Changing the culture: moving from tick boxes to creative conversation

Changing the Personal Budgets process – why? A review following initial implementation identified improvement areas The developing policy agenda encourages it (Think Local Act Personal-TLAP) Service User and staff feedback identifies issues with the current process Work undertaken prior to Care Act and guidance implementation

Introducing the Re-Script Group Core Group Members: – Social Workers – Team Managers – Specialist Services – Business Improvement

Our Journey Project Team established Work undertaken with staff, services users and advocacy agency Decision for bespoke development

Key Aims of the Group Assessment Paperwork and Processes: Leaner Supports social workers in recording their professional assessments Aligned to an asset based and outcome focussed approach to assessment Captures the ‘conversation’, the Service User’s ‘story’ and their aspirations

Key Aims Further Developed New Assessment and Process no longer in line with existing RAS Resource Allocation System (RAS) Driven by professional judgement of the Social Care Worker Non-complex, transparent and a total shift away from ‘tick boxes’ Approach to Development Work: Operational input throughout all development work From research to initial idea to prototyping to testing Ensure robust and fit for purpose at operational level Co-opt in additional expertise when required E.g. Finance, RAS Expert, OLM

Our continued journey Prototyping and phased approach – Specify RAS model – Desktop sampling of 450 current random cases – Analyse, review and modify sampling results – Make changes to model and calibrate – Develop supporting tools – Live test phase – 200 random cases – Final calibration

Creative Conversations exploring Asset Based Social Work Dr Celia Harbottle

Creative Conversation Aims To enable social workers to examine the evidence base and current policy context indicating a need for a cultural shift in social care provision underpinned by a re-defining of the social work role. Explore the need for change and what is meant by asset based social work, reflecting on pre-existing skills – under used in traditional care management approaches Facilitate social care workers to have had the opportunity to explore the need for a culture shift in social work whilst recognising that they have the core skills to make it successfully. To consider the wider evidence base for asset based social work and will be able to see its place in DMBC’s way of working

New Assessment Form Current Form – Manual form 30 pages – too long to complete – ‘Deficit’ based. Not aligned to Asset Based and Outcome Focussed approach – Doesn’t capture the Person’s ‘story’ – Fixed tick box format due to driving the RAS New Form – Lean: 10 pages, some pre- populated via CareFirst – Aligned to Asset Based and Outcome Focussed approach – Captures the Person’s ‘story’ and aspirations – Free flowing, does not drive the RAS – no tick boxes

A Look Inside The New Form

New Resource Allocation System Current RAS – A shift away from professional judgement – Tick boxes and spread sheet drives complex and hidden calculations – Inaccurate – uplifts and cases going to panel – Bureaucratic and inefficient – delays payment to Service Users New RAS – Professional judgement determines the budget – Transparent with no hidden or complex algorithms or calculations – More accurate – uplifts and panel on exception basis – Lean and efficient enabling quicker payment to Service Users

A Look At The New RAS

Professional judgement driven 3 key professional judgements: – Number of eligible unmet needs that remain outstanding (not met via Circle of Support, community or universal services etc) – Risk Severity (level 1 to 4) – Risk Likelihood (level 1 to 7) Multiply Risk Severity level by Risk Likelihood level to get an overall risk score to determine overall risk. Number of needs and overall risk score determines the cell on the RAS Grid (A to X) – (Budget amounts available once development work is complete).

A Look At The New RAS Risk Severity – Four levels: 1: Restricted independence 2: Moderate threats to independence 3: Serious threat to Independence 4: Immediate risk of harm/neglect/crisis – Definitions and guidance information in packs – broad guidance not definitive. Aimed at informing judgements and enabling consistency.

A Look At The New RAS Risk Likelihood – Seven Levels 1: Occasional incidents 2: An incident every month 3: Some incidents a month 4: An incident a week 5: Several incidents a week 6: An incident a day 7: Several incidents a day – Definitions and guidance information in packs – broad guidance not definitive. Aimed at informing judgements and enabling consistency.

Re-Script: ‘piecing’ it all together Creative conversations – Ceilia’s training Shift from deficits and services Shift to assets, strengths and outcomes New RAS driven by professional judgement Budget available to spend pre detailed support planning Care Act changes including new eligibility and Carers Compliance with the Care Act