Service Design in Government 2015, 19 th March, London

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1 Sarah Head of policy and Research at Derbyshire County Council Martha Head of Innovation Practice at Innovation Unit Ajo Service Designer at Innovation Unit Service Design in Government 2015, 19 th March, London

2 Thriving Families is a project about redesigning support for families with complex needs. We started our journey by talking to families, giving them a space to tell us their stories.

3 Alison s Story Think about How does the story make you feel? What s surprising? What questions does it raise?

4 Alison Alison Riley was referred to Thriving Families as a single person with rent arrears and no dependants. What we found when we went to visit her was a very different picture to the one we thought we knew.

5 Alison s sister stays most weekends with her three autistic sons. Alison s 14 year old grandson lives with her full time (unofficially) as he is treated badly by his stepfather.

6 Family Alison lives in a three bedroom house with her oldest grandson, James, and provides support for her mum who lives in a nursing home. Alison is currently unemployed, having been made redundant a year ago, but is actively looking for work. She also has ideas about setting up a business but doesn t know how to or who to speak to. I felt guilty about pu0ng mum in a nursing home Alison brings her elderly mother to the house in a wheelchair every day because she worries that the care home is understaffed and cannot properly meet her needs. Alison also provides respite care for her sister, Julie, who has three sons with autism. Julie and her sons live in Nottingham, but stay with Alison every weekend so Julie can visit her mum in the nursing home and Alison can help to look after the boys.

7 Money Alison receives 140 a fortnight to support her and James. However, because James is living with her unofficially, she pays bedroom tax of 40 a fortnight on two of the bedrooms in the house. After electricity, gas and telephone bills this leaves her with just under 40 a fortnight to live on. Alison is determined to keep her house as fewer bedrooms would mean her sister and nephews could no longer stay with her. She sees the tax as something she has consciously decided to pay, having weighed up the benefits to her family of spending time together. Alison has stopped going out with her friends as she can no longer afford it.

8 Health Alison needs an operation on her foot but is worried about the impact this would have on James and Liz. Alison doesn t have a car and, because she can t afford public transport, she walks everywhere. She walks to Liz s nursing home every day, some days takes her walks in the woods nearby. Alison also walks to Ilkeston to go shopping as she doesn t like the shops in Cotmanhay because she said she didn t feel comfortable using them. Alison is worried that her foot might get worse and get to a point where she is unable to walk at all.

9 Alison s Story Share with your neighbour How does the story make you feel? What s surprising? What questions does it raise?

10 What did this story make us think? We simply don t know enough about people s lives: their ambitions, their dreams, their struggles We make huge assumptions about what their lives are like and what they need We don t provide services in ways that support them

11 Why THRIVING FAMILIES?

12 Why Thriving Families? In Derbyshire almost 17% of children and young people under the age of 20 live in poverty. Families with multiple needs face underlying difficulties which combine to perpetuate disadvantage even further. The cost of families with complex needs is around 75,000 per family per year, most of which is spent in reaction to crisis. For many families this support is too little, too late.

13 The aims of the programme 1. Securing better outcomes for families with complex needs at less cost 2. Helping thriving families continue to thrive 3. Preventing families falling into crisis

14 Our commitments 1. Work collaboratively 2. Take a family-centred approach 3. Build on existing knowledge and insight 4. Challenge how the system works where appropriate 5. Active engagement of our senior leaders 6. Make things happen in our communities

15 A focus on four localities Areas where we can use and build on existing resources Gamesley Areas with strong existing networks to work with and build on Areas with diverse families, needs and aspirations Areas that require big structural issues to be tackled Shirebrook Danesmoor Cotmanhay

16 A partnership approach

17 About Innovation Unit We use innovation to build radically different public services with significantly better outcomes and significantly lower costs

18 Our design process NEW PERSPECTIVES ON THE CHALLENGE NEW PERSPECTIVES ON SOLUTIONS Discover Define Develop Deliver (Double Diamond Design Process, Design Council UK)

19 NEW PERSPECTIVES ON THE CHALLENGE

20 What we did I Ethnographic research In-depth qualitative research to learn about the needs, aspirations and assets of families in each locality. 33 families 50+ trained staff Learning from families Engaged families in a different way Engaging staff in a new process Exploring the need behind the need

21 What we did Resource mapping

22 What we did Co-design We spoke to families where they are to find out what they value in services and what kind of support works best for them. 35 families Building a shared mission + vision Talking about shared problems in a safe space Getting to the heart of what good support looks like

23 What we found out Cotmanhay Hyper-local existence Stigma of the area and its negative impact on the people living and working there Lack of confidence but a desire to do something / change something / leave Perception of Them and Us : local people vs service providers Lots of amazing people doing lots for others Gamesley Strong bonding capital and a desire to live in Gamesley, as close family as possible Low/modest aspirations Managing on a low budget, family members helping one another out in times of need A traditional work ethic but many people not in work a lack of skills or the wrong skills, transport problems

24 What do good services look like? Honesty, trust and open communication Ability to admit and explain mistakes Dependability and keeping promises Getting the basics right Connecting to the family: making families feel welcome Respect: taking time to listen Working together: with families, with each other Seeing the whole, not just parts of the picture Challenging what counts as normal Taking time to understand root problems

25 A new set of principles We need to be Always learning about families and communities, what works, how to do things better. Human. Prioritise building relationships, take time to listen and understand. A positive force for change in the lives of families and across communities. Proactive, not reactive.

