NAAPS had 4,000 members but was always a very small organisation, and never broke into the public consciousness. When I became Chief Exec in June 2010, it was no surprise to hear calls for a re-brand. It also didn’t take long to tire of people asking if it was a charity for sleep disorders, or a kind of Danish biscuit. This is my first Chief Exec’s role, but I’d been in the sector long enough to know that rushing into a rebrand  was not an uncommon way for new CEOs to wade into poorly understood politics and end up leaving rapidly, pursued by angry members.

So I approached the prospect of rebranding with caution. Soon after joining the organisation, I attended a seminar on rebranding. Two charities talked about their rebranding experiences. The “shoe string” example had cost around £50,000; a not unreasonable amount given that charity’s strong reliance on individual giving, but still about £50,000 more than we had available. The speaker from a large national charity declined to give a figure, but said it ran into the low millions. It was hard not to wonder whether the large charity couldn’t have raised more awareness of its brand (which remains relatively under-exposed) by spending millions on its core work, rather than on brand research and a rather low key change of name.

Some years ago I lived through a disastrous top-down re-branding attempt, which started with name and logo, at a time when stakeholders were concerned about quality and direction. So I was keen that we put the question of what we should be called to one side whilst we had a discussion with members about what we were and should aim to be. There was a clear consensus on our values, mission and aims, including that one of those aims should be raising awareness. There was recognition that our tiny staff team worked hard and did a huge amount on very little. The recent expansion of our membership categories and the launch of a sister organisation was still causing some confusion amongst core members.

Furthermore, the individual Shared Lives carers who were the vast majority of our members and our main raison d’etre, were least involved with steering our work, despite a rigorously democratic structure of committees and governance. It was this group we most needed to include in key discussions.

We took as much pro bono advice as we could. We decided to take it as read that awareness was universally low, without researching the issue. A market research expert helped us design stakeholder questionnaires to test ideas, first about key messages, then later on, possible names. Pro bono advice on company and charity law confirmed that it’s surprisingly easy to change a charity and company’s name. Have a vote, fill in a couple of forms online and you’re done. The riskier bit is ensuring no one else has prior claim to the brand and bagging as many possible domain names as possible. A trademark lawyer advised us that we probably didn’t need his services as our proposed names were not in themselves trademark-able. Our logo could be registered, but risks were low and that would be something we could do ourselves if we wished. (“I’ve got a story I tell to paying clients, but, basically, it’s common sense.”)

The most useful advice was that, if you are a low budget organisation representing little-known and hard to explain services, then “keep it simple, stupid”: look for a name and strapline combination which gives some idea of what we and our members do, and hints at our values. We drew up a table of possible names and straplines, with columns for each of our USPs to make it easier to see which phrases ticked our boxes. The danger of this approach is that long-winded names and straplines tick the most boxes, but it was useful for focusing us on our key messages, rather than what just sounded nice.

A USP of Shared Lives is that, through helping people settle in an ordinary family household, it can provide a sense of belonging, in contrast to living in a more traditional ‘service’. So we felt “Belonging UK” was short and catchy and it seemed to play well with national stakeholders. I was looking forward to the story it would allow me to tell about members’ work and how it was different to alternatives. This was where going back to our members for what one agency describes as “disaster checking” became vital: most Shared Lives carers hated the idea. There was also a strong feeling from some members that the phrase ‘Shared Lives’ had better feature prominently, or else. Given that mandate and the opposing need to be inclusive of our diversified membership, our options were really very few.

So we arrived at ‘Shared Lives Plus’, strapline: the UK network for small community services. It’s not particularly flashy, but it gives some idea of what we do and why. People either ask, “What’s Shared Lives?” or “What’s the ‘Plus’?” Either way, it’s a good conversation. We held our AGM at a special conference for Shared Lives carers to ensure that our core membership had the opportunity to vote on the change, which was carried almost unanimously. Rather than a pictorial logo, we opted for a ‘wordmark’, which was provided by our retained designer (www.blenddesign.co.uk) as part of his £200 per month contract. Likewise, our web company changed the logo within their contracted support hours. We replaced some ancient banners and we are ordering new leaflets as part of natural stock replacement. Our biggest extravagance was indulging in some branded biros.

