Empower and Enable

A people led approach to support planning

Empower and Enable A people led approach to support planning

Simon Stockton, Sam Bennett and Helen Sanderson

Making great support planning possible for everyone

I think the Empower and Enable model is absolutely fabulous. Its been a long time coming and I embrace it wholeheartedly.
Irene Davies, Parent Carer

Contents

Contents
About Groundswell Partnership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The Empower and Enable approach Introducing Empower and Enable
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 5

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

How the model works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Making a commitment to work differently . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Buliding peoples capacity
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Starting early and keeping it simple . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Making it worth the effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Helping people do it their way . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Giving people Time to think . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Keeping the plan alive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Helping good practice to grow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 What should a good plan look like?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Why you should consider adopting Empower and Enable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

13

Putting the model into practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Get in touch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

EmpowEr and EnablE | A people led ApproAch to support plAnning

About Groundswell Partnership

About Groundswell Partnership

Groundswell Partnership works with health and social care organisations to transform support and improve peoples lives. We are a partnership between Bennett & Stockton Ltd and Helen Sanderson Associates (H S A) comprising Sam Bennett, Helen Sanderson and Simon Stockton as Directors and a small team of associates. We are working to support sustainable change in organisations through personalisation and community-based support and are committed to sharing our learning and spreading innovation across the sector. We have learned a lot about new approaches to support planning through our extensive work in the field over the last few years, including through recent work for the Think Local, Act Personal Partnership and with Councils and User Led Organisations. This paper sets out our learning so far, describes the case for change and explores what should happen next to take make great support planning available to everyone.

EmpowEr and EnablE | A people led ApproAch to support plAnning

Introduction

Introduction
Good Support Planning is critical to personalisation. At its best provides just the right amount of space, support and encouragement for people to think creatively about how to use the resources available to them to maximum effect and in doing so it increases peoples experience of choice and control.
At the time of writing, In Control, Shared Lives Plus, Community Catalysts and Inclusive Neighbourhoods have just published a joint paper arguing that support planning should be a universally available service and should build on peoples own skills and assets to lead the planning process rather than relying on professionals. We agree with this analysis and we think the model described in this paper offers a means to make this happen which is cost effective, sustainable and truly empowering. Good support planning is not only an essential component for people using personal budgets it is also good preventative practice for people with support needs who might fall outside local Fair Access to Care thresholds for support. This short paper explores the question of what it would take to make really good asset based support planning simple and universal. It builds on the work which Groundswell Partnership carried out in developing the Think Local Act Personal guidance Rethinking Support Planning in 2011 and looks at the practical steps which providers and councils need to take to demystify the planning process and make good support planning achievable and affordable. We call this approach Empower and Enable.

EmpowEr and EnablE | A people led ApproAch to support plAnning

The Empower and Enable approach

The Empower and Enable approach

Good support planning means people need to have plans which they can evolve at their own pace, which give them flexibility to use resources in innovative ways and use paid support effectively alongside natural supports as active partners and active citizens. In order to be meaningful, the process of planning needs to help people explore how to achieve the things that are important to them and to stay safe at the same time. Unfortunately, such planning is often considered time intensive, expensive and unrealistic in the current financial climate, leading many people to feel that against a backdrop of diminishing resources and alongside the protocols and processes that local authorities are duty-bound to enforce such aims for support planning are doomed to failure. We believe there is another way. We think that by changing our ideas about whats possible, by making support planning simple and accessible, and by engaging people in the right way, we can build on the gifts, skills and talents that people and families have to create plans that are real and meaningful. At the same time we believe such an approach can significantly reduce peoples dependence on professional support for its own sake and save precious resources. Empower and Enable is a people led approach to support planning. To achieve it we need to build support proportionately around people in ways that inspire and encourage them to take control of the process. Making this happen requires councils and support organisations to work together and work differently. If we can create a space together to make great support planning happen like this then we have a really good chance of making personalisation meaningful for everyone.

EmpowEr and EnablE | A people led ApproAch to support plAnning

Introducing Empower and Enable

Introducing Empower and Enable

A good way to explain how the Empower and Enable model of support planning works is to start by talking about something that is much more familiar to us, something that everyone understands, like the process of choosing and booking a holiday.

