5.7 Starting from a different place
If we are starting from a different place in thinking about services - ensuring that the citizen is at the centre rather than the service, we also need to think differently about what the workforce does.
Activity 5.4: A different kind of job?
In Control has visualised the roles of citizen and professional like this:
Look at the roles identified as being part of the professional role. Are these roles that practitioners such as social workers, support workers and nurses undertake at the moment? What do you think might be different about working within a model of personalised care and support? Use your learning log to note your reflections on this model.
In Control 's model starts from the presumption that both citizens and professionals are experts - and professionals need skills that enable them to meet the outcomes identified by the citizen.
It is likely that you will have suggested that these skills are familiar to most health and social care professionals, though we may use different words in different professions. So 'understanding' may be translated in social workers' language into 'empathy' and 'relationship-building', for example. And 'checking' may involve 'monitoring' and 'reviewing' someone's chosen support arrangements to make sure that they are meeting agreed outcomes, and, in some cases, ensuring the person is not at risk of harm. 'Learning' is an important role for the professional. But we often talk about learning as if it comes from 'out there' - from books and training courses. This way of looking at the professional role also sees learning coming directly from the professional's experience of engaging with a citizen's changing world.
If the starting point is a collaboration between expert citizen and expert professional, personalisation seems less like a threat to the workforce than an opportunity. At the same time, it is important not to underestimate the transformation of public services required to make personalisation real. Moves towards self-directed support require a new landscape. This is partly about new professional roles and using and developing existing skills. Duffy (2010) describes the need for a 'new script' for social workers and other professionals, and a shift away from technical and procedural approaches to care management and other professional 'tasks'.
Self-directed support is likely to bring about significant change for providers, who will need to change the way that they design, deliver and market services as 'block contracts' for large numbers of service users are replaced by separate contracts for individual citizens (Hunter et al., 2012).
There will also have to be changes in how that workforce is regulated. Personalisation through self-directed support, recognising and meeting individual outcomes, inevitably creates complexity in the way that social care is provided. A Care Inspectorate Inspector summed up the central regulatory challenge like this:
What's interesting and challenging about self-directed support is that it takes you into talking about the individual and the difference that support is making, but how do we therefore come up for common standards for individualised support?(Inspector, Providers and Personalisation, 2014
We therefore give you a choice of routes to explore the next topic: the role of personal assistants:
Of course you can also choose to explore risk and personalisation in relation to adults and children by following both routes.