As well as holding a short ceremony at our biennial members’ conference, we had a new government-backed document to launch at an external conference which generated coverage in the national press. We were aiming for a report based on a survey of the impact of our members’ work, but lacked enough responses in time for the launch date, so we are making that part of a programme of post-rebrand marketing over the coming months, which our new colleague in the organisation’s first dedicated communications post will lead on.

We overspent our £0 budget, but only by £610 (on domain names, banners, biros). Our members, touch wood, seem happy with the process and the new name, but mainly happy that we didn’t squander money we don’t have on an issue many of them regard as a distraction.

The process was, however, consistently anxiety-provoking. The feeling of “winging it” on such a risky issue was not at all comfortable. I came to the conclusion that you spend thousands on rebranding to make managers and Trustees feel better about the risks involved, even if you would have reached much the same end point by yourselves.

My top tips for less-than-shoestring rebranding:

1. With members, start by establishing clear, shared messages about your work.
2. Changes to a charity’s name are a great lightning rod for disaffection: expect long-held resentments to surface. That can be a good thing.
3. Get as much free advice as possible before spending any money.
4. Settle for a good-enough name, rather than spending months and a fortune searching for a sexy one, which some people will hate in any case.
5. Disaster-check with your least-easily-pleased members. Hear unwelcome messages.
6. The launch day itself is of little interest to the outside world; plan awareness-raising and marketing activity for the weeks and months following the re-launch.

Those are my top tips – you may disagree or have your own. Either way, l’d be interested to hear from you.

The debate about day centres quickly becomes ideological and couched in black and white terms. One side believes that the alternative to day centres is casting people with learning disabilities out into a solitary existence in a ‘community’ that turns out to be at best elusive, and at worst, openly hostile. The other side believes that day centres are evidence that segregation and institutionalisation are far from the memories they should be.

I’m reminded of the anecdote a former colleague told me of a visit by an ageing member of the House of Lords to the day centre for older people my colleague was running. It became clear that Lord X might himself be in the early stages of dementia and also that he was having a very enjoyable time, chatting with people his own age. My colleague said to Lady X, as she was thanking him for his hospitality, that his Lordship would be welcome to drop in and use the facilities whenever he wished. “That’s awfully kind of you, but my husband is already a member of the most exclusive day centre in the world”.

Most of us belong, or would like to belong, to clubs and groups of one kind or another. The difference being, that most people have choices about what to belong to and to opt out of. Clubs and groups which want us as – usually paying  – members, have to design themselves around our changing wishes and needs. We often get to contribute as well as to recieve something. And we get the option of spending time on our own as well, when we wish.

I believe that the painful and often angry debates about building-based services could nearly always be avoided if, instead of asking “Should this day centre close?”, decision-makers always asked everyone concerned these three questions:

1. How could this building be used, and by whom?
2. What services do people want and in which locations are those services best delivered?
3. What relationships are there between the people who use this building, and how can we ensure that those relationships can continue, if people want them to?

If those questions were always asked, in most cases, some people would continue to use the building, at least some of the time, whilst it would also be made available to other groups within the local community. The building would be used more fully for more of the time and would have more chance of generating income for its upkeep. Some of the services in the building would continue, others would end and some new ones would begin, all in a variety of locations. Crucially, people who used the building would be more likely to share in its ownership and to shape activities and services taking place within it. And fewer people with learning disabilities would find themselves hanging around the local shopping centre, personal assistant in tow, bored and lonely.

• have a cool-sounding, or failing that mystifying name, usually reduced to an acronym
• apparently have the potential to solve a dizzying range of problems
• are a neat fit with the prevailing political ideology of the day
• have found an articulate advocate or two
• have shaky or limited evidence, and often holes that look bigger the closer you look…

Social Impact Bonds (SIBS) tick all of those boxes. The idea of SIBs is that someone, ideally a private sector investor or even hedge fund, puts up some money to invest in a promising new approach to, say, reducing re-offending, or truancy, or anti-social behavoiur. If the approach works, it generates some savings to the local council, NHS or government. Crime costs the country, so reducing re-offending cuts those costs. The investor gets paid a return on their investment from those savings. The more effective the approach, the bigger the payment. If the approach fails, the investor doesn’t get paid, so it’s the investor who has found the money and taken the risk, not the government. A win all round. Neat.

