.

Key questions

  • Leaders set expectations that people are involved in the design, commissioning, delivery and evaluation of services.
  • We consistently involve people with lived experience and carers as equal partners in planning their care and support.
  • There are co-production arrangements such as co-production panels and forums in place to give people a voice in how strategic decisions about care and support are taken.
  • People with lived experience are involved in providing staff development and training in strengths-based approaches.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Developing the skills and capabilities of the workforce

What does good look like?

It is essential to the success of strengths-based ways of working, that there is significant and sustained investment in the development of the workforce’s knowledge, skills and capabilities. Local authorities that are making progress on strengths-based ways of working have in place a comprehensive learning and development strategy for all staff which includes peer support, coaching, reflective and group supervision and investment in developing an empowering culture. In some places, local strengths-based champions will have been recruited and supported to cascade learning and support good practice, often by ‘teaming up’ with less experienced practitioners.

Another element of developing the workforce is for leaders and managers to encourage a positive approach to risk. Strengths-based social care promotes ‘positive risk-taking’ as it enables the person, supported by the practitioners, to explore different ways of being supported and achieving goals. Doing this well is about a change in outlook: from viewing risk assessment from the perspective of practitioners and organisations to identifying what risks matter most to people who draw on care, the benefits of risky courses of action, their potential for taking responsibility for risk and finally helping them manage those risks.

As we move towards a whole-place approach to working, we should see more local authorities working closely with the NHS, housing and voluntary and community sector partners to develop joint workforce strategies which clearly explain and resource the development of strengths- or asset-based ways of working.

The key skills practitioners need to develop include:

  • having a stronger focus on listening, hearing, reflection and empathy
  • asset mapping
  • conducting strengths-based conversations, care planning and reviews
  • facilitation and mediation in group settings
  • co-productive practices with organisations, people who draw on services and carers
  • story-telling in order to create a clear vision of people’s lives, including their strengths, experiences, needs and concerns
  • community building and development, and encouraging and implementing peer support.

Why is this important?

Strengths-based ways of working require different skills from traditional care-management approaches which have dominated the sector for the last couple of decades. They require practitioners to be more reflective, empathetic and devoted to working collaboratively with people, rather than doing things for and to people. Really effective practitioners, are confident at having conversations with people about their strengths, aspirations and where they draw support from within the community, and building on this into an offer of support that helps them achieve what matters most to them.

Key questions

  • We provide staff with a wide-ranging, evidence-based learning and development programme to support them to adopt and develop strengths-based skills.
  • We celebrate and recognise good strengths-based practice, and share and learn about new developments in practice.
  • We encourage and model a change in perspective towards risk so that practitioners feel they have ‘permission’ to take risks and innovate.
  • We give staff time and space to work in new ways and permission to experiment and learn from new experiences.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Understanding and measuring impact

What does good look like?

Strengths-based ways of working seek to transform experiences and outcomes for people who draw on care and support and carers. It is important that we monitor and manage performance in relation to these shifts in outcomes. In developing outcome measures, it is important to develop performance indicators based on measuring outcomes for individuals and sequence of events rather than ‘how many’ and ‘how long’. Key outcomes can include people reporting feeling that they are more socially connected to others, better able to support their own independence and are experiencing high levels of wellbeing.

Why is this important?

Implementing strengths-based practice requires significant changes to processes, system, staff development and relationships with communities, and it is important that the effectiveness of these different interventions is understood. Measuring impact is key to performance management, service improvement and accountability.

Leaders and managers seeking to develop strengths-based places, need to ask themselves:

  • What difference are we making to the lives of people we support?
  • What is the contribution of the changes we are making to the achievement of these outcomes?
  • How will we know we have succeeded?

Once in place, a clear framework and approach to monitoring and evaluating impact can ensure that local authorities and their partners can continue to make progress towards becoming strengths-based places.

Currently, the way we measure the impact of new ways of working is geared towards understanding whether we have hit a number of specific ‘output’ targets, e.g. the number of people we see, and how quickly we deal with their ‘cases’. In the future, we need to move towards understanding the impact of our combined efforts on strengths-based working on the outcomes that matter most to people.

Key questions

  • Leaders have a clear understanding of what outcomes they are seeking to achieve through strengths-based ways of working and how they can measure progress towards them.
  • We seek to understand and measure the impact of people’s lives, and how strengths-based ways of working support people to live the best lives that they can.
  • We see measurement as a tool not just for measuring impact, but also for learning, improvement and enquiry.
  • We develop and share case studies to bring the change to life and demonstrate the impact on people’s lives.

You can rate your answers with the interactive tool.

Good practice

Useful resources

View all of the domains for strengths-based approaches.

Downloads

Unlocking the potential of adult social care (non-personalised PDF version) Action planning template