1. Designing Citizen-shaped Services: The ‘Rebalance Me’ Approach “Working with people to live independent and healthy lives”

2. Why did we start... Karl Robinson Performance Manager Stoke-on-Trent City Council

3. Why Did We Start? Mandate for Change- promote independence and healthy lives. Save £100m over next 4 years Deprivation on the increase More households requiring statutory intervention

4. Why Did We Start? “I could go either way” “I am living my life well” “I’m in need of serious help”

5. What we used to do... Mark Walchester Strategic Partnerships & Engagement Officer Staffordshire Fire & Rescue Service

6. What we used to do.... Police Housing GP Access Centre Service Interactions Referrals Knowledge / Confusion Targets / Measures IT and Information Sharing Co-ordination and Accountability Culture Costs Assessments / Meetings

7. Current Multi-agency Meetings, S-o-T Name of assessmentAgency Lead MAST Multi Agency Support TeamLocal Authority MASH Multi Agency Safeguarding HubPolice and other statutory partners CAF Common Assessment FrameworkLocal Authority TAC / TAF Team Around the ChildLocal Authority & children’s Social Care MARAC Multi Agency Risk Assessment Conference Police MAPPA Multi Agency Public Protection Arrangements Police IOM Integrated Offender ManagementPolice CPA Care Programme ApproachSecondary Mental Health Teams CHIN Child in Need and Child Protectn.Local Auth. & Children’s Social Care JOG Joint Operations GroupPolice and Local Authority Operational BriefingPolice RAID and RAID + Rapid Assessment Interface and Discharge Health

8. Multi-agency Case Study

9. So what did we learn? Lots of time, effort and expense but... How had we helped? What had we fixed? People have individual needs. No single agency can meet those needs. Need for joined-up, preventative approach that: Solves the problems the citizens actually have (not the ones we think they have).

10. Logics Behind Current System

11. Logics Driving Current System System acts in this way...Due to this current thinking... Activities based on targets, related to quantity. Targets will improve performance & drive right behaviour. Intervene at point of crisis.We need to protect our budgets. Referrals - right amount of expertise not available at point of contact. Having cheaper resource up front, is more cost effective. Only here to do our bit. Front line staff can only offer services in their silo. Functionalisation leads to greater productivity. Record things & tell other agencies, to cover ourselves We worry about risk and reputation.

12. What does it feel like in the old system... Jordan Fryer Alcohol Project Worker Kieron Edridge Police Officer

13. What it feels like in the old system 1/4 Customer background What it felt like as a citizen: Impracticality of journey to the service. Support service reliant upon self-motivation. Lack of self-restraint. Feeling of self-loathing and failure. What it felt like as Professional: Workers perception of citizen Lack of caring.. K

14. What it feels like in the old system 2/4 Customer background What it felt like as a citizen: Revolving door. Numerous referrals and appointments. Constant change in client motivation. What it felt like as Professional: Question motivation rather than service provision. Lack of understanding.. J

15. What it feels like in the old system 3/4 Customer background What it felt like as a citizen: Lack of trust in services cause disengagement. Unable to challenge service provided. Issues not serious enough to hit thresholds. Multiple points of contact. Feeling as Professional: Isolated working.. K

16. What it feels like in the old system 4/4 Customer background What it felt like as a citizen: Deal with many agencies and several workers. Repetition of story. Lack of communication. Feeling as Professional: Looking after our own bit. “Same again tomorrow”.. J

17. A New Way of Working

18. Aspiration: A Change in Focus... “I could go either way” “I am living my life well” “I’m in need of serious help” Early intervention and prevention. Improve the lives of our citizens while reducing cost.

19. A Citizen’s Perspective to our... Purpose: Help me to resolve the problems I have to enable me to live my life well. Operating Principles: You fully understand me and the real problems to solve You will help me to identify solutions to my problems You will help me to help myself Pull on expertise when needed

20. ...guided by these controls... roportionate egal uditable ecessary afe PLANSPLANS

21. Aspiration: A change in perspective Police Fire Local Auth. 3 rd Sector

22. Aspiration: A change in perspective Police Local Auth. 3 rd SectorFire Locality Approach

23. Locality Team Housing Mental health PoliceEducation Citizen’s Advice Bureau Public Health JET Revenues and benefits Fire and rescue service Social care Drug and alcohol services

24. Understand me Presenting Demand: Help me with my rent arrears. Demand in Context: Help me to understand the benefit changes. Help me with my mental health. Help me to deal with issues from my past. Help me with my alcohol addition. K

25. Understand me

26. Demands in Context Top 6 Demands in Context Help me to get/keep employment 67% Help me to manage my finances 67% Help me to claim the benefits I am entitled to 42% Help me to move to a more suitable property 33% Help me to keep my home 29% Help me to live closer to friends/family for support 25%

27. System Conditions Top 6 System Conditions No.% Help Me To Manage My Finances3915% Help Me To Move To A More Suitable Property/Have A Home Of My Own 3514% Help Me With My Benefits/Claim The Benefits I Am Entitled To/Make Sure I Am On The Correct Benefit 239% Help Me To Provide Basic Furniture For My Property 177% Help Me To Keep My Family (And Children) Safe 135% Help Me With My Addiction94%

28. A different way of working. How do we work now...

29. What we do now: A different way Having proper conversations – time to listen and understand. Working together as agencies for common good of citizen. Supporting people to help themselves. Suspension of the day job Still learning what expertise is required. Tackle the real problems to solve (demand in context) Instantaneous/live data exchange. Working with the person as a whole One key support worker Don’t pass the job on..

30. What it feels like as employees in the new system Empowering Key worker autonomy. Citizen focused decisions making. Frustrating All services not currently up to speed. Resistance to change. Challenging Clients Working around system conditions Rewarding Problem solving in true sense See real improvements with clients..

31. Would we go back to the old way of working... The Locality Team

32. "I like keeping hold of a case, and seeing the issues through until they are resolved." Jo “I like having the ownership of a case, and the challenge of working with multiple issues." Chris Jul ie “The referral process is a lot faster. I get to see the citizen quickly at the point when they need advice and guidance on employment and training." Jen "By working together and taking a multi- agency approach, you can see how it's benefiting the citizen." " It's really positive doing genuinely joined up work with partners." Nikki