martin routledge: community circles · 2019-11-07 · martin routledge tweet us @c_circles • •...

Being Really Outstanding

Martin Routledge: Community Circles

http://www.community-circles.co.uk

http://www.community-circles.co.uk/wp-login.php

Martin Routledge

Tweet us @C_Circles • www.community-circles.co.uk

• Social worker, 20 years local government, third sector

• DH delivery lead for Putting People First, NHSE Head of Person Centred Care, Director TLAP, Coalition for Collaborative Care

• Leading Community Circles• Convenor #socialcarefuture• Advisor to In Control, GM Person and

Community Centred Approaches programme, Independent Living Strategy Group, Power to Change

• Board member Think Local Act Personal (TLAP), Imagine Act Succeed


• What do people and families (and CQC..) value? • Checking and growing your community links &

personalisation • Making the best of your resources to help people

& families with what’s really important to them • Practical approaches to help you to access and

make the best of all the assets in your community and your service

• Focus on residential & extra care, wider relevance

Today

What do we want?


We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us


• 350k people living in nursing or residential care homes in England. Almost all with complex needs and 70% with dementia

• Policy, commissions etc. call for them to receive personalised care offering dignity and supporting wellbeing for them and their families

• Doing this in a collective setting faces many challenges

• Research explored how personalisation is “conceptualised”, the approaches being tried and the barriers and facilitators

Ettelt, Damant, Perkins, Williams, Wittenberg (PIRU forthcoming)

Personalization & care homes forthcoming research


How do managers think about person centred care?

• Different metaphors to illustrate their understanding and ambition for

personalisation

• ..evoked the image of the “institution” to describe the type of depersonalised,

routinised care that they wished to distance themselves from.

• ..some conceded that there were elements of task orientation and routinisation

that they felt were necessary and defensible

• ..the “family home” was the most popular image used...emphasised close,

trusting relationships between staff and residents and an aspiration of treating

everyone as equals. Many spoke about offering activities that are typically

associated with the domestic home such as participation is household tasks or

celebration of family occasions

• Offering a “home like” environment was not incompatible with enabling choices

for residents, but these choices needed to be embedded in the communal

context of the home


How do managers think about person centred care?

• Other managers tended to liken their home to a “hotel”

emphasising individual choice and a customer service orientation

that they tried to instil in their staff

• This was expressed, for example, by emulating “hotel style”

practices, such as presenting the dining room as a restaurant in

which residents choose their meals from a menu and referring to

residents as “clients” or customers”.

• However it was not always clear whether such renaming made a

material difference; the range of choices are unlikely to be much

different from “family” type of homes

• The “hotel style” home was also associated with the premium

sector of the market..”

Approaches to personalise


3 levels in studies:

• The individual• The care relationship (majority in literature)• The care home as an organisation (culture

change movement)

Only a few focussed on people themselves

Approaches to personalise


CQC:• Care home reports by the CQC highlighted the importance of the

role of care home manager for promoting personalisation by ensuring staff that were capable, empowered and enabled to provide personalised care to residents

• Reports commented on various forms of decision making, user led shared and practitioner led, as an approach to implement personalisation for people with varying levels of cognitive ability

• These linked satisfaction of care with shared decision making, where residents and family members who were involved in decision making were more likely to be satisfied with their care

Barriers and facilitators


• At individual level – especially complexity of care needs

• At level of the care relationship, such as attitudes, competency and capacity of staff

• The organisational context including management and leadership

• Wider societal context


• My Home Life https://myhomelife.org.uk/• SCIE planning tool – Improving Personalisation in Care Homes

https://www.scie.org.uk/news/mediareleases/personalisation-care-homes

• Making it Real https://www.thinklocalactpersonal.org.uk/makingitreal/

• Time to Connect https://www.ndti.org.uk/about-us/what-we-do/demonstration-projects/time-to-connect/

• Progess for Providers https://progressforproviders.org/checklists/delivering-personalised-support-for-people-living-with-dementia/

