‘Good quality personal care is all very well but what we want is a full address book’.

This was what the tenants who have learning disabilities that I support told me at a board meeting early last year. I recognised this deeply at a personal level, this feeling of belonging is really important, it is the knowledge that people around you rely on you and would miss you if you weren’t there. Within the Consortium we have worked on this as a community, a community of staff, tenants, colleagues and family members. I have become very proud of our AGMs which are big enthusiastic affairs bringing together an unusual combination of, food, dancing, and ‘governance’. However I started having a nagging anxiety that while being active in the community we had not helped the people that we serve to be active parts of it.

The problem was the personal care label based silo that our services are commissioned within; we have become very efficient in focusing on the care and the label and not the person. There is much talk of the use of personal budgets and supporting people to have choice and control over the services that they use. This is clearly revolutionary but still feels like it is missing something pretty fundamental – other people.

• How could everybody get involved with the people around in them in ways that they had something to offer, as well as meeting their own needs?
• How could we as an agency contribute towards closer communities in which it is easier for; people to get to know each other, find people wanting to do similar things, and use their skills to make a difference in the world around them?

People in City and County of Swansea Social Services Department were very keen on finding ways to make our communities places where it is easier for all citizens to help and support each other. They saw this as a key element in the process of making services ‘person centred’ and ‘citizen directed’. We decided that we needed to conduct an experiment in partnership with all the people in one community in Swansea.

This felt more like it, we were thinking not just about better services for a particular group of people, but making a contribution towards something we all need which are stronger more mutually supportive communities. The problem was where to start.

We started having discussions with Timebanking Wales who had been very involved in the setting up of the ‘Blaengawr Time Centre’ this was a bold experiment in Locality Building which after 3 years had 540 participants and was generating 58,000 hours per year of active mutually supportive citizenship. These discussions led to a proposal in September 2009 for a 3 year project based in Gorseinon called ‘Time Together’. This project was to be one of the 4 experiments that would take place as part of Swansea’s Adult Social Services Transformation Process.

Time Together aims to bring citizens, professionals, agencies and community groups together in a collaborative partnership to maximise the continuing wellbeing of people living in the Gorseinon area.

It is to have 2 main elements:

• A Wellbeing Network – This is network that people can join where they share the things they are looking for to live their lives, as well as the things that they wish to contribute to make the network help others. This information is collated so that people can be put in touch with others who either are looking for similar things or can help out. People who get involved are thanked with time credits which can be redeemed for a growing list of community activities, such as community cinema or access to events being organised locally. This Network is starting off with 60 people who are currently involved using social care services and 40 people already involved in community activities, but we want it to become open to anyone in the Gorseinon area.
• A Wellbeing Alliance – The Alliance is made up of organisations that provide and commission services as well as community groups. This Alliance will support the growing Network; develop the time currency, as well as finding better ways to deliver support to people in Gorseinon.

We are going to try out some new ways of helping everybody to communicate together through this process including using ‘Swansea People’ which is a internet social networking tool that has been designed with City and County of Swansea that lets people simply share news and information in words, pictures and video. It also has some great tools to create shared maps and opinions about local issues.

It is early days with this project but we are being joined by some excellent partners. Gorseinon Development Trust are on board and are recruiting a worker to support the time bank, they are also providing the links to community groups and businesses that we need. We also have support from Community Education and interest and support from health services.

At the moment there is a lot to do, we are:

• Inviting the first 100 citizens to join the network;
• Interviewing community groups so that we can produce a detailed ‘whats on’ in Gorseinon
• Working out how citizens can exchange the first 6,000 time credits.

How will this help to improve the wellbeing of people living in Gorseinon?

Well it is an experiment, but we think …..

• It will help people to get to know each other and make it easier and rewarding to get involved and contribute to the community.
• It will help to create more locally owned, person centred joined up services.
• If people get to know each other better we can use direct payments and other approaches to help them organise their own services in ways that work better for them.
• We can organise locally and create more employment for people who live in the community.
• We can all organise supports with less waste, more efficiency and greater sustainability.

The Time Together project team is being led by Cathy Murray of City and County of Swansea.

This story was written by Rick Wilson of Community Lives Consortium.

Time Together Gorseinon

Time Together aims to bring citizens, professionals, agencies and community groups together to maximise the continuing wellbeing of people living in the Gorseinon area.

Who is involved?

City & County of Swansea Social Services has started this process off in partnership with Gorseinon Development Trust, Time Banking Wales, Community Lives Consortium, and Swansea Council for Voluntary Service.

It is one of the 4 experiments in Citizen Directed Support that Swansea are conducting  to transform social services for adults.

What will it do?

