Ken the artist

This is a guest blog in which my colleague Hannah tells Ken’s story, from the Medway Shared Lives scheme in Kent:

“We’re not staff, we don’t clock off after 8 hours, there’s no handover at 10pm, no rigid routines, and we can make sure people have an ordinary day, week, month and year.”

Ken who uses Shared Lives services joined Shared Lives carer, Sarah King in an emergency, unplanned placement in 2011. Sarah soon discovered there was more to Ken than meets the eye.

Ken has a moderate learning disability and needs support for all daily activities. However, this does not stop Ken from being popular in the community, and communicating with a variety of people, despite having a limited vocabulary.

Within a few weeks of Ken living with Sarah, she learnt that he was an artist by a chance meeting with Ken’s former tutor, who ran an art project Ken was involved with, and also a pottery class he attended regularly.

When Ken transferred to Shared Lives he didn’t tell Sarah about his art work. The college he attended thought he may have passed away, due to his unexplained long-term absence, so the reunion was very emotional for both Ken and his tutor.  Delighted to see Ken, the tutor said to Sarah, ‘You do know he’s an artist, don’t you?’

Shared Lives carer, Sarah King said: “We didn’t know… the only art material he brought with him was a child’s colouring book and some worn out felt tip pens. We set about trying to engage him in creative activities, at home and in the community. Several months later the care manager received an email about a new art project, which was to start the following week. Due to us being able to be flexible and responsive to needs and circumstances, I was able to make contact with the facilitators of the art project.  We looked at the workspace- so he joined for 1 day a week the following week.”

The 3 month art project gave Ken some really valuable art experience – he was valued as an artist by professionals in his own right. The art project held an exhibition at the end and Ken sold some great pieces of work at the final exhibition.

Continue reading

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Mystery and Bureaucracy

A twitter exchange between Rob Mitchell and Prof Chris Hatton put me in mind of the famous quote from L’Arche founder, Vanier: “Some people say that communities start in mystery and end in bureaucracy”.

Chris, a skilled combiner of academic rigour and humanity, said, ‘Bureaucracy is a vampire. It feeds on people’. Lots of people reading this blog will relate to that, perhaps because they will have felt their own lives drained by working within, or even living within, a public service bureaucracy. What is bureaucracy though?

We all come across bureaucracies. They feel inhuman: some are machine-like; some fanged as Chris says; some have tentacles which we feel reaching around us into our lives.

But a bureaucracy is always a group of people, choosing to behave in a certain way. People will dispute that word “choosing”. The nature of bureaucracies is that, whilst someone at some point wrote their rules, and other people added to them, they feel like they have come to life, operating beyond the control even of those who profess to lead to them.

But whilst Vanier’s quote is often read to mean that every community – a group of people who share some beliefs and ways of behaving – already has some bureaucracy in it, it also suggests that every bureaucracy is also a community.  He could equally have said that every community starts in mystery, and ends in mystery: the mystery of how a group of humans created something which feels so utterly unlike themselves.  The bigger the bureaucracy, the deeper its mystery: the gap between the values of the people within it and the way we feel instructed to behave. This is why I think the challenge facing public service leaders is no longer how to scale up (the business growth model of marketised public services) but how to scale down.

But even in a vast bureaucratic community, no rule is unchangeable, or incapable of more than one interpretation. The choice to be human can feel difficult, or downright dangerous, when we work within a bureaucracy, but nevertheless we make choices. Ultimately, then, the nature of a bureaucracy, lies in the choices the people within it make every day.

The need for a Slow Policy movement

(I was not aware when writing this blog of this 2005 paper by Peter Bate which has a similar theme and which draws on In Praise of Slow by Carl Honore, also new to me. Some ideas percolate, well, slowly.)

There is a slow food movement, which began in Italy, based on the belief that fast food lacks real nourishment and flavour and that its intensive production methods and short cuts are unsustainable for the environment within which it is grown and produced. Slow food is produced with time, care and the understanding of local culture, farming and ecology which can only be developed over years, or even generations. It tends to value small-scale production for its sustainability and for being rooted in community and place.

At present, government and the NHS express the importance of a policy change through the urgency of the deadlines they set themselves and their partners and the amount of money they can ‘find’ in an emergency to fund the change. NHS Sustainability and Transformation Plans (STPs), in which every area was required to set out how its health system would transform itself to survive the current resource crisis and become sustainable, were clearly important, and therefore urgent. So, most were drafted by small groups of very senior people, who regretted they had not the time nor resources to engage widely, particularly with charities, grassroots groups and people with lived experience who are the most complex and time-consuming to find and talk to. It is no surprise that STPs, despite many containing necessary and pragmatic ideas, have been widely reported by the media as ‘secret NHS cuts plans’.

This cycle of crisis, frenzied activity and shallow changes is endlessly repeated. The urgency turns out to be illusory every time: whilst a report will be rushed out in months, underlying causes of problems will remain unaddressed for years. STPs are morphing into the next set of initials whilst the NHS and social care continue to go bust.

