Changing culture, behaviour and practice in Adult Social Care to deliver better outcomes
Lincolnshire County Council (LCC) began working with IMPOWER in mid-2020 to identify opportunities to improve outcomes and maximise independence for individuals across the care pathway, through delivery of the right interventions and approaches.
The potential impact of the pandemic on demand and costs, combined with a lack of clarity over future funding, created an uncertain picture for the future. Adult Care in Lincolnshire had been recognised as a strong performer across some areas, but they recognised the need to prepare for future challenges – and had an ambition of moving from ‘good to great’.
IMPOWER completed analysis of demand across the adult care journey:
This work demonstrated the opportunity to change culture and behaviour across the service – within operational teams and among partners, and to establish a system-wide focus on supporting individuals to maximise their independence.
IMPOWER supported Adult Care to develop a new vision and ambition with a focus on supporting people to ‘stay as healthy, safe and independent as possible during all stages of their life’. To deliver on this ambition, using IMPOWER’s EDGEWORK® approach, a programme of work was launched with a focus on changing culture, practice and ways of working. This ranged from reframing digital information, advice and guidance to promote independence, through to embedding strengths-based approaches in practice by empowering practitioners to work differently.
The work began in September 2020 with a trial intervention in the ‘front door’ to Adult Social Care – the customer service centre (CSC) delivered by a commissioned partner (Serco). IMPOWER worked with the service’s staff to shift the focus of their conversations towards recognition of an individual’s strengths, and the opportunity to resolve issues at the first point of contact through a strengths-based approach and using applied behavioural science techniques.
In this initial phase IMPOWER also worked with a mixed team of Learning Disability and Mental Health practitioners to develop and apply strengths-based approaches to annual review conservations, supporting teams to co-design approaches and tools. The teams involved in this work supported each other to embed a shift in practice through regular peer support and challenge in ‘huddles’ – now incorporated into the way teams operate.
Following the success of these trials IMPOWER and LCC worked with a wide range of frontline teams across the care pathway to embed strengths-based approaches in practice and ways of working, aiming to maximise independence and improve outcomes for individuals. This work also included:
Through scaling successful approaches and interventions across the Adult Care and Community Wellbeing (ACCW) service and care pathway, this programme has delivered demonstrable impact on outcomes, demand, practice and behaviour at a system level:
These system-level achievements built upon impact demonstrated through a range of interventions trialled and evaluated in the initial phase of the programme:
In addition to delivering impact for individuals, IMPOWER have supported LCC to create a more resilient system, that is responsive to changes in demand across the care pathway. Key to this has been IMPOWER working in partnership with teams in Adult Care to build the knowledge, skills and capability to deliver and scale successful interventions and approaches, and to deliver continuous improvement in Lincolnshire. This has included:
In Autumn 2021, LCC and its key partners recognised the opportunity for applying the learning from this programme to support a system-wide focus on maximising independence across the health and care system. IMPOWER are now supporting multi-disciplinary teams in acute hospital settings to trial interventions using a strengths-based approach and applied behavioural science – to improve outcomes and support more individuals to return home with the right support, and to prevent admission to hospital.
Get in touch if you’d like to discuss the challenges your organisation is facing.
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