00:00
So the opportunity that this act gives us is an opportunity to do things
00:06
differently and it's something that everyone welcomes you know all
00:12
the social workers we're working with, all the local authorities, although they have
00:16
to dig deep to make this change they welcome the opportunity to do it because
00:21
people do feel that they've got overly curtailed in their practice by the
00:27
processes that have limited the engagement with human beings. Over the
00:33
last 18 months and as I say my background is in social work across a wide
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range- child protection, adult services, mental health, older persons a wide range
00:43
of provision and but the last two years I've been working alongside Social Care
00:48
Wales on their improvement agenda helping local authorities think about
00:52
not just what does the Act say but if we manage to change in line with the act
00:57
what does our work look like? We've got to have a sense not only of
01:01
the vision but also how we affect the work so we've worked with every local
01:06
authority adults and children services across Wales and they are working
01:10
together to try and bring about a change so we'll be very interested to hear if
01:14
you've noticed a different quality in the care plans you're getting a
01:18
different kind of conversation, maybe not, but if you have it'd be good to hear. One
01:25
of the things as I already said is that government, Heads of Service, gradually
01:33
politicians at every level recognising that we have become overly prescriptive
01:39
in our style and approach. You know an assessment document now for a social worker
01:46
has become so comprehensive that they end up having the wrong kind of
01:51
conversation with people right from the very beginning asking them all kinds of
01:54
information that isn't relevant to the person they're talking to isn't helpful
01:58
in building trust in the system. So thinking about all of that is an
02:07
important part of the shift, you know if I was if I was waiting at home
02:12
for someone to come out and assess me whatever the situation I was in that
02:16
would make me nervous if I was going to be assessed I could fail and if I failed
02:22
the assessment what would that mean to me if they didn't give me a service or
02:26
they did something to me I didn't want, so right from the very beginning
02:29
we've created a kind of discomfort and many of our service users go through one
02:34
assessment after another don't they to try and get to a service so so much of
02:41
that has to be changed and many authorities are trying not to use the
02:44
word now when they're talking to their public and that's that's probably
02:49
something that's close to your hearts as well. The other thing about those
02:54
conversations is they've been very driven by trying to ascertain whether
02:59
someone hits a criteria or a threshold or is allowed a service, now what that
03:06
has done over time is ensure that people have very negative conversations all the
03:10
conversations have been about the deficits and what people can't do so
03:14
that the social worker could go back to the base and crash this case through the
03:18
thresholds of the panel to ensure they get a service. What that leaves in terms
03:24
of our service user is a feeling of just having one conversation after another
03:29
about what they can't do, it's a demoralizing process so when we start
03:34
talking to local authorities about bringing back a more strengths-based
03:37
approach lots of things have to change- how they capture the information,
03:43
what they think is important, how they make decisions about allocation of
03:48
provision and everything has to change, so they're digging deep and
03:53
trying to ensure that the system is complying with the spirit of the act at
03:58
at every level. So what they're trying to move to is ensuring that every worker
04:05
every skilled worker across Wales has the opportunity to engage in those
04:09
empowering conversations with people, uniting all of us in the fact that we're
04:16
dealing with people who are facing challenging situations and that we have
04:20
to have sensitive conversations with people to enable them to start to make
04:23
sense of what going on for them in their lives so
04:27
collaborative conversations across the piece is what we're trying to encourage.
04:33
So you may be noticing a change in the care plans you may be noticing and
04:38
starting to see more outcome focused care plans coming through to you. You may
04:43
be noticing the more strengths based assessment so you're getting a bigger
04:47
picture of a person - their life, their history, what they can do as well as what
04:53
they can't do so your starting point is much more balanced and more open that a
04:59
feeling like we're in it together that we can make a collaborative
05:04
communication around the service user to the outcome that means flexible
05:07
conversations it doesn't mean receiving a care plan with minimal instructions
05:13
about tasks and then a review of that six months down the line checking
05:18
whether the service is still happening. Reviews should be changing in their
05:22
feel, it shouldn't be about reviewing the service it should be about reviewing
05:26
the person and their hopes and aspirations, a real opportunity for
05:31
providers to say things are different than they were when we met this person
05:36
and we need to be taking that on board so that kind of listening conversation
05:41
regularly communicating together and working together a shared understanding
05:46
of what all our work is leading to for the service user. So what the Act asks of
05:53
us, asks of workers is to ascertain and have regard to people's views and wishes.
06:02
We don't find out what people's views and wishes are unless we
06:08
have sensitive conversations where we're listening hard to what's going on.
06:12
One of the things that's captured people around the country is this concept of
06:17
what matters - has everybody heard that phrase "what matters to people"? And in
06:24
some areas that's been interpreted very literally so into their early
06:29
conversations they put a question "what matters to you?". The whole concept of what
06:35
matters needs a principle that underpins our work not
06:39
a question that we ask people if I (sorry Andrew, knocking my mic) if I was walking
06:45
down the street today and someone stopped me and asked me what matters to
06:47
me I'd struggle to answer that question so unless I'm in a sensitively guided
06:54
conversation I won't get to be able to articulate that or even think about what
06:59
things are going on that matter to me but we've had some interpretations where
07:04
social workers have had referrals from hospitals saying oh I've had the what
07:07
matters conversation it's a walk-in shower, end of conversation. So we need to
07:13
get to a process a much more flexible understanding of what trying to get to
07:21
the important things for people actually means and that means thinking about how
07:25
people ascertain views, wishes and feelings and from that ascertaining of
07:33
those feelings we can get to people beginning to articulate what an outcome
07:37
would be similarly if I said "what's your outcome?" wouldn't even know what anybody
07:43
meant so they that emerges out of our conversations with people