Sheik, Roumanah and Kirsty

Here’s a lovely story of inclusion, kindness and creativity from Hertfordshire Shared Lives as we continue to celebrate Shared Lives week.

Kirsty Stubbs moved in to live with Sheik and Roumanah Tafajoul’s family in February of this year. Kirsty has an acquired brain injury from an accident five years ago and had been in a Care Home ever since. Kerry Faulkner from Hertfordshire County Council Shared Lives writes about how they made the match made in the middle of the pandemic:

“Kirsty’s mother contacted me and was extremely keen for her daughter to be in Shared Lives. We had to be creative with matching as we couldn’t do any of the usual processes as this would mean Kirsty having to self-isolate in her room for two weeks if she even had a tea visit and the carers were not able to visit her due to the restrictions, so Sheik and Roumanah and their family Skyped her every week for months so they could get to know each other. Kirsty’s family met the Shared Lives family and worked with them to ensure a smooth transition. The room was adapted for Kirsty’s needs as she is partially blind, so they installed an ensuite shower room and an OT visited to install grab rails etc.

“Just after Kirsty moved in Sheik and Roumanah found out they were having another baby (which was a bit of a surprise for us all!) but we all worked together to ensure there was a contingency plan in place to allow continuity of care for Kirsty and the other gentleman they support in Shared Lives, with an additional ‘support carer’ approved alongside the one the family already had.”

Kirsty’s mum Joyce writes:

“The Shared Lives secret should be made widely known – amongst health and social services, charities and many more.  Since my adult daughter, a head injury survivor, moved to her wonderful new Shared Lives family in February 2021, she has been able to enjoy family meals, movie nights, helping the children with their spelling, listening to their bickering and simply being accepted and valued for the person she now is since her accident. Working with the family is a pleasure, most especially since the family has now expanded to include a new-born baby girl. Kind, caring families with appropriate experience and a suitable spare room are out there, as are countless adults with particular needs.  So please spread the word so that more people can be looked after by those who know how to care.”

Own it

I enjoyed meeting colleagues from Hertfordshire at the council’s annual Festival of Practice: a week of seminars, learning and reflection which the council invests in its social care team and their colleagues in the council, NHS and the voluntary and community sector.

During my session on Escaping the Invisible Asylum we talked about the difficulty of introducing asset-based or strengths-based practice into stressed, medicalised systems, if we want those new approaches to take root and grow. However small the beginnings, the goal must be complete transformation of the local system, so that every intervention in people’s lives is asset-based. Key tests for this are that all services and interventions:

  1. Look for what people can or could do, not just what they can’t
  2. Connect people and minimise the extent to which they disconnect people – our close relationships are key assets
  3. Build resilience for the future, rather than just addressing ‘presenting need’.

Only services and systems which are co-designed with the people who use them and work at the front line will achieve these changes, so these are shifts in who has power and responsibility. For instance, if your service is genuinely asset-based, its systems will treat the risks that people take as theirs to own, but will share ownership of the risks the organisation carries or creates: the individual remains in control wherever they can exercise that control, even when things get risky for them or the organisation working with them. The older person who falls regularly but wants to live at home has that right. Great hospital discharge teams support that person to understand and mitigate that risk, rather than pushing them into a living situation which feels ‘safer’ to the professionals.

We discussed the behaviour changes that would be needed if a system was to become genuinely asset-based, and the systems needed to make those behaviours possible, such as offering help to people to plan for a good life, rather than always starting with a needs assessment. The table below suggests some behaviour changes at the front line, and the leadership behaviours needed to make those changes possible and safe:

Workers and volunteers Commissioners and leaders
Seeing capacity & potential as well as need Building in more time: offer planning before assessment?
Humility and courage Healthy workplaces.
Confidence: focused on what matters most to people Seeing risk more clearly

Measure good (& bad) outcomes

Valuing relationships, networks Thinking ‘whole-household’
Sharing responsibility: ask more, offer more Sharing resources, knowledge, power

The most important question, then, is what changes would these new approaches ask of people who use services and their families? And what would they be offered?

Too often, a move towards community-based approaches is framed as asking for more volunteers, or asking more of families who already have unsustainable caring burdens. It is much rarer for those currently in charge of resources and systems to offer to share that power and the responsibility which goes with it. At the heart of that reluctance is a lack of trust, and asset-based thinking starts with trust: faith in people’s ability to take responsibility, in their creativity and that they won’t act purely in their own interests. This is why coproduction is so important: any asset-based system has to be co-designed with the people who will use it, deliver it, share responsibility for it and ultimately own it.