Moving on?

When is the right time for someone to move on from support?

Much traditional support work works to a tightly-defined timescale and has targets about ‘moving people on’.

Some services offer people a Catch 22 situation: on the one hand, we will become what may be the only supportive relationship in your life, in which you may be required to organise your life around that support, or even move into our building, but on the other hand you mustn’t feel dependent on us, and we will end that support and leave your life as dramatically as we entered it, on our terms and at a time of our choosing.

Mayday’s PTS strengths-based coaching, which we offer ourselves and support a growing network of othercharities to offer, has some core principles, and one is that people begin, pause and end their coaching as much as possible on their terms. So, coaching cannot be imposed, and it focuses on what feels most important to them at the time. It can be paused -if someone doesn’t want to see their coach for a while, we don’t regard that as ‘non-compliance’ or ‘close the case’; we are patient. And our aim is for the individual to reduce and end their coaching, having filled their life with more confidence, more meaningful relationships and activities, and a bigger support network outside of services.

Does this mean that people become dependent and never ‘move on’? Typically, no. People in one group of people living in temporary accommodation where amongst nearly 40 people there had been no move-ons in 4 years, coaching led to 14 move-ons in 14 months. In another, where 80% of supported people typically return to homelessness, 67% of people supported by Mayday moved completely outside of homeless support services. 8 months is a typical move-on time for this group. Coaches are in some cases able to manage bigger rather than smaller caseloads than other workers, because for every person who currently needs intensive help, there are others who have stepped back, or moved on.

So, by relinquishing control over support timelines, a service which offers effective support can reduce those timelines for moving on. By relinquishing the service’s anxieties about dependence, and trusting the power of more reciprocal, chosen and equal relationships, the risk of dependence can fall rather than rise, along with the risk that falling off a support ‘cliff edge’ breaks that person and sends them back into a new crisis, and new support needs.

POSTSCRIPT

One of my colleagues who coaches writes in response to this blog:
I’ve recently noticed with a couple of people I meet with that when we meet it’s not for as long. Because the pressure is taken away and the ball is in each person’s court they are empowered to actually be proud of the steps they are achieving (whatever that looks like for them) rather than worried about looking “worthy” of the help and support.

More freedom to practice, tighter grip on data

At Mayday Trust, we recruit PTS Coaches using a highly values-based approach so that the organisation can trust coaches to take on unusually autonomous roles, with a lot of freedom to act for the coach and the individual they are working with. We recruit people who love to reflect, share their work and communicate with their peers, and provide opportunities to do that regularly, which reduces the need for the expensive and time-consuming processes which many organisations use to check and monitor their staff. People can come to coaching on their own terms, with more choice about what information they share with us, and we enable them to set and change their goals, rather than doing that for them.

All that freedom could lead to us having an unclear picture of what the impact and outcomes of the work is. So that freedom for people to choose and control support relationships at the practice end, has to be matched with an unusually strong focus on tracking outcomes and learning which sits behind that practice. Many organisations which collect a lot of data, are also rigid in the services they offer and how they manage staff, but if data collection is done effectively, and it is showing that support is working, it should allow for more rather than less autonomy. One of the ways we collect data on outcomes is using WEMWBS scales. Ashraf Hamzah, Head of Social Impact at Mayday Trust, describes our journey to introduce WEMWBS and reflects on its value in this blog for the What Works Centre for Wellbeing. Lilly Broujerdi and Shauna Hemphill, who are coaches with Mayday Trust in East Northamptonshire, reflect on what it’s been like to use the outcome measuring approach in real life, its limitations and what we’ve learned here.

Activists and radicals welcome

At Mayday Trust, we believe we can not just improve but change and replace broken public service systems. In fact we think we have to – there is no other viable future for our public services and the people who seek or offer support within them. Our part in making this happen is to demonstrate a different kind of support relationship which could be embedded into any long term support service and to help providers and local areas to create services and systems which can make those relationships effective, sustainable and scalable.

We are currently recruiting for three posts, including one of our ‘PTS’ coaches who support people going through tough times such as becoming homeless. This role will work in Hackney and Westminster in central London. Coaching is different to traditional support work because coaches:

  1. See the whole person: avoiding forms, assumptions, eligibility criteria or targets. We start with strengths and potential to build trusting relationships.
  2. Are led by the person without ‘fixing’: tough times shouldn’t be permanent, but we stick with people for as long as they want. We offer personal budgets where needed.
  3. Engage with the world outside of services: building connection and community, helping people to access resources and to challenge systems which are harming them

The ‘front end’ of our support and that provided by other organisations using the PTS approach is very flexible, but we collect lots of data, outcomes and learning to show that it works. So we are increasing (doubling!) our communications team by adding a comms officer. And we are recruiting our first fundraiser to help us find and bid for more funding sources. Later in the year, we will be recruiting Trustees to our board as well – watch this space.