It will have 2 elements

A Wellbeing Network – This is a network that anybody in Gorseinon can join. People can share the things they are looking for to live their lives, as well as the things that they wish to contribute to make the network help others. This information is collated so that people can be put in touch with others who either are looking for similar things or can help out. People who get involved are thanked with time credits which can be redeemed for a growing list of community activities, such as community cinema or access to events being organised locally.

A Wellbeing Alliance – The Alliance is made up of organisations that provide and commission services as well as community groups. This Alliance will support the growing Network; develop the time currency, as well as finding better ways to deliver support to people in Gorseinon.

When will it start?

We are working to launch Time Together in September 2010.

How will it help?

It is an experiment, however we think it will do the following things:

• It will help people to get to know each other and make it easier and more rewarding to get involved and contribute to the community.
• It will help to create more locally owned, person centred joined up services.
• If people get to know each other better we can use direct payments and other approaches to help them organise their own services in ways that work better for them.
• We can organise locally and create more employment for people who live in the community.
• We can all organise support (as well as potentially life opportunities) that create less waste, offer greater efficiency, and are more sustainable.

How can you get involved?

• If you deliver services or support in the Gorseinon area please contact us about you can help us build the Alliance by clicking here.
• If you live in the Gorseinon area and you want to get involved with people around you please let us know  by clicking here.

Information about our partners

• City and County of Swansea Social Services Department
• Gorseinon Development Trust
• Time Banking Wales
• Community Lives Consortium
• Swansea Council for Voluntary Service

Time Together Gorseinon April 2010

Time Together Gorseinon

Please Let us know what you think?

This work was very successful and was incorporated into Swansea Adult Services Transformation Process.

This process contains 4 action experiments; two of these will focus creating more person centred approaches to assessment and care management, and two of these will focus on community development.

Time Together Gorseinon is one of these community development experiments. It is a 3 year collaborative process to:

• Bring citizens, professionals, agencies and community groups together to maximise the continuing wellbeing of people living in the Gorseinon area.

From now on we will be using Sustainable Lives to provide updates and news about the development of Time Together, and the wider issues that surround it.

Please let us know what you think

These Community Action for Climate Change Networks are running a second series of FREE events during November 2009.

In order to meet your local need to take action on climate change the events will offer an opportunity to:

• network with others from community groups, from small businesses, form local authorities and others,
• build on the learning gained at the Sustainable Behaviour change workshop that many of you attended on 15^th September in Gregynog, Newtown,
• develop local action plans, and
• Identify future training and development requirements

Each event will have a slightly different focus for developing action plans and you are welcomed to come along to your local Network and /or whichever location suits your needs best.

Newport – November 12 – will explore action planning on a large scale

Llangollen – November 18 – will focus on a joint understanding of good practice for Small and Medium Enterprises and community action

Aberystwyth – November 26 – will use as live examples from three different community groups that are currently planning local action

All events will have inputs from a diverse group of speakers to stimulate our thinking and planning.

You can find out more information about these events by following this link and get an application to take part in the events by following this link.

This was posted on the Wales Alliance for Citizen Directed Support website at www.wacds.org.uk this week.

The Steering group wants to launch our Alliance in Spring 2010.

Summer barbeque

Before this point we want to have achieved a number of things:

• Have wide agreement to a set of principles for Citizen Directed Support.
• Have agreed with partners some large demonstration projects involving large scale collaboration between citizens, commissioners and providers, this would include projects including multiple agencies, involve collaboration between, citizens, commissioners and providers, and involve transformation of service areas.
• Have established a directory of practice experiments that fit within our principles that partners are exploring, these experiments would be smaller scale, such as re-development or particular elements of service, like assessment and care management, or new models of service delivery, or new forms of collaboration with citizens.
• Have in development an evaluation framework for Citizen Directed Support that can be used by partners to review these projects and experiments.
• Have a list of agencies, and individuals who are supporting aims of the Alliance.
• Have agreed a representative structure through which the Alliance can mange it’s work openly and accountably.

So there is a lot to do, if you are interested in making this happen then there is a lot you can do.

• Get involved, and get others involved, in building our principles – you can find out how by following this link, through this process you will also register your interest in the Alliance (so that kills 2 birds with 1 stone).
• Start talking with partners about projects or experiments that you feel would fit within our developing principles, let us know your ideas.
• Show your support of this process by commenting on this website.

I look forward to hearing from you

The work that we are doing in Swansea potentially fits well as one of the large demonstration projects described above.

Interesting stuff

The Wales Alliance for CDS Steering Group and Provider Network want us all to build the Welsh principles of Citizen Directed Support together.

We want to do this in a way that builds a strong, collaborative and open Alliance from the outset.

To do this we have created a wiki group at www.welshcitizensupport.wikispaces.com, a wiki is a website that everybody can change and alter together.

