The Social Services and Well-being (Wales) Act, 2014, mandates local authorities in Wales and their contracted care providers to deliver services in a ‘person-centred’ way. In effect this means that services must better support service users in articulating their needs and wishes, record them and plan services and interventions (support packages) based on these expressed wishes.
Although this all sounds straightforward, there are many practical and cultural reasons why this person-centred shift might be ‘resisted’. I use the term resisted not to denote deliberate or ‘oppositional’ resistance, but more often resistance arising from a lack of knowing what is possible or how to make steps towards the new possibilities. A gap between what is currently available and what needs to be made available.
Resisting the shift
– Services may not shift because they have no experience of best practice and simply do not know how to respond in a person-centred way. They may not have many options available locally.
– Service users often have difficulties in communicating due to physical or psychological problems and they may not be used to exercising choice and autonomy or know what is available to them, outside of the limited range of local authority facilities.
– Advocacy services are patchy and again, may take time to adjust to the new possibilities rather than advocating within the range of current provision.
– In addition, service users may be used to having contact with services which are less responsive to their individual need, and have literally been conditioned, to be passive recipients of whatever care and support they are offered.
– Staff may lack the knowledge or skills to implement person-centred practice.
A new and varied ‘offer’
Perhaps an overlooked ingredient within this mix is imagination. Custom and practice dictates that services will do what services have previously done (‘the offer’), and it takes leadership, social entrepreneurship and organisation to change this cycle and thereby enhance ‘the offer’. It remains to be seen if direct funding for care packages, personal care budgets and the market for providing new services, can be made flexible enough to cater imaginatively for individual need. In my view, there will need to be an increase in provision from the third and independent sectors as well as social enterprises to create a truly mixed and varied offering.
Conversely, some local businesses may be willing and able to work flexibly with local authorities and local care providers. However, they can be prevented from ‘reaching out’ by lack of experience in this area and red-tape. Unlocking such potential could go a long way towards making more widely available ‘services’ which exist but which do not currently extend to individuals within social care settings. So, could businesses extend to meet social care half-way, and open up a wider offering for service users?
The rise of the coffee shop
One of the features of the high street across Wales, and the rest of the UK in the past decade or so, has been the emergence of the coffee shop. Seemingly resistant to recession, the march of the coffee shop has been relentless. They have established themselves in the national psyche as the venue of choice for the everyday, affordable luxuries, which add quality to life. The existence of these businesses (or increasingly – social enterprises) which act as social hubs in the same way that pubs used to, led me to think about the potential role they could play in developing new possibilities for individuals receiving support, by blurring the boundary between ‘formal’ social service and ‘regular’ community facility.
Proposed examples
– Book clubs have become a popular organised pastime in many coffee shops across the country, how difficult would it be to make them a little more inclusive?
– Coffee shops offer an excellent location for social skills exposure, training and practice.
– Coffee shops often have space which could be utilised at quiet trading times, as relaxed spaces, which could be made available for designated purposes. For example, individuals with mild cognitive impairment will often benefit disproportionately from being able to associate within a local and familiar setting, rather than a day hospital or similar setting.
– Many individuals receiving support packages are interested in returning to work. Often, they will need a little more coaching and support than is usual but this may be time limited. How about a foundation level catering qualification for working in coffee shops?
Blurring the boundary, between business and support, could exponentially increase the available offer to service users. There are undoubtedly barriers to such flexible provision, including training, arrangements for supervision and insurance, but where there’s flexible funding and goodwill – there may be a way.