Range of support approaches

https://myhomelife.org.uk/

https://www.scie.org.uk/news/mediareleases/personalisation-care-homes

https://www.thinklocalactpersonal.org.uk/makingitreal/

https://www.ndti.org.uk/about-us/what-we-do/demonstration-projects/time-to-connect/

https://progressforproviders.org/checklists/delivering-personalised-support-for-people-living-with-dementia/

I statements

What good personalised care and support looks like if it is working well

We statements

What organisations and their people need to do to make sure actual experience lives up to the I Statements

Who can and should do what? Example of Wigan


• Wigan Deal• Age Well programme (with CCG)• Key staff & infrastructure support

(Quality, Knowledge officers)• Grant programme to support

wellbeing & health in care homes and extra care

• Care homes & support provider responsibilities

• One approach – Community Circles

Embedding Community Circles

A practical resourcehttps://www.dropbox.com/s/3gp83w8265edmho/CC%20E%20Resource%20linked%20FINAL.pdf?dl=0


How Community Circles work


What can Community Circles help with?

• Building or regaining connections in your

community

• Developing interests

• Planning and managing change in your life

• Bringing more people into your life

Can be short or long term


How do Circles work?• Connectors recruit, train, match and support

volunteer facilitators who help the Circle come

together, share ideas, develop actions and check

progress

• Family, friends, neighbours and others make up

the Circle

• Circles meet, chat, plan, help make things that the

person at the centre wants, happen,

BUT The approach is flexible and is often adjusted to

circumstances

Essence of a Community Circle


• Circles are facilitated by volunteers and bring

together family, friends, staff and community

members around a person

• A Circle is based on what matters to the person

• The person is at the centre of their Circle, with those

who love and care for them, supported by a

volunteer

• Everyone has something to contribute

• Circles help people feel more connected, Circles

make changes

• Circles use tools and ways of recording information

to support the conversation

Depth and breadth approach


Community Circles began

working initially with three

care homes, coaching a the

home and key staff member

through the process of

developing Circles

Care Homes


Care Home Hubs


Supporting a group

of care homes in a

geographical hub,

coaching and

mentoring staff to

develop and embed

Circles, to map and

access community

opportunities and

share ideas and

resources


• Purpose poster

• Relationship Map

• What’s working/What’s not working

• Four plus One Questions – tried, learned,

pleased about, concerned about?

• Perfect Week

• Community Map

Person Centred thinking tools


Purpose Poster

No such

thing as a

silly

question

Have fun

together

Keep in

touch via

our What’s

App group

Cath – facilitator

Donna –

hospitality

Kath - recorder

To keep Arthur

involved with DIY

and have social

time with family

and friends

Relationship Map


Margaret

Family

Friends

Paid

SupportCommunity

Son Lee

Sons David, Sean and John

Care

home

staff

Danielle

volunteer

People

from

church

Alan and

Brenda

People at

Rugby

Memories

Network

Mapping

Family and Friends Community Life

Work and Learning Community Groups

Easy to get to location

Need a ride distance


Community Mapping

Community mapping is a

process where participants

make a map or inventory of

the resources, skills and

talents of individuals,

associations and

organisations

Who knows who?

Who know what?


Key Learning

• Care home and extra care

context

• Connector roles

• Key service staff roles

• Partnership with the council

• Volunteers

• Communication

• Community Connections

• Sustainability


Where can Circles work?

Wherever people are looking for a way of helping people achieve, connection, inclusion, purpose – for themselves or others

• Families

• Community and voluntary groups, including faith groups

• Local charity services

• Support provider organisations

Can combine well will other ways of supporting people to connect and flourish – exploring alignment with Keyring, Shared Lives, Timebanks, Wellbeing Teams

Staying in touch with Community Circles


• We share free materials, you can become a member,

join our community of practice

• Twitter: @C_Circles

• Facebook: Community Circles

• Website: www.community-circles.co.uk

http://www.community-circles.co.uk/

martin routledge: community circles · 2019-11-07 · martin routledge tweet us @c_circles • •...

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