Change is coming – are you ready! #changemakers

Update!!! Thanks to everyone involved for a fantastic #changemakers conference on 20th March 2014. Much more to come – but for a quick preview – see  http://storify.com/burcuborysik/a-story-of-changemakers-in-housing-with-support-an?utm_content=storify-pingback&utm_medium=sfy.co-twitter&utm_campaign=&utm_source=t.co&awesm=sfy.co_jeZB&dm_i=F3O,2AUYW,2EG23F,8CDOM,1

We are in serious countdown mode at Sitra – with less than 24 hours to go before our annual conference. http://www.sitra.org/training/free-sitra-annual-conference-2014-change-makers/

The theme of the event is #changemakers – and I am excited that we have gathered together a programme representing some of the most exciting thinkers and doers – not just on the podium – but in the audience too.

However, this blog is not intended as a spoiler! I have seen enough of the coverage of George Osborne’s budget to not wish the #notnewnews tag to be applied to our conference programme!

However, there is a real challenge to understand how positive change continues to happen within a sector significantly impacted by austerity, welfare reform and a shifting commissioning base.

I have been looking with great interest at the work being carried out within the NHS – particularly around #nhschangeday. We could do a lot worse than look at the leadership approach being advocated by Helen Bevan – and I am very interested in her perspective around how change happens, and how we need to build up our sector ‘rebels’ and ‘boatrockers’. (http://www.slideshare.net/NHSIQ/better-care-fund-helen-bevan)

I really like her graphic as to how we plan for change ……. and how change happens.

change

I know that the conference will inspire me as we clamber up the hills of change to ‘keep on trucking’. The sector has a long tradition of innovation and change, and I hope that the day will recharge, inspire, delight and create change in equal measures. I look forward to seeing you tomorrow – or to you joining us throughout the day under the umbrella of #changemakers.

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Pulling Together – Coproduction in Action

At the end of January we brought together a fantastic group of clients, front line workers and organisation leaders to celebrate the launch of Pulling Together. If you haven’t had a chance to check out this great resource – then visit www.pullingtogether.org.uk

The Pulling Together website provides you with up to date materials on the following areas of welfare reform:-

The Work Programme

Personal Independence Payments

Resettlement for Under 35’s

Universal Credit

The site also includes FREE training resources including lesson plans, presentations, exercises, links to broader resources and a guide to the co production and co delivery of courses.

Critically all the training resources were co produced in a unique partnership between Sitra and SHP– working with Sitra coproduction experts, and our welfare benefits trainers – and SHP frontline staff and clients. This means that what you get in the training is not just what the ‘experts’ say – but rather – what the clients and front line staff think is essential that you know – and using their experiences and voices throughout the training.

This exciting collaboration really comes to life if you take a look at this clip about what it felt like to be involved in the co production process.

SHP  have been enthusiastically putting the resources to use – working on sessions for front line staff, for clients as part of internal meetings and training sessions and on a one to one basis using exercises or information from the training to support key working session.

The project was supported by the London Housing Foundation – who are self declared funders of ‘great ideas’. We are delighted that they took this initiative on board and help us bring it into focus.

I really hope that you find the materials useful – and we are keen to get your feedback on what works for you – and how you have used them. We are committed to keeping the resources and the wider web upto date – so let us know if you develop anything that you would like us to share.

In the face of all the changes going on – we hope that this ‘pulls together’ much of what you will need!

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Still time to make some noise…….

It will be no news to those of you in the housing sector how critical housing related support services are being cut in some areas of the country. It is something we have been covering at Sitra through our work with individual members, commissioners and central government. Whilst it is well known that housing related support, alongside a wide range of public services, has experienced cuts at a local level over recent years – the scale and breadth of recently proposed cuts to services is of great significance. There are a large numbers of authorities who are out to consultation on their budgets and will be voting on decisions this week. Here is snapshot of what is happening out there:

Nottinghamshire County Council – Services in Nottinghamshire have already been significantly cut since 2011, and the latest budget proposal presents an additional 35% cut of the remaining funding. If the budget goes through, the remaining services will only be able to focus on the narrowest set of clients that may include some services for  people with mental health problems, vulnerable younger adults, women escaping domestic violence and short term support for older people to tackle isolation. However to continue to fund these services, they are proposing a cut to all drug and alcohol accommodation services, offender accommodation services, homelessness preventative floating support and move on. Framework provides detailed information about these proposed cuts and a call for support through their Think Again campaign.

