If we’re ever to achieve personalisation, social workers need to get out of the office
Meeting the challenge of co-production in adult social care can seem both essential and impossible. We look at how the sector can move to a “no decisions about me, without me” approach
In 1981, in Hampshire, a group of disabled people living in a traditional residential home were responsible for significantly changing the expectations and potential of both service users and professionals alike. By convincing the budget holders to hand over money and resources to arrange their own support directly to the disabled people, ‘project 81’ set a radical social policy standard and cajoled a profession into becoming allied to its community.
This is partly why we now talk about personalisation, self directed support, independent living and all those things that look to put people first and move us away from the traditional one size fits all approach. The last 30 years have seen a variety of positive changes. These include the development of Access to Work, providing adaptations for disabled people in the workplace, and the Disability Living Allowance, developed to cover the additional costs associated with living with a disability. Both of which were heavily influenced by disabled people who had identified what was wrong, and what needed to change. Given the opportunity people can be very good at finding out what works for them and how to implement it.
The challenge we currently face is not about how to get everyone signed up to the grand plan of inclusion. We all recognise that it’s just not on to be making choices for others without consulting them. Public policy now seems to be echoing this with the secretary of state for health declaring there will be ‘no decisions about me without me’. However, we won’t be able to achieve these objectives whilst social care provision is seen as an “us” and “them” service.
Part of this problem is that previously professionals were considered to be the only experts. Users (previously “clients” and before that “patients”) were merely passive recipients of the expert’s knowledge and service. While it is a bleak and simplistic view to say that it was thought easier if users were as passive as possible in the delivery of care, I believe social care has deeply suffered from the institutional approaches to service delivery of the past. Their remnants haunt everyday activities, and prevent us from realising the dream of inclusion.
We need to abandon our identities as user and professional and see ourselves as one entity; actively related to the consequences of our actions. This is co production and emphasises the fact that we never do things on our own, but are in it together, chasing off past demons, and laying out social justice foundations for the future. Disability Cornwall, for example, created “DC 100”, a group of 100 (funnily enough) Disability Cornwall members who regularly participate in surveys on community issues and initiatives. While the “Whose Shoes” learning tool aims to help social workers be more aware of how their actions affect their users.
However, making co-production work in real life can be harder than in theory. My advice is to think less about the corporate plan and other people’s quality marks, instead get out of the office and focus on your community. Learn why particular positions and beliefs are held and then question them. Ask for feedback from your users and listen to it. Test out new ideas, share new plans and build active communities of ‘doers’ that work together to get things done. Do this and when your ‘project 81’ comes along your ideas wont be held back by the past, rather your fresh and collective community voices will be visionary.
• Stephen Lee Hodgkins is Project Director of the Disability LIB project.