1. Introducing Empower and Enable

Not that many years ago, travel agents were busy people with large offices and waiting areas full of glossy brochures, where people came to see experts to arrange the best holiday possible. Whether you wanted two weeks on a sunny beach in a far-flung place, a weekend city break, or a camping trip in the lakes, travel agents were the first destination you needed to go to plan your trip. But things in the holiday business have moved on. Now you dont need to go to a travel agent to get ideas about where to go, how to get there, where to stay and what to do when youre there. Now, information about how to make the best holiday for yourself is everywhere, on the web, on the TV, in specialist travel magazines and in

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

newspaper supplements and once youve chosen your holiday, you can book some or all of it quickly and easily yourself, without ever needing to visit a high street. Of course some people do still visit a travel agent, but those that choose to, do so in the knowledge that this is one option amongst many for arranging the ideal break. We think Support planning should be as easy and as democratic as booking a holiday is for people now. It should be something people choose how to do, in a way that reflects their individual tastes and sensibilities, getting the information that they need easily from a range of sources. Over recent years the numbers of people choosing and booking holidays for themselves has grown as information and booking processes have opened up. Likewise with support planning, if we make the process simpler encouraging and open for people to try out for themselves, over time and step by step, people will do more for themselves and rely less on expert professionals. This is the simple but powerful idea behind Empower and Enable.

How the model works

Making a commitment to work differently
The number of hours we can spend on one to one support planning is tight but thats a good thing because it means we have to be creative. People are really up for this approach and really excited by the prospect of making this work. From a pragmatic and value based perspective our staff want to use Empower and Enable.
JEnny PiTTS non ExEc dirEcTor PEoPlE for PEoPlE

The real power of Empower and Enable is in its ability to work as a universal approach to support planning. It is not about working with a small number of people who can be persuaded to do DIY planning taking on the whole process for themselves, it is about changing our whole approach to support planning in a way that can work for everyone. Adopting the Empower and Enable model as a default approach allows us to overturn unhelpful and costly assumptions that people

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

need professional support for most or all of the process. We should be aiming for a position where people need a little rather than a lot of support and where that support is simple and easy to access and gives people the confidence to make their own plans.

Buliding peoples capacity

We dont need professionals in our lives all the time. Disabled people should be the ones leading the process not the other way around
lorrainE GradWEll cEo BrEakTHrouGH uk

We cannot expect people to direct their own support if we disempower them at the first stage of developing their support plan. We need to enable people to believe that they can direct their own support and this should involve developing their support plan. Making sure that people who introduce the idea of support planning believe in peoples capabilities to plan for themselves and starting conversations in the right way, is the most important step we can take to developing an empowering and enabling approach. Where people have limited capacity, the focus should be on finding ways to engage people who know and care for the person in planning and keeping the process as close to the individual as possible. This may inevitably require more professional input, but the key aim should remain not to over-support people.

Starting early and keeping it simple

The current process is too disjointed and professionally top heavy. Support planning needs to start much further back in the customer journey and link up all the way through.
david clayTon; dErBy ciTy council, SEnior PracTiTionEr oldEr PErSonS SErvicE

Derby are working towards a one-page sign off sheet which they can share with people up front so that people know what information is required of them and understand this as distinct from the task of creating their own plan. If processes are clearly explained early on in this way then people are much more likely to feel willing to take hold of support planning for themselves. This in turn makes it easier for staff to introduce the idea of planning, what it is, how people can be

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

involved in leading the process, how other people have made their plans, and the different ways people can be supported to create a plan.

Making it worth the effort

If its meant to be my plan, then I want to do it my way not have someone dictate to me how I need to do it
PErSonal BudGET rEciPiEnT and SuPPorT PlannEr

A good plan should feel useful and realistic. It doesnt need to be a huge undertaking or highly detailed. People need to understand and believe in the benefits of making a plan. The main trap to avoid is making the plan something which is focused on providing the information needed for signing off a budget. This should be considered separately. Information for sign off may fall out of the planning process but it is not what the plan is for.

Helping people do it their way

Some people might do all of the plan themselves but equally it could be about people doing some of the parts for themselves and understanding they can get tailored help for the parts they want support with rather than having someone else lead the whole process.
david clayTon, dErBy ciTy council, SEnior PracTiTionEr oldEr PErSonS SErvicE

People approach new things in different ways, and we need to understand how best to work with people in order to engage them really well. Some people might prefer to follow a simple step-by-step approach where everything is explained simply and all you need to do is follow the order of tasks set out for you. For people who like planning in this way the following guide to support planning might be a useful starting point. www.supportplanning.org Other people might prefer a looser way of working, where they are given some rough guidelines, and let loose to be creative. For people who like working in this way, the following tools may be a good way to start.