Worcestershire County Council – Their current consultation proposes cutting spend on preventative services from over £15m to £6.5m. It includes proposals to cut substance misuse services by 75%, older peoples support services by 50%, over 70% cuts to services for people with learning disabilities and the complete removal of housing related support funding for services for ex offenders.

Derby City Council – Proposing a cut of £2m, having cut by over £2m last year. This will reduce their overall spend on Supporting People by over 70% in a two year period. Details of proposals are outlined here.

Torbay Council – Proposing a cut of £3.2m to housing related support services. Including 100% cut to services which include Integrated families, Criminal Justice Accommodation Services and sheltered housing. In addition there is a proposal to cut 100% of the funding to the Employment Support service for people with disabilities. Information about the Torbay proposals can be found here.

London and the South East – In a recent survey of commissioning priorities across this area carried out by Sitra, we identified further evidence of trends in commissioning where ongoing cuts serve to undermine large swathes of the positive focus on preventative services delivered through the vision of the Supporting People programme, and underpinning the future visions for a preventative focus within communities inherent in the Care Bill. A summary of this research can be found here.

Local members are busy on the ground campaigning against the cuts, whilst some authorities are busy continuing to champion the cause of preventative services.

If you are part of that group making the case – then we hope that a reminder of some of these resources might be helpful:-

Outcomes – Housing related support has a detailed and robust outcomes framework, which measures the outcomes as defined by the individual service user. The outcomes have been collected since 2007 by St Andrews University, and approximately two thirds of local authorities continue to collect this information and submit it to St Andrews. The outcomes have also been mapped across to a range of other public outcomes frameworks – as shown for example in this Sitra factsheet on Older People.

Data – In summer 2013 Sitra gathered together data from a range of authorities across England. This data brings together performance data around cost of services, alongside performance indicators and housing related support data. The data is combined in a tool which enables the benchmarking of authority spend against different client groups, types of provision and outcomes collected by St Andrews. The full set of data can be found here.

Cost Benefit Analysis – although the bulk of this research was carried out in 2009, this continues to be used to provide a robust argument at a local level. This research provides a detailed set of counterfactuals which support the argument for investing in preventative support.

 Case studies and influencing votes – Organisations have many fantastic case studies, and this is an opportunity to ensure that those voting on the decisions at a local level are fully aware of what the services they are considering deliver the individuals and the wider community. Some example case studies can be found here and a useful way to argue the case with councillors can be found here. 

This is a critical decision week for many services around the country.

 It is very important that everyone with an opportunity to add their voice to secure preventative housing related support services does so now.

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What difference does a name make…….#support #resilience #prevention??

Have spent a great morning with members in the South West today – talking about key policy areas for the sector and continuing our focus on the health and social care. I was delighted to be joined by Robin Johnson, who I left this afternoon leading members through a masterclass in Psychologically Informed Environments. 

However, and I need to choose my words carefully here, members of ‘the sector’ were raising the challenge of what we now call the ‘sector’. I was seeking to explain to University colleagues and health commissioners present in the audience what we understood to be housing related support. I was firmly told by some members that this is no longer how they refer to their services, and actively discourage staff from ‘looking back’ to the old SP definitions and descriptions of the work that they do.

So – what do they now call their services – and how do they differ from what they were offering 4-5 years ago. It does seem that some of the key is in the name – services now being described in terms of their role in the community, their focus on wellbeing, their contribution to resilience and their success around prevention. Some even went as far as to say that they were discouraging the connection with housing – not wanting to make the link explicit.

So where does this leave the services they offer – and how do they distinguish themselves from other community based services offering similar resilience based approaches. How does a support worker offering advice around financial management differentiate themselves from an outreach Money Advice worker? How does a support worker offering support to engage with community activities differ from a befriending service? Surely the key difference is that these activities are being carried out with the sole purpose of ensuring the client has sufficient support to enable them to remain in their home?

I think that members are probably in tune with raising the question of how we brand the work that we do – and that this may be yet another nod to the pervasive influence of localism. What floats the boat of resilience in the SW, may be staunchly anchored to the post of housing related support in the WM. However, I think breaking the link between the work we do and ensuring client stay housed will serve us badly. If we are to continue to push for housing to be recognised as having a central role in the health and wellbeing of individuals, in the prevention of entry into more acute services and the key to remaining independent and being able to contribute actively to the community then we need to shout out about our connection with housing. If local authorities will no longer pay for housing support, then we may need to convince health commissioners to pay for wellbeing support – but they need to understand that the wellbeing comes from being supported to remain independent and critically ‘at home’ (wherever that may be).