On this website you will find a set of principles for Citizen Directed Support in Wales that are growing and developing through contributions from Alliance members and Provider Network.

The steering group aims to have agreed principles that have wide support and agreement by the end of November 2009.

Please do get involved in this process, you can do this by:

• Contacting debbie.chegwen@communitylives.co.uk to join the Wiki group, we will send you an invitation to join the group that will set you up as a member.
• Add your thoughts and contributions to our evolving principles on our wiki pages.
• Pass this information on to any agencies, groups or individuals that you feel have a stake or interest in this process and encourage them to get involved.
• We will send out a regular email to wiki group members containing the latest text of the principles and outlining what changes have been made.

To find out how to use the wiki group, please look at this video we have produced to explain how our wiki group works.

Please get involved, there are lots of ways you can contribute;

• You can focus on a particular principle, or all of them.
• You can focus on making the language accessible, or spelling or grammar.

However you contribute you will be building principles that have the potential to transform social care in Wales, and demonstrating our shared role in this Alliance for change.

If you don’t what to use the wiki pages please let us have your comments either by contacting Debbie Chegwen 01792 646640 debbie.chegwen@communitylives.co.uk or placing a comment on the Alliance website at www.wacds.org.uk .

There is now a facebook group which you can join at http://www.facebook.com/group.php?gid=154370365756 .

You can find all this information on the Alliance’s website at http://wacds.org.uk/wiki_page/

The Alliance look forward to hearing from you

Night-time response workers

This has developed in partnership between City & County of Swansea, Community Lives Consortium and Walsingham Wales.

The idea is simple, we will try to re-model the existing sleepin support that is dispersed across 12 different supported housing schemes in the Gorseinon area and replace them with 2 community based wakeful staff that can arrive at any of these addresses within 15 to 20 minutes.

Why are we doing this?

• We want to create a community based night-time support service that is more responsive to people’s needs where ever they are living in the community, this is a logical extension of the Targeted Support programme we have been exploring to create more responsive and consistent services in the community.
• We need to respond to the working time directive and its implications for sleep-ins. We will no longer be able to provide night time cover in this way without paying the rate as working hours. This would mean eventually changing all sleep-ins to a wakeful shift which would have significant funding implications for the local authority.
• We want to develop a service that is better able to utilise the potential of Assistive Technology for efficiently supporting people in the community.

What would this Social Care Response service look like?

We are delivering a response service that contains:

• Initially half time Response Team Manager
• A team of staff paid to stay awake at a local base paid at wakeful rate. Staff will be available to respond to a number of support needs during the night time.

The initially response staff will respond to calls from;

• Staff and managers currently supporting tenants – These calls will be from a wakeful member of who requires additional staff assistance to provide support. An example would be in the case of when two staff are required to deliver personal care when there are manual handling guidelines in place. Once this support has been provided there is no longer the need to have two people at the service and the response worker returns to the local office.

• Call centres responding to Telecare used by tenants - In this case response workers will be responding to assistive technology alerts. They will receive a phone call from the call centre and will go to the service to respond accordingly. An example may be that a sensor has been triggered when a service user has got out of bed but hasn’t returned to bed after the ‘normal’ amount of time. The response worker will go to the service to check that everything is ok.

How have we set this up?

In order to test this model of service out we have mapped out the community living services and have decided on a geographical area where there is a natural cluster of services.

There has been an assessment of these services to determine what type of support is required at night. These services have been colour coded as Red, Amber and Green.

A red service is a service whereby a member of staff is definitely needed at the service at night. This would need to be a wakeful member of staff in order to comply with the working time rules.

An amber service is a service whereby a response service could be used if certain risks were resolved by, for example, looking at assistive technology.

A green service is a service whereby a response service could be used if the response staff could arrive in a timely manner. E.g. within 15 – 20 minutes.

In putting this in place we are working through 5 implementation phases:

• Phase 1: May to July 2009 – We will be explaining this pilot to staff, relatives and service users. The Response Team Manager will develop the necessary systems and policy framework for the effective running of the service. They will also recruit and train the response workers.

• Phase 2: August 2009 – The Team were in post and receiving training.

• Phase 3: September and October 2009 – All of the green services will use the response service. This will be reviewed.

• Phase 4: November to March 2010 – Technical difficulties will be resolved with the amber services and these may turn into green services.

• Phase 5: March 2010 -A review of the response service will take place before it is rolled out across other geographical areas in Swansea.

It will be interesting to see how this re-modelling of service develops, it is another potential approach to developing more integrated, responsive, locality based models of service.

Fit for the Future

I came across this document from the brilliant Forum for the Future and the NHS Sustainable Development Unit called Fit for the Future.

