Pirates on bikes will help wellbeing, not time and task
Shropshire Council are one of the early adopters to the revised Making it Real framework on personalised care and support. Their ongoing commitment to practice co-production with people who access services led them to invite TLAP’s co-production members to a visioning session. The invitation to Shropshire was to think differently about how people can use their direct payments - a method likened to thinking like a pirate.
I’m Rob Price, I work for Shropshire Council’s Adult Social Care Financial Assessment Team, and it’s my job to determine what citizens pay towards the cost of their care packages. Yes, it usually goes down well when I say that in front of the recipients of our direct payments. I was at the same visioning event that Caroline Lewis describes here. In which members of TLAP’s co-production group supported us to think differently about the use of direct payments. This is my take on it, and the thoughts that arose during and afterwards.
Envious care and support packages
There was a time, before the Care Act, when personal budgets were young and citizens ended up with envious packages such as season tickets to their favourite football team (seldom Shrewsbury Town). The pendulum quickly swung the other way. These days you won’t see a membership to the National Trust on many a care and support plan. There’s a tension between the need of the council to manage its budget and the well-being of the citizen. So, are the menu choices for personal budgets in need of a Gordon Ramsay style make-over?
From eating fish and chips to cycling and thriving
My first ever experience of direct payments was a story from another local authority. An Armed Forces veteran of the Iraq war, who we will call Dave, suffering from PTSD came back to a collapsed marriage and inability to hold a job down. He got a small flat above a fish and chip shop, where, withdrawn from society, he would stay, only venturing out for fish and chips or kebabs. He put on weight and was poorly motivated. His social worker took some time to engage with him, and, together, they organised a direct payment. The result? A bicycle. He became more engaged in his own wellbeing, slowly gained confidence, lost weight, re-engaged with his children and got a job. The bike enthused him and enable him to thrive rather than merely survive.
‘Thriving’ was a theme that ran through this TLAP-led visioning event. Clenton Farquharson, chair if the board, articulated that so clearly, as well as his preferred ‘citizen’ rather than ‘service user’. If we must use labels, let’s make them participative rather than indicative of passive recipients of services. This event was fully participative.
Two opposing sides to direct payments
It is very easy to see adult social care services and direct payment recipients as two opposing sides: you want our money, we really don’t want to give it to you, but if we must, you will find that paragraph 15, subsection (3)(b) of the document that you signed means that we have the right to make your life miserable if we don’t like what you do with it.
It doesn’t have to feel like that. Yes, it is council money, that’s public money, but have we attached too many strings to it? During the TLAP session we were encouraged to think creatively, to think like a pirate, but for me that was not as Catriona Duncan-Rees, TLAP co-production advisor, described: inclusive, cohesive and collective. No, for me, I was Douglas Fairbanks Junior (that’s Orlando Bloom or Johnny Depp to our younger readers), swinging from a buffeting, canvas, arcing my cutlass sword through the red tape that would set our ship free. Cutting red tape not only makes citizens’ lives easier, it could make ours (as staff) easier too. And that’s not a bad thing.
Spending money on wellbeing rather than tasks
So, back to the bicycle, I can see that it won’t work for everyone, but I remember chatting to a woman with Asperger’s who had a dog on her lap who told me that she couldn’t have spoken to me without that dog’s calming influence. Yes, PAs will always have a place in direct payments, but so should bicycles, dogs, mindfulness retreats, and, dare I say, a pass to Alton Towers? Importantly, such a move to a focus on wellbeing rather than specific hours and tasks, could also mean that we all spend money more wisely.
The key now is to harness the palpable energy of our newly-formed pirate collective. Our next event is already scheduled for this month and my tricorne should have arrived by then.
Shropshire Council & Making it Real
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Support from NCAG with Making it Real & visioning sessions
What is the National Co-production Advisory Group