 What do you think? What do you now call the work that you do?

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Final Chapter – Ukraine 2013

After a long and eventful night on the train – we arrived – at 8.00am precisely – in the port of Odessa. We were met by Father Jan, who was to take us out towards the Daughters house out by the Black Sea. We drove past a long boulevard of houses, all of which looked as if they had gone up in the last 5-10 years – which were the holiday homes of Russians wanting a vacation by the Black Sea.

The Daughters of St Vincent  provided the most amazing hospitality, a shower and a chance to revive after the long journey – and I began to fully understand the connection between how the DePaul services operate in partnership with the catholic community in Ukraine. The nuns that we met were to reappear later in the day, administering medication and support to the homeless men and women of Odessa. They had received full medical training as nurses or social workers, and then dedicated their life to serve under the order of St Vincent, which has charity as a calling.

We then went to visit the day centre which had been established in Odessa over the last two years. Based in a residential cul de sac, the day centre provides facilities for twelve (maximum sixteen) homeless people a day. Because of the location, it is not possible for people to come to the centre directly, and so people are identified on the basis of highest need, at the food and medical station in the heart of the city, and then driven directly to the centre.  They have one day a week which is women only, and women are able to come and get clothes, have a shower, get a haircut and have vital medical help. There are lots of medical challenges, partly because the hospital service won’t respond sometimes to medical emergencies for clients because of their inability to pay. The sisters of charity support the project, and are trained nurses and social workers, so come to the centre every day to support the staff and provide vital medical help. Many of the clients have terrible wounds, often from dog bites.  The weather conditions mean that in the summer, clients are suffering from sun burn and dehydration from heat, and in winter, the extreme cold runs risks of frost bite.

One of the key services on offer in the day centre is centred around the recurring theme of lack of ID. The centre works with the clients around the issue of document recovery – to support people to reclaim their id papers.

There is a Government shelter is in the city – and de Depaul can refer people directly to the shelter. People can stay in the shelter for one month for free, and then can stay on with 150 grevna per month. Those who stay there can take a shower, clothes etc…. The precise size of the homeless population is unknown, but the fact that DePaul has worked with over 4000 unique individuals at the feeding station over the last 2 years provides an indication of the scale. Because of this, access to the day centre, and the showers, clothing, support that it offers is rationed to once every three weeks – prioritised very much on the basis of need.

Interesting parallels with UK homeless provision emerged in discussions with the staff at the day centre. They had identified that there were two very distinct groups of homelessness, those who are long term homeless, and those who are new to the street. Much like the current UK focus on ‘No second night out’ they were seeking to work as priority and as quickly as possible with those new to the street. They recognised that this was the most effective work and have been engaged in some really successful mediation with Depaul brokering a connection and sending people home to their own city. Odessa, partly because of its geographical location, and because of port status does attract a lot of people from other cities and countries – hoping to find work

Our final destination was to the mobile feeding and medical centre. This usually took the form of a large single decker bus, providing some dry space for medical support and to talk with those new to the service. On this day, the bus was not available (a long and enlightening story!) but the service was still on offer from a much smaller van. We found the van parked up in a park very near the station and surrounded by roads leading off from the station.  60 or 70 come to this site every day. – and twice a week go to another market as well where they might see an additional 70 people. At least 30 people get medical attention at the bus.  Because the bus was unavailable – medical support was being offered next to the van – and whilst the best efforts were made to maintain some dignity, the van was parked by the roadside, on a busy thoroughfare. Critical interventions being made, but in far from ideal settings.  I spent some time talking to the guys coming to the feeding and medical centre, and it is clear that this service represents an absolute life line.

Our final discussions were around what longer term provision the city needed. There are high hopes that in the near future there will be an opportunity to develop a purpose built centre to provide the critical medical support, and those services offered by the day centre. This would be a fantastic step forward for those living on the streets in Odessa. The commitment and energy of those providing support has been quite overwhelming, and to date – there has been huge amounts of evidence to show that Depaul and those working within the community to support their services have not only a strong and clear vision – but also a very significant track record of bringing vision into reality.  The London Housing Foundation funding has played a small part in supporting this work, and I feel privileged to have been party to some of those decisions, and inspired to think – what next?

 

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Day 2 – Riding the night train…..

Day two – moving towards Odessa We are now on the move to Odessa – 14 hours over night – sharing tales of our lives, dreams for the projects that work with, and enjoying an opportunity to debate and discuss.

