Why Strengths Based is part of Workforce Pressures Solution
If our workforce really are our most important asset in social care, it’s time for a rethink. You can’t have failed to hear about the crisis in social care and the large number of vacancies that are exacerbating pressures in the already overstretched sector. In my new blog mini-series, a collaboration with Andrew Burridge, NWADASS, I’m going to be examining why there’s a problem in the first place and providing some practical advice and solutions for changes we can make right now, as well as in the longer term, to recruit and retain more of the right people to work in social care.
The case for adopting a strengths based approach to delivering public services is compelling. Shifting from a deficit approach of what’s wrong to a compassionate, enabling approach that starts with what matters improves lives and increases our independence. It’s no wonder that public services are increasingly looking to adopt a strengths based approach as not only does it improve outcomes, it reduces demand for costly public services which after more than a decade of austerity feels like a no brainer. Just as importantly, it improves engagement and motivation in staff which in turn improves the quality of services. The reason for this? Firstly a strengths based approach helps to reconnect staff to their core purpose or motivation that brought them into social care in the first place: making a difference to people’s lives. And secondly, at its very core, a strengths based approach is about relationships and it refocuses where staff spend their time and energy to where it’s more enjoyable, more fun and has more impact.
Adopting a strengths based approach can sometimes translate into a primary focus on training staff to change how they work but if we only focus here, we’ll fail to change. A systems approach isn’t a nice to do, it’s imperative if we’re serious about shifting to a strengths based approach.
A strengths based approach is grounded in building relationships that enable us to get to what matters, not just what’s the matter. At its core, it has to be about the relationship between residents and the people who work at the front line of public services. But if we only focus on changing the way staff work, we won’t get the impact we need. I have worked with 100s of staff to support them to adopt strengths based approaches and there are key themes that emerge that if we don’t act on will mean we’re not successful in shifting our approach.
In my experience, staff welcome and want to work in a strengths based way, it fits with their values and their sense of purpose for working in public service. Equipping them with practical tools and techniques to put the approach into practice is imperative. But equally valuable is to listen to the stories they tell that give insight into what happens in practice. These stories are like gold dust for leaders to understand where to focus their efforts to drive change in the system. Being responsive and driving these changes builds the confidence of staff and residents that you’re serious in your aspirations and fundamentally makes it easier to do. And as behavioural science tells us, if something is easier to do, we’re more likely to keep doing it.
Focus on what matters
A strengths based approach improves lives based on what matters
So what are some of the themes emerging from listening to staff stories of trying to work in a strengths based way? They are numerous, and varied and sometimes surprising and with every group of staff I work with, I learn something new. So I want to share with you a flavour of the system challenges that I hear playing out on a routine basis.
Time. It takes time to build relationships and work in a strengths based way. It takes time to enable and support people to do things for themselves rather than doing things for them. But if we know that we are going to achieve better outcomes, shouldn’t we be allowing staff the time they need? Doesn’t this come down to what we choose to measure performance on? Are we measuring performance based on task and time eg. number of assessments completed, number of visits undertaken or time to complete tasks? or are we measuring the impact we have been able to make to someone’s quality of life? Staff will naturally place their focus on how their performance is measured so what messages are we giving through what we are measuring?
More time Better Outcomes
It takes time to build relationships and focus on strengths. What messages are we sending to staff about how they use their time.
Community. Connecting people into their communities is pivotal to a strengths based approach. If I’m lonely and suffering with my mental health and well-being as a result, what will I benefit more from - going to a day centre or reigniting a once loved passion for singing with people who live near to me? The answer should come down to personal choice but ultimately if staff don’t know what’s available locally, how can they give that choice? So do we change up how we expect staff to utilise their time? How do we support staff to spend time developing knowledge and connections in their local community? Or do we invest in new roles like community connectors or prescribers whose job it is to get to know their local patch inside out and to help people connect?