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

Tools to help you with your support plan: www.bit.ly/hsa-infocards A Support Planning Graphic Template: www.bit.ly/hsa-sp-graphic (pdf) Some people might prefer to have instructions in real time to follow perhaps from a video clip on You Tube or a TV programme. A small number of councils are beginning to develop video guides for people to follow in developing their own plans. As these resources become more widely available we will be highlighting them through our website. For others working together with other people in a class or group environment might be the best option. For people who like this way of working a planning live session might be a really good way forward. www.bit.ly/hsa-usingplanninglive If you would like to hear about how to tailor support planning to peoples individual learning styles, in a different way, you can view a short video explaining the approach. www.bit.ly/hsa-EmpowerEnable-video

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

Giving people Time to think

Its really important not to rush people. We want to give people the time to think through what they want to achieve and what will work best for them
kiM HaWorTH, coMMiSSionEr lancaSHirE counTy council

Once people have some tools to use to start developing their own plan we need to give them some time and space to get on with it. After a week or so we can then contact the person in the way that we agreed with them to see how their support plan is developing. If we discover then that the person wants more help, we can offer this in the form, for example, of a drop in, or by linking them up to someone who can provide advice before leaving them to take the next steps. People to People in Shrewsbury, which operates as an independent social enterprise offers drop ins and peer support to help people plan. Set up by Shropshire Council to support everyone with eligible social care needs in Shrewsbury, People for People are adopting the Empower and Enable approach as their default approach to support planning. They are taking advantage of the location of the new practice is in which is the middle of a busy residential area next to a dentist to set up 2 weekly drop in slots for people to get advice to make their own plans. In turn, people supported by the practice will be asked if they would be willing to support others in the same way and this approach is being used to build up local capacity for peer support and encouragement for people to use it. Once people have had a chance to get going, we can agree the next time to call and see how the person is getting on, for example, in two weeks time. If when we call this time, the person wants more help, then we could offer to link them up with someone who can help them to plan. This could be a peer supporter, or a care manager. Using this approach we offer resources and support as the person needs and wants it, rather than starting with the default being a care manager to plan with you. Planning needs to be seen as an iterative process which shouldnt often need to take more than a few weeks but is flexible and can be built on over time. In the meantime, a number of things may need to happen to ensure people have their needs met. A short term plan could be agreed and a short term package of support may need to be arranged in the interim. Information can also be gathered in order to sign off a budget but these things can happen in parallel to

10

EmpowEr and EnablE | A people led ApproAch to support plAnning

How the model works

the creation of a longer term support plan. Once people are happy with their plan they should be able to share it in a way that feels appropriate to them. Some information may be more personal and private than others so it is important for the Council to offer a summary sheet which can capture only the information which is required for sign off and anything else which people may wish to share with others such as care providers or personal assistants.

11

EmpowEr and EnablE | A people led ApproAch to support plAnning

Keeping the plan alive

Keeping the plan alive

As with any planning process, when we try things in the real world we may need to adapt and tailor our approach to achieve what we set out to do. Likewise, once a plan has been signed off, it would be unreasonable to expect people to rigidly stick to it. People need permission to be able to adapt their plans when things change and to understand what changes are possible without having to involve social services. Where plans are within budget and people want to try different ways of meeting their goals, then it makes sense to enable this to happen with the minimum of fuss and without waiting for a formal review.

Helping good practice to grow

People involved in support planning will also likely need time and support to adapt to a new way of working with people. They need to understand the approach and become familiar with using different approaches and tools to suit peoples individual circumstances. Like People to People in Shropshire, Derby City are using Empower and Enable to shift how they approach support planning. The personalisation team in Derby City has developed a new, core training package which is being rolled out to frontline staff engaged in supporting adults. The course is three days long and Empower and Enable is introduced on the first day to get people used to the approach. Derby have developed a toolkit and a workbook to support learning and encourage good practice. Advice to staff emphasizes their commitment to the model.

12

Derby City Council is committed to an Empower and Enable approach to Support Planning where the model of Support Brokerage exists for customers to produce their own Support Plan and Support Brokerage external to the Council is available. The model seeks to create community based support as a desired outcome of Self-Directed Support with less reliance on paid Support Brokerage. Social care workers are expected to adopt this approach to Support Brokerage and be the last rather than first resort for Support Brokerage.

EmpowEr and EnablE | A people led ApproAch to support plAnning

Keeping the plan alive

What should a good plan look like?

