Category Archives: In Control

Keeping the person at the centre – A guide to implementing person-centred integration

Today Nic Crosby, Director Children and Young People, of C4CC partner In Control, guest blogs for us, introducing the third paper from their ‘A Life not a Service’ series. This latest paper explains the basics of a new person-centred and integrated approach to whole life support…

In previous papers we have set out what we mean by ‘person-centred integration’, thought in more detail about people, communities and their strengths, about whole life and whole family approaches to support and now we are publishing a guide. This paper uses some simple ideas to think through how we understand what we currently do to support people, how we spend funding and what personal budgets mean and in so doing begin to highlight how our system wide approach needs to change to focus on providing whole life support instead of historic silos of labels and needs.

We see it as vital that we take a whole life and all age approach; services may for some time continue to be split in to age bands, however that’s not the experience of people. Rarely does being a year older feel much different – apart from a chance to recount those grey hairs or buying a beer at the pub becoming legal.

Our services are not organised around people but by department, label, need or some other unfathomable reason.  In developing a whole life approach the support we offer should similarly reflect a person-centred approach; we suggest that there is a single role, ‘a named person’, who works closely with the child, family or adult needing support and they are not bound by one service area but able to support the individual to think about their whole life and how they might make use of support and any available personal budget.  In turn, the personal budget is not shaped by a service but by whole life thinking – all eligible funding goes in to one pot to make one budget to meet one set of agreed outcomes which relate to the person’s life.

One mum who has had a sneak preview told me earlier in the week: “but Nic it is common sense”. Yes it is.

There seems to be something about the human condition that means we attribute greater value the more complicated something can be – or at least when it comes to public sector land.

This set of papers, which gives a good background to our first ‘Whole Life means….’ conference next week, is about a simple, straight forward and most importantly a person-centred approach to integration.  Our conference in Watford will be exploring this with all our members (50+ Children’s Services and many others) and some great speakers including Jamie Bolling, Chief Executive of the European Network for Independent Living, Sam Bennett, Head of the IPC and PHB team at NHS England, Alex Fox, Miro Griffiths, Lynne Elwell, Andrew Cozens and many more.  It’s the first time we’ve worked across the ages with such a diverse group, so now it is a case of we’ve written about it and its time to take the plunge and make it happen

What does ‘whole life’ mean to you? There will be around 130 people sharing what we think in Watford, but longer term there needs to be plenty more…

To read the latest paper, click here.

To read more about the ‘A Life not a Service’ series click here.

 

A Life Not A Service

Services for people of any age and in any number of situations, who require additional support in their daily life, are challenged by reducing budgets and ever increasing demands for support.

Integration, if person centred in foundation, has the potential to deliver a transformed offer of support and access to people of any age. There are major risks though, and much should be learned from the roll-out of personal budgets. What started with creativity, flexibility and exciting changes for people in how they lived and experienced, support became more difficult as the focus shifted to systems and process i.e. as the focus shifted from being person-centred to system change. On top of this, there is the likelihood that it will be seen as a further opportunity to cut costs; whilst there may be efficiencies in a simpler and ‘whole life’ focused offer of support this cannot be the primary driver.

For us at In Control and many others, integration around the person provides an opportunity to tackle silos of need, arguments about funding and territories being fought over. More though, it provides opportunity to think again about how support is provided and what it focuses on; we would explain this as a combination of investing in the real wealth of individuals and resilience, and investment in community wealth and inclusion. Strategies and work to transform the public offer of support need to centre on how to support people to develop their real wealth; their skills and knowledge, their personal and social networks of support, their assets. Those same strategies will also need to be centred on developing the wealth and inclusivity of local communities of all forms; how buildings can be more accessible, how people can be more welcoming and respectful, how community assets can be used for the benefit of all.

A life not a service’ sets out an approach to integration that centres on the individual, those closest to them and local communities. This guide with its accompanying briefings (Briefing one, explaining the thinking in more detail and Briefing two, which thinks about this approach with regard to Mohammed Aaqil and his family) explains what we mean by real wealth and community wealth, and restates using (with permission) Heather Simmons’ graphic about Values / Approach and Mechanics the importance that all this work retains it focus on values and improving the lives of people.

As important as it will be to maintain a person centred approach to all parts of an new integrated offer it is essential that the foundation for all this work is a set of values, for example; inclusion, transparency, honesty, simplicity. As stated, we are all too aware of what happens when the focus shifts from people and a simple set of values to approaches dominated by complexity, paperwork, risk aversion and the misguided thinking that constraining creativity and flexibility will cut costs.

An integrated offer, with clear eligibility, accessible information, support from a named person, upfront indicative allocations of support and funding, creative and flexible solution finding, building on strengths, focusing on outcomes and not needs, with a family and whole life focus….all this is possible. There are examples across this country and others where, on a small scale such approaches have been put in place, where values of transparency and simplicity are clearly visible in the support offered to people. The challenge is to maintain the values base, to maintain and strengthen the person-centred approach to integration and the new system and not to miss the potential which so many people want to see realised.

Children, young people, families, adults, older people: all are people, all are whole; our offer of support has to centre on this fact, offer support that invests in people’s real wealth and the wealth of their local community.

Further information on the reports, future publications and how you can get involved is available here.