Here’s where the holes appear. Turning success in social work, or work with offenders, into savings, and measuring those savings is hugely complex. Assuming you can measure the impact and that you can put a cash figure on that impact, people’s lives are complex, so the intervention might be brilliant, but stymied by the failure of another service, over which the agency and its investor has no control.

Even if you can do that, a reduction in the work of a service such as the NHS or the police, doesn’t necessarily equate to a saving. To ‘cash’ the saving, you have to close something, or sack someone. Those are difficult political decisions. Much more likely that new work will rush in to fill the gap in over-stretched services. These are some of the reasons why SIBs pilots have tended to involve a bit of cheating, where the government has applied a nominal saving to a positive outcome, rather than insisting the saving is realised.

So SIBs seem some way off in social care. I’m surprised by often they are suggested in areas of work where outcomes are not consistently measured, let alone turned in measurable cash savings. I can’t see how you can introduce SIBs before a payment by results system is up and running, and payment by results (PBR – a next big thing from a few years back) has not always been a resounding success in itself.

Finally, it’s a feature of ‘next big things’ (NBTs?) that problems start getting re-interpreted in terms of the shiny new solution. SIBs solve the problem of a lack of up-front investment. Where you have a well-defined problem which is resulting in increased spending on an expensive service, and a well-evidenced approach with proven results, but nevertheless no possibility (why?) of government investment, SIBs could well be the answer. But there are other, much less complex ways of investing in risky new ventures and for many cutting edge social care interventions the main problem is not, in fact, lack of up-front investment, it’s lack of evidence, lack of political will, lack of local leadership…

Whilst writing this, I’m aware that our work is often challenged as being over-hyped. And I know how tempting it is to over-claim when trying to sell a radical new idea. Without the risk of falling into NBT territory, there would probably be no radical new ideas. Perhaps the answer is to get equally excited over Next Small Things (NST), which, by pure coincidence, works rather well for an organisation promoting all things micro-scale.

In a blog in the near future, I’m going to look at Local Area Coordination (LAC), one of the most exciting ideas I came across during the White Paper engagement exercise and I’ll try – as dispassionately as I can – to look at whether it should be the next thing, big or small.

“It’s sometimes hard to stay positive about the changes in social care, but meeting Becky Daykin from Notts Independent Living Consultancy ensures that you will. Despite the challenges, along with her business partner Sarah Moakes, Becky has stepped from the world of social work to be a part of the practical changes ensuring personalisation can offer real choice.

Together they now run a new micro-enterprise which combines their thirteen years of experience to assist people in setting up and manage Direct Payments. They offer support and advice on being an employer, recruitment, setting up payroll and employment contracts etc. They also offer training for personal assistants, organisations and corporate businesses about disability, equality and deaf awareness. All their staff are disabled and receive either Direct Payments, a Personal Budget or Disabled Students Allowance.

Becky herself is Deaf.  Others often see this as a barrier but it is not the barrier she is most concerned about when she speaks of her experience in running her business, where the real struggle is with Local Authorities to make better use of micro-enterprises in delivering small local services.

She commented, “Too often Deaf People are seen as not able to manage their own budgets and are directed by the social work professionals towards managed budgets. This means they are not being referred to our service.”

In Becky’s experience, when she has scored highly in a tender for one such authority, she was still not eligible based on the financial section, a problem many micro-enterprises without financial resources or track record can experience. The thing that concerns Becky is that professionals are being misled or are assuming they can only give users the information about providers on preferred provider lists. Although this is not the case it is still creating a real problem in terms of choice and control. The authority may feel in control but they are not effectively offering control to service users.

Becky’s answer is not to be defeated but to continue to provide direct payment support services whilst also developing a manage budget package for people and local authorities to use. Also she sees the role of developing training for care professionals, especially local authorities, as essential. This helps to highlight the changes desired by people with sensory impairments and helps people see personalisation as a real instrument for choice.

Shared Lives Plus’ sister organisation, Community Catalysts, works with one of the local authority areas which Becky serves. Here a worker is funded to support local micro-enterprises and set up the local forum of which Becky is a member. Becky said, “The forum is a great source of information about the changes at the authority but frustratingly too few of the excellent providers involved are known by the workers or receive referrals from the authority.”