Today – we visited the deputy mayor of Kharkiv with portfolio responsibility for social services. She presented an opportunity to hear about how the government views the homeless population, and how it views the solutions available, and the vision for the future. The prevailing theme around access to services without upto date ID remained. We then moved on to visit the feeding station in Kharkiv – where Sergei was in control and managing the service. (we had met him last night at the shelter). There were about 30 people at the feeding station, and the rain had stopped a lot of people coming out. On some occasions there can be up to 90 plus people attending the feeding station. Depaul provides everyone with a ‘one use’ cup for their soup and bread – but many are coming with their own units to take away additional portions of soup for others that they are connected with. The mother and baby unit was the next project we went to see – and this was a project that some members of party had visited almost 5 years before. Sister Renata had shared a vision of how the projct should be some 5 years ago – and now, returning to the project, some years on – the vision had come to life. This most amazing project provided a roof over head for women and their babies and young children. Women were provided with support, therapy, counselling, skills development and an opportunity to learn essential skills to help them live independently in the future. Sister Renata and her compatriot Sister Camilla lived onsite, and Victoria and Anya provided the daily connection with the women. Once again the issues of supporting women, many who had left orphanages, to regain ID and to get future support for themselves and their children. Victoria said they were looking for a name for the house – and the best option so far – the house of Hope. I like it. So – we head onto the train to Odessa – and so the night unravels…….

 

 

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Ukraine – day 1 draws to a close….

Day 1 draws to a close  – and we have spent the afternoon visiting schemes across Kharkiv. The first was an amazing children’s centre, that had been set up specifically to deal with the issue of street kids. When it started over 7 years ago, there were anything up to 50 street children at a time requiring support from the centre. Since then, there has been a number of policy changes, which has increased the level of fostering within the Ukraine, and has reduced sigfnificantly both the number of children in orphanages, and also the number of children who were living on the streets.  With some very honest discussions within the project, there was a strong recognition of the celebration that this reduction has caused, but also a recognition that the offer from the centre had to change to recognise the change in potential clients.

 

When we arrived at the centre we were greeted by bouncy 8 year olds, fresh from working with a great team of student volunteers – who had been running arts, crafts and sports activities. The centre included a good range of access to counselling, advice and importantly a safe and secure space for children and young people to attend up to three days a week. However, in the absence of street kids, who were the children who were still using the service? The social work leading the project, Alyanna, recognised the need being driven by families in crisis. Through a positive relationship with social care teams, families at risk were identified and children referred direct to the centre. There they are provided with skills to develop resilience, connection across communities and an opportunity for social workers to work through a preventative strategy to support them within their family unit.

 

We then followed the DePaul team over to the government shelter – over in the East of the city. There, in a building and land gifted by the city, was the only direct access provision available. The team of DePaul volunteers were involved in providing hot food and support to those using the shelter, which was divided into emergency provision, and provision for those who stayed for longer periods whilst receiving support, particularly those who had recently left prison. We are here during a surprisingly mild period, and I can only imagine the pressure on the service when the temperature drops to -35. The centre has only been open for three years, and as each winter passes the demand for services grows exponentially. Last winter as the temperature dropped, there were over 100 seeking shelter each night. When they were groaning at the seams, people were still turning up, recognising that they wouldn’t get a bed, but asking still just to come in and stand for the night.

 

Staff talked extensively about their work linked to helping residents to regain critical identification papers, without which access to other services, resources, accommodation or work are out of the question.  This is a particular issue for anyone who has had stays in prison, or for those with a physical disability. The work to regain ID’s is tortuous, but the centre is developing expertise in understanding the different pathways to help residents regain their identity and there was a huge commitment and skill base within the group of those offering this critical role.

 As ever, the stories of those who are homeless are the glue to any service. We had a chance to talk with Juraj, who was the first ever resident of the government shelter. His need for a roof over his head was paramount, and the security and support it had provided had changed his life. He had spent many years in an orphanage and on leaving had fairly quickly gone into the prison system. The shelter provided a way out of that pattern, and he was now in a position where he had stability in his life, was able to work, but not yet in a position to have enough money to move into independent accommodation. There is no straightforward pathway, halfway house or move on available, so the gulf between where he is now and where he wants to be remains significant. It is clear that he is well loved and supported in the centre – but also that whilst he values that – his next stated ambition is a family he can call his own – and that he has chosen for himself.

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