We need a slow policy movement in our public services: a new norm for how to create change. No more flurries of reports and plans from the same group of highly paid people, who remain embedded in group-think. No more heroic leaders on a mission to fix things.

Instead, the slow policy approach would be to cultivate different people and networks which are more deeply-rooted in the lives and service cultures of those affected: people with lived experience, their families and front line workers, who all need training, preparation and a slower pace in order to contribute meaningfully. A change programme would examine the problem or challenge from the point of view of people use services, families, front line workers and people who do not or cannot currently access the service. The conversations with them will start with “What does a good life look like?” not “How can we improve, cut or close replace our service?” The questions will include, “What are you willing to contribute to achieving the goal we all agree is important?” (which is a different question to “Will you pay for our service?”, or “Will you volunteer for us?”)

In place of short term pilots generating tentative findings, new models should be implemented on a small scale but with a plan to scale them up incrementally if they appear to be working, until they replace the current system. As my colleagues in Local Area Coordination say, ‘move slowly, to move fast’. With people who use services genuinely involved in their design and delivery, we would finally have the confidence to remove resources from models which do not work, rather than continuing to resource the status quo, regardless of how much more effective new models proved.

High Performance Failure

Every public service organisation has the potential to forget its purpose – working for the people who use its services – and instead being run for the benefit of those who work for or lead it. This happens in poor services through incompetence or laziness, but it also happens in high performing services, which get seduced by their own reflection.

The recent scandal of St Olave’s school, found to be unlawfully expelling sixth formers whose first year results looked like they might bring down the school’s A level results and threaten its league table position, is an example of this phenomenon. This was a state school, spending public money, which was lauded as one of the best, but which was in fact becoming in some ways one of the worst: wilfully failing and damaging young people at a crucial time in their education. This now appears to have been the practice of a number of ‘top-performing’ schools, who presumably shared the view that their league table success, and accolades for their leaders, outweighed the importance of harming those pupils seen as inconvenient. Arguably, this ‘wheat from chaff’ view of children is just a reflection of a wider crisis of values within the education system, with its lingering fondness for selective schools.

The school system has some features of which make this ‘high-performance failure’ more likely. The head teacher and the education system places huge value on the ‘heroic leader’, with ‘super heads’ wielding unchecked power. 2016 Harvard Business Review research looking at hundreds of heads showed that the most lauded head teachers, who made dramatic short term gains in academic performance, often through excluding more pupils, left no lasting legacy of success, but probably a trail of destruction as they removed ‘problem’ pupils and staff who disagreed).

Governing boards can lack real power, with parental voice limited or non-existent. Despite talk of empowering pupils, the focus of most school policies is on their compliance to rules set by others. An extreme example of this was circulating the internet today: the behaviour policy of an academy school, which, whilst clearly starting with the laudable aim to raise young people’s level of ambition (speaking clearly and confidently in full sentences, for instance) had strayed into an Orwellian nightmare: shy pupils could expect to be punished for speaking too quietly (city hypothetical future job interviews, this would make them appear ‘not that bright’) or even failing to smile enough, which was ‘ungrateful’ and ‘negative’. Despite glib slogans about how successful this would make children (“We’re Charter. We’re smarter”), it’s hard to see what leadership or creativity skills could be learned from being subject to such a monoculture.

This is partly a product of the gap between simplistic notions of success and quality in the education system, and what makes a diverse group of children not just as academically successful as they can be, but also as happy, kind and resilient – which are outcomes either unmeasured or which take second place to results. We also see this gap in adults’ services which are ‘high-quality’ but fail to help people achieve wellbeing or build resilience. Continue reading

The Asset Based Area 2017

This new Think Local, Act Personal resource started as a blog post here. Thanks to the TLAP team and its Building Community Capacity network, along with inspiration from local areas such as Wigan (see the Wigan Deal link below), it has now become a how-to guide giving ten pointers towards becoming an Asset-Based Area. Here is my blog for the Dept Health social care blog on the paper:

A GP noticed that one of his older patient’s appointments were increasing, and felt that this was not for medical reasons, but due to her isolation which had worsened following a bus service closure. He linked the lady to her Local Area Coordinator (LAC).

The coordinator helped her to build more links and activities in the community to reduce her isolation and to approach a community organisation which ran a community bus service. Her increased support networks meant she felt less reliant on her GP.

They were also felt to be key to her quick return home from hospital after a heart attack.

The LAC helped link the community organisation to colleagues who gave support for a successful bid for a new community bus service.

At a time when primary care services are feeling under huge pressure, it can be hard to argue for new approaches and creative thinking. But this story shows that, with the right help and a positive mindset, someone possibly viewed as a ‘problem’ can not only find ways to help themselves, but their new connections can also lead to benefits for the whole community.

LAC is an example of an asset-based approach, which, like all similar approaches, starts with questions like, “What does a good life look like to you?” and “What can we do together to pursue it?” Coordinators have the time and remit to get to know people: not just what they need, but also the goals and capabilities they and those around them can bring.