Technology Enabled Care. I think people are a bit scared by this term. But I think the fear comes from not really understanding the art of the possible. Technology Enabled Care or TEC as it’s known, can be instrumental in changing people’s lives and enabling them to be more independent. For me, one of the earliest stories I heard, still stands out the most. How the introduction of technology to someone's night time routine meant that carers and loved ones could be alerted should something go awry in the night removing the need for a person to be paid to sit in the room with someone while they sleep. TEC is a growing industry with new innovations introduced all the time giving people back their independence to function more independently at home and out in the community. TEC can also help to create capacity. For example, if a person can be enabled, through TEC, to feed themself instead of needing someone to feed them, then that frees up the capacity of the carer to support them in different ways - like helping them to get out into the community. How do we equip staff with the knowledge and confidence to build TEC into care options? How do we show not tell the art of the possible? How do we remove the fear?
Risk management. We have to manage risks to keep people safe. But sometimes is this at the expense of their happiness? A strengths based approach requires a different approach to risk where we seek to balance the social and emotional risks of not doing something with the often physical risks associated with doing it. We replace, what if Julie goes wondering while she’s out in the community with, what are the risks to Julie’s mental health and happiness from not being able to go out, and how can we manage the risks of her going wondering when she does? With this comes the need to accept that we won’t always get it right first time but we will manage the risks so nothing goes horribly wrong. And importantly, how we respond when things go wrong is key to creating a culture where people feel able to take a more balanced approach to risk - do we blame or learn?
Positive risk taking
It’s a question of balance
Commissioning. This is huge and I’ll come back to it in a future blog but for now I’ll give you a flavour. Fundamentally, if we are not commissioning the type of support that people want in order to live the lives they want to lead then we won’t deliver a strengths based approach. If the relationships don’t exist between commissioners and front line staff and residents, how will we know what we should be commissioning? And if we commission like we’ve always commissioned, how will we stimulate the market for new and innovative support? If we continue to commission on a time and task basis rather than for outcomes, how do we enable staff to spend the time they need with residents to work in a strengths based way and improve lives? What if we shifted our commissioning models to pay based on maximising independence and quality of life? And really importantly how do we change the relationship between commissioners and providers and indeed between providers to enable greater collaboration? With better collaboration comes better intelligence and data, more opportunities for innovation and creativity and higher levels of trust which in turn delivers better outcomes for the people we support.
Andrew says:
“Strength-based approaches” has been an exciting idea for thinking about public services for some time, and in NW ADASS we’ve aimed to incorporate the ethos into our work. The Care Act itself provides a starting point for understand care and support, requiring local authorities to ‘consider the person’s own strengths and capabilities, and what support might be available from their wider support network or within the community to help’ in considering ‘what else other than the provision of care and support might assist the person in meeting the outcomes they want to achieve’. For adult social care assessment this means ‘an approach that looks at a person’s life holistically, considering their needs in the context of their skills, ambitions, and priorities’.
SCIE provide a useful set of resources for thinking about strengths-based approaches Strengths-based approaches - Care Act guidance | SCIE. This is all part of a movement in adult social care which explores changing the narrative, drawing upon the person’s strengths and assets and considering the relationship between people being supported and those providing care.
Kath explores strengths based approaches through five lenses.
Time is key and organisations might feel that there isn’t the capacity to change ways of working. However, an additional benefit of strengths-based approaches may be that in addition to supporting the person’s independence less formal care is required.
Community. Community is key and one of the central themes of our Care 2030 Strategy. We’re interested in new models of homecare which support teams to play a greater role in connected the person to the circles that exist in their community.
Technology Enabled Care. Technology is increasingly being used and in all our lives continues to be a disruptor, through the “internet of things”. How can technology complement people’s social lives?
Risk management. Ultimately people should be empowered to make decisions about their own lives. We’re interested in the connection between direct payments and strengths based approaches that lead to innovative ways of meeting assessed needs.
Commissioning. We’re planning to support our commissioners with learning sessions around strengths based commissioning. We recommend this comprehensive resource from the National Centre for Post-Qualifying Social Work and Professional Practice at Bournemouth University: Asset-Based Commissioning - NCPQSW.
Moving to a strengths based approach is complex and that’s why we need a systems approach if we’re serious about changing how we work. Strengths based leadership driving strengths based culture across multi disciplinary teams with what matters to the resident at its heart. I think of it like a pepper mill - we need to sprinkle strengths based on everything we do, constantly asking ourselves the question, does this support and enable a strengths based approach? I truly believe that if we are successful in implementing strengths based approaches to social care, it will go a long way towards addressing the current workforce pressures being experienced within the sector.
