Regular readers of my blog will know how keen I am to have a focus on relational strengths based social work practice at the heart of adult social care. The Care Act has provided us with the legislative architecture to do just that. Of course, re-framing the way we work and addressing the tendency for processes and procedures to tip the balance in the wrong direction is a constant challenge.
In my visits to local authorities I have been heartened by the developments in practice that are focusing on strengths based approaches and the different conversations social workers are having with the people with whom they are working.
On a recent visit to West Berkshire, I heard about the focus on restorative practice approaches and the 3 conversations model and was pleased to meet with Sam Newman, a social worker and Director of Partners for Change, a bespoke change management organisation specialising in personalisation, innovation and financial sustainability. He kindly agreed to be my guest blogger this week. I will be working with people across the sector to develop a practice framework that brings these approaches together in a helpful way.
Sam Newman: 'I am convinced that the only way to make change really happen is to get to the heart of what people think they do when they turn up to work.'
It was great to spend some time talking with Lyn about our 3 conversations model and how it can contribute to a blueprint for adult social care that delivers on the promises of personalisation, and is practised in a context of community and asset building, local area co-ordination, restorative practice and other like-minded approaches.
It seems to me that, unless we collaborate together to build a sustainable and compelling story about how social care and social work can deliver value, and really add to people’s independent lives, we face a distinctly uncertain future.
I am convinced that the kind of change Lyn is talking about is essential and I have become more than a little obsessed about how you really make change happen. I have lived through a series of paradigms, world views, approaches in adult social care and yet, on my watch (and others) we have still ended up with a system that is process led, bureaucratic, and - despite many fine words - is in constant danger of losing the person at the heart of it all.
As one director recently put it ‘we have built a system based on queues and waits’. I would call it a sorting office – they may well work for letters and parcels, but not for people. Queues and waits are really bad for people – particularly those who have probably spent many weeks trying to find other ways of creating solutions for themselves or their family members and have had to fight their way through the system to arrive at their own particular queue or ‘wait’.
In our current way of working a social worker’s quality, performance and productivity is measured in terms of forms completed per hour/day/week. Adult social care systems, by their own admission, have become ‘assessment for services’ factories. And we try and control spending in our austere times by making it harder and harder for people to get anything from us.
So how come person centred planning came (and went) – and didn’t change these things? Who decided that direct payment processes must become so onerous, so bureaucratic, and so self-defeating that people with direct payments would often wonder why they bothered – because they would often end up with the same kind of things that they would have had anyway – but having expended much more effort. (This is not to deny that for some, a direct payment has been a lifeline to choice, and to quality of life). Where did the half a billion pounds of reform grant to support personalisation go. What return did we get for that?
Prevention strategies (including those I participated in creating) may have had many fine words in them but largely they have not influenced the core experience of people and families who need support to get on with life. Commitments to dignity, respect, autonomy and citizens’ rights have still left us with practice which is largely governed by the requirement to complete assessment forms that have grown like topsy and have too often become the end in itself, rather than the means.
So it was really refreshing to talk with Lyn about the requirement for really deep listening – and how we can re-introduce it as the default activity. I have become convinced that the only way to make change really happen is to get to the heart of what people think they do when they turn up to work, what practice they display, what behaviours characterise their work, and ultimately the detail of the conversations they have with people and families.
The ‘three conversations model’ provides a set of tools to enable our committed, principled and skilled workforce to have conversations based on what people want to tell us, not what we want to ask them. It makes us see them as people (not clients, service users or even customers), reminding us they are often part of a family neighbourhood and community.
I have seen how, if you dynamically and intensively replace our ‘assessment for services’ culture with a commitment to proper conversations, we can really listen and begin to deliver the holy grail of better lives for people and families, and a reduction in the consumption of health and social care resources, matched with a liberated, productive and inspired workforce.
Find out more about the 3 conversations model and the work of Sam Newman's organisation:
Will someone please tell me how this works with very elderly people say 80-90 who really don't want to go out they just want someone to help them dress and eat! Most people I see would think I was talking a foreign language if I went out and said "how can I connect you"? can someone please just let me know what I am supposed to be asking people without all the 'connect' jargon! Surely we all have conversations with people when we see them about what they can do, what they would like etc! Personally I think it is rubbish, it won't change anything long term because there are not enough community resources for one thing, for another elderly people as I said just want someone to help get them with personal care and meals, things like that. They would just say "I don't know what you mean" and to be honest I couldn't explain because I don't either! Can someone just please give some case studies of how this model has worked with housebound elderly people. I am beginning to despair and I can't possibly be the only social worker who hasn't a clue what this is asking for, or what I should actually be asking in English not jargon! If I hear or read one more article etc that says 'what can I connect you with" I will scream! What on earth does that mean!!