The future of support services is already here – let’s shape it.

Let’s offer people what we would want

If you or I feel stuck, lost or in crisis, we might well look for a counsellor, life coach or career coach to help us. That person is not going to put us through a long and gruelling paper-based assessment. They will not focus all of their attention on itemising all of our problems, weaknesses and what we can’t do. They will establish that we understand and want what they have to offer, then get to know us and help us to identify what we want to work on and what our goals are. They will try to help us see our strengths as well as our problems clearly, and to find our potential. They hope to give us confidence so that we can make our own changes and move on. We may well be willing to spend considerable amounts of money on such support, but we probably don’t demand the evidence base first: it’s common sense that having space to focus on ourselves with someone who’s sole aim is to build us up, is likely to work, and if it doesn’t, we move on and find someone who feels like a better fit.

Large and growing numbers of us choose support when we are going through tough times because we expect it to be a positive experience which may have painful moments but will ultimately help us grow. There can even be a status attached to being able to afford and valuing yourself enough to seek ‘executive coaching’ or a personal trainer.

It shouldn’t be revolutionary to suggest that support for people who are going through the toughest times, like being homeless, should also follow that model, if we want it to work, but it still is. People who are homeless often have so many labels attached to them, with so much ‘risk’ and ‘complexity’, and have so little value attached to their lives, that even dedicated professionals can struggle to see a past and a future beyond the current moment of chaos, or strengths and potential beyond a long list of risks and needs.

In the two months I’ve been at Mayday, I’ve heard countless stories from our coaches about people making changes through working with someone who has the freedom to think like a sports coach rather than a support worker. It always starts with people building trust: “You are the first person who has actually listened to me in years”. And it progresses to potential and achievements – big or small – that enable someone “to feel like a human being again”. Much of it has been with people who are homeless, but we’re also using the approach with young adults and with people with long term health conditions, as part of a social prescribing programme. It’s not rocket science, but it is complex, nuanced work with a huge body of resources and learning behind it, and a strong community of practice and support structure including clinical supervision. The openness of the front end of the model (less assessment, paperwork & lots of freedom to act) has to be matched by the rigour with which we collect data on impact and outcomes.

Last week, some of the evidence from that data, and from tracking people’s progress over two years, was published by new economics foundation. It showed that the PTS Response enabled people to take control of their support and to form a respectful and dignified support relationship, which gave them the space to set their own vision for the future based around the practical actions and social achievements which mattered most to them. People reported huge improvements in their wellbeing including an increase in self-esteem, sense of purpose, and optimism, as well as better mental health including feeling happier, and a reduction in anxiety. The approach and culture of the services that coaches were working within made a huge difference to the levels of success, and to work well, services offering it need willing to reshape a range of their work around a strengths-based ethos. The full report is here.

Charities must do more than survive, we must change too

I’ve been immersed in my new role at Mayday Trust for over a month now, getting to know the team and understanding Mayday’s unique approach to strengths-based working. We offer a carefully co-designed model of strengths-based ‘PTS’ coaching to individuals, and support other organisations to adopt and embed that model, which enables workers and the people they work with to co-design a support relationship which works for that person, builds on their strengths and in which they feel in control, not labelled, risk-assessed, pathway-ed or pipelined. And we work with partners to design more human, empowering and connecting support organisations and systems, to replace public service models which work for organisations, rather than for people.

I’ve had some of my long-held assumptions and beliefs challenged, which is a big part of what Mayday exists for! As a team we are starting to shape a rejuvenated work programme that we will be relaunching soon. With our New System Alliance partners in Wales (Platfform) and Homeless Network Scotland, we are also holding a free seminar on March 3rd on learning from the PTS response, based on an independent evaluation by new economics foundation (nef), which will have lots of practical lessons and suggested actions for charities interested in going on their own transformation journey.

In the meantime, our colleagues at NCVO have published a blog I wrote with help from Cat Harwood-Smith following a session I facilitated for British Red Cross about how charities can get really ambitious about strengths- and assets-based working, based on a report for NCVO and RSA called Meeting as Equals.

Core business for BRC is disaster response, which presents some challenges for asset-based working. Crisis response usually needs to be rapid, pre-planned and highly structured. A crisis can be a very appropriate time for top-down, command and control leadership. If your living room is under three feet of dirty water, you want essentials to arrive now, rather than to embark on a lengthy discussion first. Perhaps as a result, the disaster response sector has not always been the first to embrace ideas like co-production. Throughout the pandemic, the huge surge in people coming forward through mutual aid and other informal groups has shown us that ordinary people will self-organise and step up, often without the input of an organisation or charity. So what does asset-based disaster-response work look like? British Red Cross are on a really interesting journey to find the answer to that question. The full blog is here:

Nurturing innovations to scale

“You need to combine the vision and human story with the attention to detail of what the system needs, and have the data to make the case.”