Becky firmly believes that service users can also be providers of services and ensure that real and accessible choices are available. When local authorities stop acting as sentries to these new approaches the changes personalisation promises can be realised.

Two personal thoughts on integration of health and social care: one is the view of Richard Jones, one of the most effective social services directors (and our newest Trustee), who says something like, Don’t ask us to integrate our structures, because we will. But it will take up all our attention and on past experience it’s doubtful whether end users will notice the difference.

The other is, do we need integration at the level of structures, at the level of communities (perhaps through GP practices and their colleagues commissioning jointly on a small scale), or at the level of the individual. If individual payment by results support contracts were based on a unified outcomes framework (across health and wellbeing) and if people with long term support needs had the opportunity to pool personal budgets awarded by both social care and the NHS, how much would it matter whether the area’s head honchos were part of one organisation, or just good friends?

SIR – As a society we face a growing care challenge. We should celebrate the   fact that we are all living longer lives, particularly disabled people and   those with long-term conditions. But the unavoidable challenge we face is   how to support the increasing number of people who need care. It is a   challenge which we are failing to meet – resulting in terrible examples of   abuse and neglect in parts of the care system.

The presentation the co-leads gave to Andrew Lansley MP and Paul Burstow MP is now publicy available. It outlines a future care and support system which would have moved from a crisis service focused mainly on high end services, to a well-being service which gave people opportunities to plan for their future at a much earlier stage and which focused on people’s gifts, skills and assets as much as their needs. The co-leads saw the Dilnot proposals as an important lever for change of this kind, as they would reduce the fear associated with older age and give people more chance to plan.

Whilst expensive services may always be rationed, community-development based approaches such as Local Area Coordination show that access to support to think through non-service solutions need not be. The prevention group heard that there is no prevention and therefore no real savings without focusing on people’s abilities and potential, not just on their needs. It questioned whether there is such a thing as a preventative service, or whether it was more important that every intervention has a focus on reducing the risk of dependency. To do this, you have to think about the whole person, not just concentrate on one set of needs. For instance, aiming for a health intervention with a focus on NHS savings may well simply shunt costs to social care or housing, and vice versa, whereas looking at the whole person within the context of their relationships, family and community has a real chance of achieving outcomes, whilst also making a saving to the public purse as a whole. This made integration at the level of the individual (integrated outcomes frameworks, pooled budgets) and the community (jointly commissioned, home-based health, care and housing contracts) seem more important than structural integration.

You can read my blogs about the future of social care on the government website and elsewhere, such as this one for the Campaign to end loneliness in older age: Is ending loneliness a preventative service?  http://bit.ly/vh7DqX

The government has said it wants the co-leads to stay involved in drafting the White Paper, so although the engagement process has officially closed, I remain, as ever, interested in your views.

My understanding of the rationale for excluding residential care users from Direct Payments, was that people may have been encouraged to buy the same old thing they were being offered before, which would not then amount to a radical change in the choice of provision out there. I’ve written a number of times about the ways in which the state and professionals have proved adept at assimilating the mechanisms of personalisation into their existing world view; I’m sure that having the option of transferring residential care users onto Direct Payments would have added to that problem.

I’m equally sure that the two-tier system which has resulted, with people who continue to use residential care excluded from one of the key aspects of personalisation cannot continue. It just doesn’t feel fair that I should lose a key route to choice and control when I move from receiving home care to a care home. However, I’m equally sure that opening up Direct Payments won’t by itself transform residential care. It will need to be part of re-thinking how care homes work. Community Care’s recent article on care provider Dimensions, which attempted to introduce more choice and control in one of its care homes, shows that addressing staff expectations and practice was more important than introducing an individual service fund approach to personal budgets.

It’s also worth noting that older people have been spending their own money on care homes for years, without the private care homes market establishing a reputation for forging ahead on choice, quality and value. As the Southern Cross debacle demonstrated, being an individual consumer of the product of an uncompetitive industry is not a very empowered place to be.