Hello Debbie - thanks very much for your interest. The points you make are important and this way of working requires us to have real and meaningful conversations with people. In answer to your illustration about a 80 – 90 year old – my experience of working with older people is that they generally have a very clear view about what is important to them and what a good life means to them which may include but never is limited by the tasks and times that you talk about but which often define our social care response. I’m not as confident as you that we always have conversations with people about what they want, what they like. My experience of the social care system is that is has become obsessed with assessing people for services, and moving on as quickly as possible. The model is trying to replace the automatic response – what service can I throw at you? – with an inquiring conversation about what really matters to that individual, and seek solutions with them that are meaningful and effective – and there is strong evidence that connecting people to other people and resources in the community is often much more effective than a time and task service.
Sam Newman, social worker and Director of Partners for Change
Sam and Debbie, thanks for your comments and I think the conversation highlights how over time social work lost its focus on practice.
Relational conversations with people are about understanding what matters most to them and what would make a positive difference to their overall wellbeing. Of course, the practical help older people need with daily living must be addressed, but our approach has sometimes meant we have been too focused on the volume and turnover of their care packages. We need more emphasis on what really matters to them and how they can be involved in shaping happier lives and experiences that help them feel included and valued.
In exploring the use of this model within adult services it seems that the focus is on locality based work in the community, I can however see significant potential for use of the 3 Conversations Model within central point of access teams. I am interested in your thoughts and views regarding the use of the model within this type of service.
There are links to Partners for Change, the originators of the 3 Conversations Model, near the top of the blog post. I'd suggest contacting them directly re: resources etc.
6 comments
Comment by Debbie posted on
Will someone please tell me how this works with very elderly people say 80-90 who really don't want to go out they just want someone to help them dress and eat! Most people I see would think I was talking a foreign language if I went out and said "how can I connect you"? can someone please just let me know what I am supposed to be asking people without all the 'connect' jargon! Surely we all have conversations with people when we see them about what they can do, what they would like etc! Personally I think it is rubbish, it won't change anything long term because there are not enough community resources for one thing, for another elderly people as I said just want someone to help get them with personal care and meals, things like that. They would just say "I don't know what you mean" and to be honest I couldn't explain because I don't either! Can someone just please give some case studies of how this model has worked with housebound elderly people. I am beginning to despair and I can't possibly be the only social worker who hasn't a clue what this is asking for, or what I should actually be asking in English not jargon! If I hear or read one more article etc that says 'what can I connect you with" I will scream! What on earth does that mean!!
Comment by Sam Newman posted on
Hello Debbie - thanks very much for your interest. The points you make are important and this way of working requires us to have real and meaningful conversations with people. In answer to your illustration about a 80 – 90 year old – my experience of working with older people is that they generally have a very clear view about what is important to them and what a good life means to them which may include but never is limited by the tasks and times that you talk about but which often define our social care response. I’m not as confident as you that we always have conversations with people about what they want, what they like. My experience of the social care system is that is has become obsessed with assessing people for services, and moving on as quickly as possible. The model is trying to replace the automatic response – what service can I throw at you? – with an inquiring conversation about what really matters to that individual, and seek solutions with them that are meaningful and effective – and there is strong evidence that connecting people to other people and resources in the community is often much more effective than a time and task service.
Sam Newman, social worker and Director of Partners for Change
Comment by Lyn Romeo posted on
Sam and Debbie, thanks for your comments and I think the conversation highlights how over time social work lost its focus on practice.
Relational conversations with people are about understanding what matters most to them and what would make a positive difference to their overall wellbeing. Of course, the practical help older people need with daily living must be addressed, but our approach has sometimes meant we have been too focused on the volume and turnover of their care packages. We need more emphasis on what really matters to them and how they can be involved in shaping happier lives and experiences that help them feel included and valued.
Comment by Ann-Marie posted on
In exploring the use of this model within adult services it seems that the focus is on locality based work in the community, I can however see significant potential for use of the 3 Conversations Model within central point of access teams. I am interested in your thoughts and views regarding the use of the model within this type of service.
Comment by Janet Ryalls posted on
How do we implement the 3 conversation Model?
How do we get started?
How do we get buy-in?
Is there a guide?
Comment by Mark Osterloh posted on
Thanks for your questions Janet.
There are links to Partners for Change, the originators of the 3 Conversations Model, near the top of the blog post. I'd suggest contacting them directly re: resources etc.
Thanks
Mark
Blog site manager/editor