Over the last decade, Nesta has supported some of the best people-powered health and care innovations to scale their impact and demonstrate the value and potential of these approaches.
Read about them in the report here.

Nesta’s report on scaling innovations

“Critical analysis and a homogeneity is often what people strive for, for good reasons like quality
assurance, but more often than not it’s relationships which make or break a project.”

Some things I’ve learned about change 5: Charities as allies not leaders?

Earlier in this series, I argued that how we work is as important as what we do, but that who the ‘we’ is, is most important of all. Who owns our organisations? If we want to believe that charities are owned by the people or communities who use them, what are we doing to make that real? What power do those people have to change what we do? Just as importantly, what responsibility do they share with us? When I genuinely own or control something, I have both. In my paper for RSA and NCVO, Meeting as Equals, I set out how charities could and should take that co-ownership principle into their campaigning and influencing work. That would mean questioning the power and privilege of our own positions as paid employees of publicly-resourced organisations, and campaigning on the issues which people felt were most important to them and being prepared to be an ally rather than a leader of those campaigns. The charity sector has formidable resources and national infrastructure: to remain relevant to a generation which does not wait for permission to raise their voices, we need to demonstrate we are willing to use our resources not only in support of our own operational goals and immediate stakeholders, but as allies to a wider range of grassroots groups. This will mean building trust, demanding less control and taking more short-term risks, but it will build the campaigns, messages and stories which will capture the public’s imagination and build a new generation of leaders who have lived experience and a powerful voice.

People must lead their own civil rights movements. But not all civil rights movements have been equally successful. People with learning disabilities for instance, are often excluded from what should be their own civil rights movements (as Philipa Bragman of user-led organisation CHANGE once observed). So I believe a role remains for charities to build evidence, attract funding for less popular causes, work on complex issues with policy makers, and to connect people who might otherwise be isolated voices. We can only do that effectively if our own teams and networks are diverse enough to understand at a deep level the layers of oppression that some groups and communities face.

Shared Lives Plus has often been described as punching above its weight. I’ve found that, having built a platform, the more we share it, the further our messages go. In recent months I’ve been talking with my colleagues who lead on our work in the four home nations about how to structure our influencing and partnership building with our still very limited resources. I’ve concluded that we are at our most effective when we can influence at three different levels:

  • The vision level: this is longer term and agenda-setting.  
  • The investment level: winning resources and investment. This is medium term, or cyclical where it follows government budget setting cycles.
  • The practice level: this is short term and reactive, fixing immediate problems.

Our members often want us to focus on the practice level: for instance, trying to fix immediate and pressing regulatory challenges that are causing them problems right now. We had some success with this, when the Tenants Fees Bill, now an Act, threatened inadvertently to make Homeshare’s business model unlawful in England. With support from parliamentary allies and ultimately government Ministers and officials, we were able to win an amendment that averted this nightmare scenario.

Investment level influencing can be harder, more complex and more hit-and-miss, because it often involves trying to build the case for investing in our work in 150 different councils and as many NHS organisations.

The vision level ‘thought-leadership’ is the most nebulous. It can only be done as part of building broad alliances, unless you get lucky and a powerful politician latches onto your work or message (but be careful what you wish for!) It’s hardest to evidence the impact here. It can be the most interesting to do, because it involves making links between and drawing out themes from the work of many different charities. It’s very time-consuming.

If you focus only on short-term, practical influencing, you can be constantly fire-fighting, and feeling you are banging your head against a brick wall. It can be hard to stay interesting to the people you are trying to influence, who often cover a wide range of issues. You get pigeon-holed. If you only do long-term thought leadership, you may lack tangible evidence that you are making any difference. If you can sustain influencing activity at all three levels, you can use the broader networks and more senior relationships to help you when practice-level or resourcing issues come up, and you can use practice-level work to make tangible your vision.

I’m leaving this role at the point where the government has finally published its years-delayed social care White Paper, which cites Shared Lives as an example of scalable innovation, and which includes £30m of funding for an innovation programme. It’s one of those rare moments when years of work done by our members and us could result in significant change. Those moments are rare, fleeting and easy to miss, and this time, I’ll be cheering my colleagues on from the sidelines as they try to grab it, and I immerse myself in my new role.

Some things I’ve learned about change 4: Mission vs Money?

Many charities describe a battle between ‘mission and money’. This came up a lot when I chaired the government’s review of health and care charities as charities which had grown during the ‘good’ years of increasing government funding, had to face up to what they’d sacrificed along the way, in terms of community roots, volunteers and supporters, and the capacity and potential of the people they worked with and frontline workers who were often working in increasingly narrow and reduced roles. When charity leaders try to reverse financial decline, this can often alienate sections of their team who can’t see the charity’s values and mission in rounds of restructure and cuts.

