A joint project on accommodation with care in South East Wales involved collaborative working between housing and social services, ten local authorities and a range of other organisations. Kirsty Doe reports
Collaboration and working in partnership are described as the way forward for public services. It can be an easy mantra to say, so what does this mean in practice? How easy is partnership and what is involved? this article offers some experience from a collaboration in South East wales. the project managers are supported through the European Social fund through the welsh government
What is SEWIC?
The South East Wales Improvement Consortium (SEWIC) comprises nine directors of social services across South East Wales. They identified a number of potential collaboration initiatives relating to adult social care to share learning, make best use of scare resources and deliver better outcomes to service users.
Extra care to accommodation with care
One workstream was on extra care housing – an interesting selection for social services, and which would need some connectivity with housing. In some authorities these were together under one director, and in others quite separate. The project lead for this work pulled together practice and experience across the region and linked with the Housing Learning Improvement Network (LIN) in England holding a conference on extra care and making recommendation to have a Wales section of the Housing LIN.
Taking forward collaboration work can be a matter of two steps forward and one back – and there are not the operational day to day outcomes of putting a care plan into place, or supporting a service user to remain at home. There was opportunity to review the workstream remit to take account of connections being made with providers of accommodation and care providers. This was highlighting a need to separate accommodation and the care that people need, both to allow for better outcomes for people – such as scope to move provider without having to move home – and to allow for better transparency of the costs of care, withopportunity to work across authorities for shared approaches to payment levels.
The SEWIC directors, WLGA and Welsh Government European Social Fund team agreed to revise the workstream to consider a broader remit of ‘accommodation with care’, with an extension of the existing project manager role (on telecare/assistive technology) and a project support officer recruited. This allowed for a closer synergy of work stream projects, recognising a sharing of connections. The funding remained through the European Social Fund and WLGA.
Aspirations and intentions
The ‘accommodation with care’ project has high level aims to:
• Promote empowerment; independence and wellbeing in different accommodation settings and improve the quality of life for service users and patients.
• Prevent or reduce levels of need and service dependency of frail, elderly or otherwise vulnerable people by:
– Reducing the number of avoidable admissions to care homes;
– Reducing the number of avoidable admissions and readmissions to hospital;
– Facilitating timely hospital discharges;
– Reducing the need for more acute, chronic and expensive forms of health and social care interventions.
• Support and reduce pressure on informal carers.
• Increase awareness of different housing options and models for health and social care professionals as well as service users.
Making connections
A reference group, made up of a mixture of social care and housing leads from each local authority, is established and meets every six weeks to share ideas and best practice and allow for joint learning. The terms of reference, agreed by all attendees, include agreement to share information as to existing provision, unmet needs, and development opportunities.
Housing associations and registered social landlords are regularly engaged with and information is shared both ways, to assist housing associations in getting the information they need for developing business cases and new investments and for local authorities to be aware of the plans for their area. A regularly updated matrix summarises the current position in each local authority area and is shared across partners.
Mapping what we have
The project is working towards mapping provision across the area, to identify gaps and pressure points for authorities to be able to better plan for development of future provisions and having the right information to plan for sustainable, future housing. This means getting perspectives from every level:
• Technical – what is being developed in terms of technology and standards in the fields relating to social care and housing
• National – policy and guidance being formulated at UK and Wales Government level
• Regional – the networks and cross connections that exist
• Local – the particular circumstances and connections to be aware of, including community concerns and local ‘small p’ politics
Researching the data
SEWIC also commissioned a research report by Swansea University that looks into the take-up of NHS services from different care settings and this information has been used to inform local authorities and housing associations, again to be able to better plan for future provisions. This report has been shared with providers, local authorities and the UK housing LIN.
Dissemination and discussion
A vital element of the project has been to create opportunities to bring people together so that there is a sharing of ideas and experience – so that there is no unnecessary ‘reinventing the wheel’.
An accommodation with care workshop in July 2013 was attended by local authority commissioners, housing associations, Supporting People representatives and a range of care providers from across the region. The workshop provided opportunity for collaborative discussions to take place between people that may not normally meet, to be able to discuss what each area can offer in supporting service users.
Presentations were made by people from a number of sectors and involved examples of collaborative approaches already taken. Workshop groups in the afternoon were able to look at next steps in terms of accommodation and it was agreed that further workshops would be beneficial to share ideas and resources. From attendee feedback, a
follow-up workshop was planned – with a planning group including care provider and accommodation provider colleagues – and took place in December.
Looking ahead
What has been evident is that the different SEWIC adult work streams have come much closer together. Information from the adult brokerage hub has highlighted areas of unmet need or increased demand. Housing colleagues have been able to get a clearer picture of social care needs, whilst social care colleagues have gained a better understanding of the planning process
and timescales needed to develop (or re- develop) supported accommodation. We are seeing a developing evidence base to assist in forming local authority social care market position statements – and which informs accommodation providers of the range of models of care being considered as well as highlighting to care providers those areas of over provision and where there are gaps. The feedback has been that all parties find this valuable – and a next step is to take forward detailed needs mapping questionnaire with operational teams as to number and needs and with providers as to their capacity and appetite to work with others.
At the end of the project, we expect to have a range of tools to be available for the partner local authorities, including templates, case studies, a summary of key learning points and an inventory of schemes in the region, and hopefully a collaborative forum that
will continue as being part of ‘how we do things now’.
What have we learned?
First and foremost that collaboration isn’t easy – particularly if you are looking to get busy people to share something of themselves out of their specific role and specific local authority! Time is needed to build relationships and levels of trust so that people feel comfortable to share ideas and information, and trust that it will be used sensitively and constructively. Relationships have to be fostered, using face to face meetings as well as telephone and e-mail – and good empathy is required – particularly if colleagues believe that their own jobs may be adversely affected. It does mean an element of culture change – all too often people can perceive that ‘knowledge is power’ – and so are understandably reluctant to share it, so the SEWIC project team has sought to be a neutral and independent ‘critical friend’ – providing information when and where asked for – and being honest if answers are not known. It was summed up when one colleague at a reference group meeting commented ‘at the start you were probably getting 70 per cent accurate information – now, as we get to know each other, it’s probably up to 95 per cent’.
In essence collaboration needs:
• Patience – to stick with things even if they seem really slow
• Persistence – to not give up, and keep seeing things new
• Pooled information – sharing what we have, when we have it
• Project focus – keeping overall objectives in mind, about making things better
• Personal approach – to build relationships and trust
Keep up to date with the latest developments by visiting: www.ssiacymru.org.uk/home. php?page_id=7062
Kirsty Doe is project support officer – collaboration and integration at SEWIC