26 We need to have Trust & honesty that works in both directions. Keep our promises. Be dependable. Admit mistakes. Be truly accountable. Practical & sustainable services, relationships and interactions that provide consistency and are of real benefit. Agility & flexibility to respond to changing circumstances and try new ways of doing things. Help families to have this too and support their transition points.

27 We need our services to Meet real needs and get the basics right. Build community capacity to be able to take ownership of and pride in its future. Focus on family outcomes above all else. Form alliances and work in partnership, with families and each other.

28 NEW PERSPECTIVES ON SOLUTIONS

29 What if services Were truly joined up, working together for co-designed, shared outcomes Focused on tackling core problems not treating symptoms Worked on a much longer timescale Were structured by area, becoming neighbourhood experts Had access to data and local knowledge Tried things out, even if they didn t work first time, and were honest about their mistakes Empowered front-line staff to take action Had time to really get to know a family and build up trust

30 What we made 8 ideas

31 What we did Prototyping We ve never been asked our opinion in this way before Cotmanhay resident at prototyping workshop 45 families Involving people with early ideas to learn what is most important for them Prototyping, not (yet) piloting A safe way to learn: fail early, fail fast

32 Prototyping Insights People only come into the system when they are defined as a problem and this deficit model is both damaging and unhelpful. Volunteering, helping and caring for others is not a just selfless good deed but forms supportive relationships and gives people a sense of purpose and community. People can become invisible to services: supporting others alone, struggling to cope, nowhere to go, isolated. Communities need an open, friendly space not dictated or overshadowed by individuals. Community groups need to be more visible and connected.

33 What we made 3 new models Integrated working between services CONNECTED TEAMS New relationship between services + community FOR COTMANHAY BY COTMANHAY Family-led support FAMILY TO FAMILY

34 What we re doing Implementing Building a business plan Gathering evidence & talking to people (families and council staff), looking at things we ve done in the past & why didn t it work Working together in new ways

35 FAMILY TO FAMILY Alison I spend all my time supporting family members through their difficulties but there s no-one to support me. Time and patience - to build trust and relationships EVERYONE NEEDS STAFF NEEDS More time for local staff to spend supporting volunteering and local action Informal group activities to build people s confidence EVERYONE NEEDS Sustained support for volunteering, which bring about a sense of purpose and community EVERYONE NEEDS EVERYONE NEEDS Community focused services, designed by local people Someone to show you how to do things, so you can then have a go yourself FAMILIES NEEDS The ability to access community assets EVERYONE NEEDS

36 FOR COTMANHAY BY COTMANHAY I want to set up my own business FAMILIES NEED A welcoming place where you can just go regardless of who you are, your age and what you are interested in. The right support to grow confidence and make things happen EVERYONE NEEDS FAMILIES NEED Good quality local intelligence about what works locally Alison A space to collaborate and test ideas with people who listen EVERYONE NEEDS STAFF NEEDS Time to get things off the ground and prove that change can happen! EVERYONE NEEDS A feeling of being a part of something amazing!

37 CONNECTED TEAMS My psychiatrist has always been there for me and my family. He knows our situation and has supported us through difficult times. Other support hasn t been right for me. People make assumptions. I don t fit into their boxes. Claire STAFF NEEDS Greater links with community, and tapping into local knowledge Better information and communication about what can help be accessed EVERYONE NEEDS FAMILIES NEED Services which tackle wholefamily/ community problems not just single issues or individuals FAMILIES NEED On-going contact after the support period has ended STAFF NEEDS Joint commissioning and procurement, based on the needs of people in Cotmanhay STAFF NEEDS Buy-in from senior officers and leaders

38 What next? Running the three service ideas/pilot from May Continuing the design process in three other localities Spreading the process to other council departments Looking for opportunities to join things up (HWB on social capital and health outcomes) Training up professionals: council staff and partners Finding new opportunities for local people to get involved Spreading the word!

39 Reflections

40 Reflections Disciplined process has been vital Having a critical friend (especially someone who is not as close as you are) Grabbing like-minded people when you find them and getting them interested and involved But recognising that you can t wait for absolutely everyone to get it Gathering evidence to reinforce the case for change Not giving up. Keep energy and not letting anything distract you Training members of staff to innovate to create sustainable innovation

41 What do we wish we d known before we started? I wish we d known how easy it was to do it Go and speak to people Go where people are How much ambition people have in the community and their ambition for things to change Having the belief that you can do this and that you are not alone I wish we d known how hard it would be to change It s a slow process there are quick wins but culture change takes a long time and can t be rushed You need determination and stamina Having council departments signed up and believing in the project

42 Reflections How could you use this approach in your own work? What are the barriers to doing this work?

43 Thank you! For more information on Thriving Families please contact: Martha Sarah Eaton,

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