For anyone implementing Empower and Enable as an approach to support planning it will be important to understand whether the approach is being successful. Using tools such as Working Together for Change can be a great way to develop a shared understanding of how people are experiencing change but checking the quality of support plans will also be a helpful lens to understand how practice is changing. Quality audits for support plans have tended to be driven at least in part by whether they contain the information which councils need to sign off the personal budget. We think this is confusing and misses out important information about what a good plan should look and feel like when the process has been led by the individual. Below is a checklist for auditing the quality of plans which captures these elements better. The checklist draws on the learning developed in the TLAP paper Rethinking Support Planning and our subsequent work with people taking steps to use this approach over the last year.

13

EmpowEr and EnablE | A people led ApproAch to support plAnning

Keeping the plan alive

Plans should be:

What to look for

 Increased variety of plans  Reduced one to one support time for

Personal
My plan. reflects who I am and it makes sense to me. Support to help me create it is light touch and tailored to suit me.

support planning
 Increased use of person-centred

support planning tools

 Use of non professional language to

Goal orientated
My plan sets out what I want to change and achieve and describes ways I can do that.

describe goals and outcomes

 Goals are personalised and reflect

what is important to the individual

 Less emphasis on needs and tasks  The plan contains information about

achievable
My plan is practical and achievable and says enough for me to understand how to put it into action.

how to achieve goals and outcomes  The plan makes good use of the resources available  Plans are achievable within the resources available
 Plans vary in length and detail  People decide how much to share in

ProPortionate
14
My plan feels the right size for what I want it to do.

their plans
 People decide who to share their

plans with

adaPtable
I can adapt my plan if things change and I know I can get support with this if I need it.

 Plans can be adapted to take

different routes to achieve the agreed goals and outcomes  People understand where to go for additional support  People understand what can be changed without needing to talk to their social worker
 Over time people take on more of

emPowerinG
Developing my plan has helped me gain confidence to do more next time .

the planning process

 People who have created their

own plans support others to feel confident to do the same  Good Stories are shared
 Plans consider peoples social and

social
My plan helps me think about how to maintain and improve relationships and networks that are important to me and give me a sense of belonging and purpose.

community links  Reviews show people are able to use resources to strengthen social and family networks  An increase in use of pooled budgets

EmpowEr and EnablE | A people led ApproAch to support plAnning

Keeping the plan alive

Why you should consider adopting Empower and Enable

There are many reasons to use this approach, it clearly dovetails with the core aims of personalisation by building peoples confidence to take more choice and control over how resources are used, but more than that we can now say from experience that the model is proving to work really well for people, that staff and people engaged with it value the approach and crucially in the current climate that it offers the potential for significant savings. It is not always true that a best practice way of doing things is also the most cost effective and sustainable approach but in this case we believe it is and evidence from a number of early adopters suggests the same. Shrewsbury have been testing out the approach initially for people with short term needs:

In Shrewsbury people with short term support needs are offered an Independence Budget following assessment in order to achieve shortterm goals around independence. People are encouraged to lead the planning for achieving these short-term reablement goals and longer term goals if they have further support needs. To support this, they are encouraged to attend drop in sessions which are led by local Peer Support expert volunteers who have already developed a support plan for themselves or a family member. The aim is to give people the confidence and information to lead their own planning and to grow this body of local volunteers as people increasingly lead their own planning. Early indication is Support Plans are up to 50% more cost effective as people draw on natural and mainstream supports.
JEnny PiTTS, dirEcTor PEoPlE2PEoPlE cic

15

Lancashire are also making plans to embed Empower and Enable as their core approach to support planning and are looking to increase the number of people developing their own plans from 1% to 15% over the next 3 years. In addition they are aiming to make simple DIY tools much more freely available and move the majority of support planning expertise out of the council to rest within a network of community based organisations who will provide peer support and training for people to plan as a first resort rather than one to one advice.

EmpowEr and EnablE | A people led ApproAch to support plAnning

Putting the model into practice

Putting the model into practice

Making Empower and Enable work in practice requires a joined up effort. It means changes to back office systems, strong leadership and a different approach from those involved in support planning. Our ongoing commitment is to continue to support learning from places working to embed the Empower and Enable approach and to share that learning back with the sector. We are always interested to support people in taking steps towards adopting Empower and Enable.

Get in touch
If you would like to talk to us more about how we could help you with this please contact us at sarah@groundswellpartnership.co.uk

16

EmpowEr and EnablE | A people led ApproAch to support plAnning

www.groundswellpartnership.co.uk Twitter: @groundswellUK www.facebook.com/GroundswellPartnership