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NHS Highland and The Highland Council - 2023

The challenge:

Is the way we are delivering SDS supporting people to live good lives across Highland?”  

NHS Highland and the Highland Council asked In Control Scotland to facilitate an ambitious 100-day self-evaluation of their practice against the SDS Framework of Standards.

Our approach:

Alastair and Pauline carried out an appreciative inquiry exercise, speaking to dozens of frontline practitioners, partner organisations, and interviewing supported people over the course of 100 days.

The inquiry started broadly, first ensuring we were asking the right question, and then looking across the whole system for areas that worked well, and those that needed attention. After the first in-person session, four areas were identified for further exploration:

  • Standard 6: Risk assessment

  • Standard 7: Flexible and outcome-focused commissioning

  • Standard 8: Worker autonomy

  • Standard 10: Early planning for transitions

 

Online sessions were then organised to unpick these topics in more detail, and learning was shared back to the project board as this progressed.

On the final day, a set of human learning systems experiments were designed, each seeking to test a hypothesis for a potential change in system or practice.

The learning:

There are a great many conflicts at play for practitioners that affect their ability to fully support people in a way that reflects best practice in SDS:

  • Eligibility criteria are often seen to be pitching needs against outcomes

  • Deficit based systems against asset based ideals

  • Professional judgement against rigid systems

  • Rural and urban inequities

  • The need for creativity against the demands of a bureaucracy

 

An overarching reflection was that the core purpose of social care is often diluted to become a transactional process of ‘assess to assist’, and this is where practitioners spend the majority of their time. Within this, there was a question to answer about how workers are invested in to advise, support, guide, and walk alongside people of all ages, needs, and abilities as a true partner in supporting them to live a fulfilled life, rather than concentrating on assessment, care planning and review.

 

What happened next:

In Control Scotland is supporting the two Highland organisations to implement these experiments, including a reframing of eligibility criteria and the role of social work, developing innovative commissioning and redesign of remote and rural localities, and supporting the development of worker autonomy.

If you would like to speak to us about a similar project get in touch: info@in-controlscotland.org.uk

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