A colleague objected to a recent tweet in which I asked whether introducing Direct Payments for over and under 65s who use care homes would have very different connotations. He felt the suggestion was ageist and played to assumptions that older people don’t want choice and control, which of course they do. The difference I was interested in is not in the intended outcomes or in people’s ability to use Direct Payments. I think that personalisation within every care setting and for every age group is a given, and that, with the right support, there is no reason that Direct Payments shouldn’t become an equally important part of achieving choice and control for older people and their families, as for working age adults.

But if we’ve learnt one thing from the personalisation reforms, it’s that there’s no point in trying to reformat the demand for a service without also reformatting the supply. The market of care home provision for working age adults is nearly entirely used by people who are funded by the state, whereas the market for older people’s care homes is split between state-funded provision and privately purchased provision, with the latter the only area of growth in the market, whilst the former sees increasing numbers of providers go out of business as the margins become ever-more unworkable. It’s not unusual for one care home to house older people using their own money to buy care at one price, alongside people who are receiving care block-purchased by the council at a lower price. What would happen if the latter group suddenly became individual consumers, but with less money to spend than people who were already ‘self-funders’? 

Some of the most interesting developments in the use of Direct Payments seem to me to be those where people form small groups to purchase collectively. As a group you have much more chance to shape care, acting more like a commissioner than just an individual consumer. I’ve blogged below about what might have happened if a few thousand of Southern Cross’s users or their families had formed a user group, or even a buying co-operative. A group wielding that amount of purchasing power (Southern Cross’s users gave it and its shareholders around £600m per year to play with), might even opt to buy something very different from residential care, or to work with providers to create new kinds of support and accommodation.

I think there is a growing consensus that excluding care home users from Direct Payments is not sustainable. But I hope that the transition period is thought about very carefully and I suspect that introducing collective purchasing should be a part of that. And whatever happens to the way the money is managed, the kind of basic choice and control Dimensions, Anchor and others have started to introduce should be non-negotiable.

We had our board and team planning day this week. It was fantastic to be part of a group of people bringing the same passion, but from very different viewpoints, to thinking about Shared Lives and other small community approaches to care and support. Part of the thinking was about how we ensured that Shared Lives and micro-enterprises became much better understood. We decided that our offer was about citizens, communities and costs: our members help people to become citizens, who can contribute in all kinds of ways, as well as receive great support. Our members build upon relationships and communities. And doing this isn’t more expensive than traditional care: increasing numbers of areas are using it as a way of bringing down costs whilst helping people to live better lives.

Some of the discussion was about the place of Shared Lives and micro-enterprises within the personalisation reforms (which I’ve written about a number of times below).

 I’m not sure it’s a coincidence that we latched onto personal budgets as the key driver for personalisation at a time when we are all more consumerist than we’ve ever been. And I’m sure it’s no coincidence that the rise of consumerism has been accompanied by a rise in loneliness and isolation. There are many people, including many younger people with physical impairments, whose goal is to have my own flat, my own car and my own job. Those are admirable goals and it’s one of the great achievements of social care that those goals are no longer out of reach for lots of people.

But we are also at risk of adding to the isolation epidemic, particularly but not only amongst older people, through treating people as if they exist in a vacuum. I will never forget the words of a mother of a man with schizophrenia who had been living successfully in a group living situation. When he was on his own, the voices he heard became much harder to ignore. The council, in her view, was forcing him to move out of group living into his own flat, ironically in the name of ‘choice and control’. The place of his own on offer was a flat in a sink estate a long way from his Mum who was a key part of his support network. She said, “I don’t think ‘the community’ will be turning up on his doorstep bearing casseroles.”

Helping people to gain a sense of belonging requires more than a greater choice of services, or services which are higher ‘quality’, or more ‘innovative’, notwithstanding that those are good and useful things for services to aim for. 

This is why having a sense of belonging is intimately tied up with responsibility and why it cannot be bestowed on someone by a service. When we talk of people talking about responsibility in this country, we are often talking about money. Are you living on benefits? Do you have a job? Are you a drain on resources? Some people will always need some support from the state to live a good life. But having the opportunity to be responsible for others should be about more than money. The key insight of personalisation is not that everyone’s needs are different it’s that everyone’s contribution is different. When we ‘protect’ people from having any responsibilities, we stop them making a contribution. We take huge risks with their citizenship and we tell them they don’t really belong.

http://www.campaigntoendloneliness.org.uk/guest-blogger/caring-for-our-future/