Sometimes this means that someone accessing a service will need less formal support.  However, asset-based thinking shouldn’t be limited to ‘informal’ or voluntary organisations. Nor should it be seen as only relevant to preventative services. It needs to be embedded across the whole system, including in approaches to supporting people with significant health, care or other needs.

Shared Lives carers, having been through rigorous approval processes to join local CQC-regulated schemes, are matched with adults needing support, such as people with learning disabilities, mental ill health or dementia.

This is not a referral process: matching means both parties getting to know each other and making a positive choice to share their lives. The adult either moves in with their Shared Lives carer or visits them regularly for short breaks or day support.

James has significant learning disabilities and mental ill health. He has spent significant periods in institutional care and still needs some hospital stays, but his life with his Shared Lives carer Phil revolves not around the times when he is most unwell, but around the day-to-day things he and Phil both enjoy doing such as fishing and going to the greyhound races.

The Asset-Based Area was coproduced with input from many people and organisations working in asset-based ways, from the Think Local Act Personal national network for practitioners and commissioners who share an interested in Building Community Capacity.

We wrote it because we cannot successfully or affordably add in asset based approaches around the margins, whilst ‘core business’ remains unchanged. We need whole areas to take up the challenge of becoming asset-based, resetting their relationships with local citizens, as Wigan council and a few others attempted. It is time for steady, incremental, whole-place change: it’s all or nothing.

Merry Christmas!

I’m very grateful for this great guest blog from Sarah.

Sarah, who lives in Yorkshire, is a poet,a spoken word entertainer, inspirational speaker and drama-based trainer in the (sometimes tricky) subject of Dementia. She is also a qualified life coach but prefers the term “useful chat” to “coaching”. She cares for her own disabled son full time, is a Grandma to three (soon to be four) rowdy children, is addicted to Coronation Street and is totally dependent on a well maintained diary and her never ending To Do list.

Sarah lives in Yorkshire and has been providing short breaks through Shared Lives for a year. She knows what a fantastic service this can be because her own son has used Shared Lives for his own short breaks in the past. Sarah writes:

Christmas seems to be a bit like a popular yeast extract spread; loved or loathed.

Just mention the C word to anyone and it’s almost guaranteed to receive one of two responses. Either “Oh it’s too early”, “can’t afford it”, “hate bloody Christmas” and other negative (almost visceral) reactions or the opposite response of the starry eyed, wistful “Oh I LOVE Christmas”, “I can’t wait”, “such a wonderful time of year”.

However we feel about it, we will navigate life a lot more easily when we accept that others opinions do not always match our own.

I have had to learn to love Christmas, my son loves it so life is easier if I do too. When I say he loves it, I mean he REALLY loves it. He has a Santa duvet cover, He has snowmen in his bedroom, he listens to Christmas music on repeat twenty four hours a day, we keep a countdown to Christmas poster in the kitchen. You may be thrilled (or horrified) to know that we have a mere one hundred and thirty sleeps to wait until we can open our presents and set fire to that pudding.

One of our Shared lives links was a match made in heaven for us. We have a Shared Lives visitor who loves Christmas. He brought his own festive bedding with him (there was no need we had plenty!). He plays Santa Claus is coming to town on repeat (genuinely not annoying where the entire family has become completely immune to living in a Bing Crosby background noise environment).

On one particular visit he took it upon himself to take all the decorations out of their storage and put them up. It was June. We had a tree up. He did a sterling job too: Every bauble, fairy light, Christmas wind up musical item, bunting, holly, mistletoe, ornaments. all displayed with expert care, ready to surprise me with.

Deciding to adopt a “if you can’t beat them- join them” attitude, I joined in and so did my son. We all donned a Santa hat and got stuck in, tweaking the lights, adding the tinsel, singing carols, talking about what we hoped Christmas would bring us all this year. We talked and listened and laughed and at one point I sat back and just stopped to enjoy the moment, to commit it to memory, to drink in the fun and the pure joy. I am not embarrassed to admit feeling a little emotional- I suppose Christmas is a nostalgic time of year.

Neither of these young men were glued to their iPads, neither was sitting in their head phones drowning out human communication, they were both engaged, connected, happy and relaxed.

Later that night I was trying to navigate the darkness of my bedroom as my early-rising husband had gone to sleep ages before me. As I fumbled around the end of the bed trying to locate my Pyjamas, I felt something unfamiliar. made of fabric, with beads/ buttons on. I managed to find the torch on my mobile- there in the beam I see that our guest had really had done a thorough job: it was a Christmas stocking hanging on the end of my bed.

This is just one of the many aspects I love about Shared Lives. We have the freedom to connect with people in a way which truly makes sense to them, on this occasion, it made sense to us too. Our customers have the freedom to not only be at the heart of what we do but to actually lead the way we do it.

I have often heard Shared Lives carers talk about how much they learn through their roles and I second that with a great big “YAY” as I raise my glass of sherry and ( whether you love it or loathe it) wish you all a very merry Christmas.