Is it really up2us?

By Andrew van Doorn - on 31/05/2013

HACT's Deputy Chief Executive reflects on the up2us project, a five year HACT-funded project that recently concluded, which aimed to stimulate and create a space for innovation in housing care and support.

What does it mean to personalise housing care and support services? How can it be co-produced and deliver real choice and control for people? Does working collectively, pooling skills and money between people, improve their wellbeing or is it just a whole load of nonsense and a fad that has very little impact? And what can housing associations do to drive forward transformation in care and support at a time of increasing resource constraint?

These are all questions HACT set off to answer as part of its up2us project, the evaluation of which is published today by HACT and nef. Started over five years ago, in response to the new personalisation agenda that was beginning to gather a head of steam in adult social care, up2us wanted to create a space for innovation and experimentation in housing care and support.  Six pilots, mostly lead by housing associations, were set-up in Barking & Dagenham, Oxfordshire, Norfolk, Kensington & Chelsea, Kent, and Knowsley.

Six pilots all trying out different approaches, in diverse local contexts and with a broad range of people. The ground rules were simple but the challenge complex: what could we do if we implemented new personalisation approaches in housing care and support, encouraging people to pool their resources to organise and buy things together, and use co-production as the technique to achieve this.

HACT and the local housing associations put £60K on the table for each pilot for a two year programme of experimentation. Local partnerships were formed, steering groups were established, staff seconded to support the pilots, champions identified, and on-going support from HACT was in place. nef was commissioned to evaluate the pilots and provide an on-going learning programme, and a national group convened to provide insight, critical review and challenge.

So what happened? I could not do justice to the pilots by describing all that took place and all that we learned together in this blog, for that you will have a look at the final report – ‘Buying things together’ . It’s a bumper collection of rich and detailed case studies, key learning, ideas and tips for housing associations: the good, the bad and the ugly!

Safe to say it wasn’t all plain sailing and there were many challenges along the way. There were highs and lows, frustration and celebration, as people who use services, their family and carers, care and support staff and commissioners, all came together to do something different and try something new.

From the start it was clear we were asking people to chart new territory. To turn upside down the dominant models that had been embedded in the sector over many years, and in an environment of considerable funding uncertainty and flux. Personal Budgets were relatively new and hadn’t reached a critical mass (and are hardly impacting on housing support). But expectations were mounting around a transformation in culture and service design and delivery, driven by the principles established through self-directed support and personalisation – choice and control.

A number of major challenges stood in front of the pilots – how could you bring people together to share the costs of their care and support, particularly if they are spread over large geographical areas? What would they want to buy together? How do you build the confidence and skills of people to take greater control? Are there techniques like participatory budgeting that can be used? How do commissioners and managers manage their anxieties when they are being asked to hand over power and decision-making to the end user? And how are front line staff empowered to experiment and take risks with people and encouraged to change themselves?

Co-production was at the core of the approach, and with a new engagement between people and services, creativity went into overdrive. A new user-formulated community networking web portal was launched that brought together local people, local knowledge and local resources (a bit like Facebook but with added protection for vulnerable adults).  A user run co-operative was established and expanded to run joint activities for members. People jointly purchased overnight care and support, and gym equipment. Small amounts of money were turned into personal budgets in supported housing schemes. Participatory budgeting was introduced into a day centre and Extra Care housing residents began to jointly commission their support.

What became clear was the quality of the front line staff, willing to take risks, experiment with new ideas, challenge their own ways of working and able to work at the right pace for the users and build on their talents and assets, was key. A strong problem solving approach proved critical in overcoming the many barriers put in their way, as was having supportive managers who were willing to let-go of power and manage their anxiety about change.

Although funding was available to support the pilots (mostly paying for staff time), much of what they did was achieved within existing resources, just deploying them in different ways.  The desire to experiment, learn from this and build confidence to move forward became a powerful process to achieve larger change within a constrained resource base.

The willingness to work collectively and with groups, something that had been largely driven out of the sector in favour of more on-to-one styles of working was also key. The evaluation found that helping people to build relationships and social networks had a major impact on their wellbeing and sense of control. By working together people were able to exert greater power, increase their choices and do things at lower cost.

What up2us has shown is that personalisation is much more than just personal budgets and that co-production and experimentation results in longer-term change for organisations and improved well-being for people. You should give it a try, once you have there’s no looking back!

Links

'Buying things together' – the final evaluation of up2us is published today. A copy can be downloaded here.

A suite of resources from the DCLG Working Group on Personalisation and Housing Support, chaired by Andrew van Doorn, can be found on the Sitra website.

A blog by Lucie Stephens sharing her reflections on up2us, who led the nef evaluation, is also published today.  To read Lucie’s blog, please click here.

Tags: 
healthcare and support in housingpersonalisation

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