We have been very fortunate in Shared Lives Plus in that our income remained stable and even grew from some sources during the pandemic. What we lost in earned income we partly made up for in savings from our previously huge travel bill, and from new grant income. Our grant funders (including the Pears Foundation, Fidelity Foundation, Ellerman Foundation and the National Lottery Community Fund) were exceptionally pragmatic and flexible as our needs and priorities changed. But before the pandemic we had also been on a considerable journey to develop consultancy and contract income, and to build the value of our paid-for membership offers to individuals and organisations. This needed a more ‘commercial’ mindset, but none of wanted to lose sight of our values. 

The model below is still a work in progress, which I was at an early stage in discussing with colleagues when I got my new role. It’s an attempt to show that charities create different kinds of value, and that those kinds of value don’t have to pull the organisation in opposite directions. I believe we create at least four kinds of value:

  • The direct impact we have on people’s lives
  • The value of our brand, by which I mean the impact we have on how people think
  • The value of the data, learning and insight we generate
  • The surplus we generate once we’ve paid all of our bills

Most of our activities are about more than one of these kinds of impact and the diagram suggests some roles we play when, for instance, we provide direct support, which generates social impact, and also, if we’ve been able to cost it sustainably, surplus. In reality, most things we do create all four kinds of impact to an extent, or could do, so our support work on its own might look more like this:

Lots of impact and some surplus, with some insight and a little brand value as well. Could we increase the value of this work in those weaker quadrants, for instance, by doing more to generate and use data and insight from that work? Could we communicate the value of that work and the lessons learned more widely, to increase its brand impact?

In other words, charities can’t be battlegrounds between people who are focused mainly on impact, and people focused on keeping the finances afloat. A healthy charity will create all four kinds of value, and it’s always useful to consider how a piece of work that has been thought of as being only, or mainly, about one kind of value, could be tweaked to create the others.

10 Actions to become an Asset-Based Area

My first paper on the asset-based area written pre-pandemic with Think Local Act Personal’s building community capacity network, made the case for adopting an asset-based approach to care and support. This new version (opens new window) is built from the work we did with councils and innovative organisations on the Social Care Innovation Network, and interviews with councils, such as Leeds, City of York, Swindon, Kirklees and Hammersmith and Fulham, and organisations including Choice Support and Wiltshire Centre for Independent Living, that are taking practical steps to shift in the direction of an building asset-based communities. It all starts with an area’s citizens and leaders telling a different story together about what kind of place we want to be….

This report explores:

  1. What is whole-system change and why do we need it?
  2. What will we all do differently in an asset-based area?
  3. First steps
  4. Local areas putting the asset-based actions into practice

The ten actions are:

10 Asset based area actions

https://www.thinklocalactpersonal.org.uk/Latest/Ten-Actions-for-an-Asset-based-Area/

Some things I’ve learned about change (3): Pragmatic Radicalism

The goals we set ourselves can be self-fulfilling. The level of ambition we set ourselves can define how funders and potential partners see us. And it’s one of the ironies of the charity sector that the level of belief leaders have in their organisation’s ability to create – to be – radical change, is often inversely proportional to their size. That means that small, growing organisations face two dangers: one is not reaching scale and sustainability; the other is scaling, but feeling ever more tightly tied to their original business model. One of the reasons I’m so excited about working with the team at Mayday Trust is that they are one of the very few charities which has been willing to divest itself of services which, although they were well-rated, were not felt by the people using them to be creating enough real sustainable change in their lives, and were not challenging or replacing the broken systems which were keeping people dependent and unfulfilled.

We are often asked ‘How will we scale up?’ by people who control big budgets. It’s a fair question, but part of its answer lies in a question that I often ask in return, ‘How will you scale down?’ Because resources, time and energy will always be limited, so we will only scale up small models which work, if we scale down big, broken systems, and dismantle stuck organisations which consume vast quantities of public money just to stand still. The holy grail is to be a large organisation which uses its scale to drive real change and take real risks. This is only possible in my view when large organisations ‘network’ themselves into small, autonomous units, using self-managing teams and other devolved-power models. In any centralised bureaucracy, it’s hard for the leadership team to see beyond the organisation’s ravenous appetite for time, money and energy; to recognise the untapped capacity and potential of the hundreds or thousands of people in the organisation’s shadow. Add to that, that leadership teams often lack diversity and there is a recipe for perpetuating inequalities such as the inverse care law.

So as a small organisation, it’s important to set a vision and an ambition which feels exciting enough, and potentially big enough, to engage people whose jobs require them to think big. But the plan for getting there must have practical steps. It must include income sources and an ability to work with the reality we live in now, while trying to create a different reality for the future. I call this ‘pragmatic radicalism’.