This document looks at the social, political and economic responses to climate change that we might see over the next 20 years and the impacts that these will have on our health and the types of healthcare provision available to us. The report presents four scenarios describing radically different worlds in which the NHS might operate.

Helen Clarkson of Forum for the Future suggests that:

• ‘We strongly believe that this isn’t necessarily bad news. By focusing on our wellbeing and leading more sustainable lifestyles we can find the low-carbon/high quality-of-life sweet spot. That’s something not just for the NHS to consider but other organisations in the public sector, and all of us as individuals.’

This document echos with respect to health much of the logic that we have employed in developing approaches to sustainable social care, specifically:

• Helping people to take much greater responsibility over their lives and their services, and supporting communities to be more assisting of it’s members.
• Developing a far more effective model for early intervention and creating resilience rather than dependance.
• Ensuring that public services do not just adjust themselves to the potential impacts of climate change but become the conduit for wide-scale community behaviour change with respect to sustainability.

The officers of City and County of Swansea have really engaged in this and came up with a range of definitions for personalisation and Citizen Directed Support, thanks to them for these 100 word definitions.

Personalisation to me means the incorporation of a number of concepts. Enabling, empowering are two but behind that is ensuring that people have enough information to make an informed choice without constraint. It also means that people have the right to give the right away to trusted others. Not everyone wants responsibility and we cannot thrust it upon them. The very fact that people are touched by our services means that they have needs that they are unable to deal with at the time. Personalisation suggests that we assist in enabling people to address these needs in whatever way is right for them.

‘Citizen Directed Care allows and encourages individuals to have greater control over the services they need to obtain the independence, well-being, social interactions and autonomy which they want. It allows and enables individuals to take a greater degree of personal responsibility for their lives and lifestyles and to choose how they will engage with agencies or others to deliver services in ways which will meet the outcomes which are best for them. It will enable individuals to understand their rights and entitlements, whilst also recognising the constraints imposed by society and the responsibilities of being a citizen.’

• A fundamental shift from a consumerist model of care to a model of co-production
• Capacity building within the community, and building individual social capital within these communities (interdependence)
• A move from individuals being recipients of a service to active participants
• The outcomes agenda, individual budgets or direct payments alone will not ‘transform’ social care and a more fundamental cultural shift is required
• This will require understanding and sign up from politicians, senior and middle managers, staff and service users and their families
• Understand the changes that need to occur throughout the Commissioning Process
• It will require a change in roles for professionals and front line staff
• A change to how we perceive risk as an organisation, a change to how we contract and understand and manage performance
• A change to how we allocate and manage budgets
• Key phrases; feeling in control and having shared responsibility, having choice, flexibility and responsive services.

Personalisation should mean exactly that. As an authority we should be prepared to develop a range of solutions and options for people to have support and take action from the  individual discussions we have with people. People will vary on the levels of choice and control they aspire  to and how  they direct their own support and we need to respect that. Many will have their primary focus on improvements to the reliability, consistency and quality over the sorts of services they already receive and we need to achieve this while fostering a culture that allows for innovation for those who wish.

Personalisation is finding out what matters most to service users and carers and using this knowledge to make a positive difference to their lives. It supports their interdependence and well being, through a relationship centred and collaborative approach to the achievement of personal outcomes, in a manner which values and respects everyone concerned.

This requires:

• A common understanding of outcomes

• A commitment to social justice and equality

• Increased service user and carer control

• Supportive risk management

• Working within the context of families and communities

• Making the best possible use of all resources, including those within  families and communities

• Supporting frontline staff and volunteers

Personalisation is putting the service users with their family and carer(s) back in the centre by self assessing or co-assessing holistically.  It’s about the ethos that the individual/customer knows best, allowing/enabling people to shape and control their own services – thereby their life.  It’s about putting more resources into prevention and reablement, making people part of their community and vice versa.  Transparent allocation of resources to provide a full range of services, developing the marketplace, making choice real.  Access and inclusion where citizens have equal rights and opportunities.  It’s about supporting better health and social care outcomes by seeing images of possibilities by good support planning.  Give staff and users permission to do it differently, not prescriptions.

• Individuals are supported to have as much control over their support planning as they choose or are able to manage, through a range of methods such as individual budgets or use led services.
• They are equally helped to become part of mutually supportive communities which they have investment in and influence over.
• Agencies deliver services to individuals achieving explicitly agreed individual outcomes.
• They also actively support communities to build their capacity for collaboration and mutual assistance.
• Explicit shared systems of communication exist between individuals, community groups and agencies to support collaborative decision making and local adaptation.

The Wales Alliance for Citizen Directed Support is now picking up this approach and are building on the work to create a shared definition for Citizen Directed Support across Wales. You can find out about their work at their website at www.wacds.org.uk