West Berkshire Council

The Corporate Director of Communities' Blog

Staying focused on 'the main thing', each week in a busy and diverse directorate

Each week our Communities Director, Rachael Wardell, puts an aspect of the Communities Directorate under her microscope, to give you an insight into the challenge and variety of the directorate's work.

 

You can view Rachael's previous blog about making improvements to our Children and Family Services..

Image of Rachael Wardell

The Main Thing (Part 3) - Public Health

Written on: 18-9-2017

2017 - Soft toys

We went 'live' on our replacement case management system last week. Had the implementation not gone reasonably well, this could easily have dominated the week for me, even though I only use the system from time to time, rather than all day every day, like the majority of staff in children's and adults services. Catastrophes end up at the director's desk (and rightly so). There was one day's delay; one morning when the link to the system didn't work, but otherwise...calm. I'm not naïve enough to believe it didn't dominate the week for others though; including the 'super-users' and 'floor-walkers' assisting the implementation, and the staff who came in at the weekend to update the system with the manual records they have been making since the predecessor system was switched off. With nearly a fortnight's worth of manual records, this task will probably claim more extra hours over the next couple of weeks. I'm grateful to everyone who takes so seriously the need to maintain good quality records.

Meanwhile, the absence of high drama around the case management system meant that I could focus on other things. The week had a decidedly 'public health' flavour to it. Public health has only been part of my remit since April 2017, when a corporate re-structure removed the housing and commissioning services from the Communities Directorate, and installed public health instead. Fortunately the pre-existing close working with public health colleagues, and links via the Health and Wellbeing Board mean that it's not been too steep a learning curve for me. A meeting focused on public health expenditure on Tuesday, and an all-day Budget Board on the Thursday brought public health spending into the spotlight. The public health budget is currently ring-fenced, but that doesn't protect it from close scrutiny of 'value for money' questions. Where public health expenditure should be focused to do the most good is an important consideration. In a district like West Berkshire, the public health outcomes at population level are generally very good indeed, mainly thanks to the relative affluence of the population. As a result, our attention points more towards various disadvantaged or marginalised groups whose outcomes are often significantly worse. However, if we target too narrowly, there's an argument that we are ignoring public health's intentionally population-based remit. So, this is a contestable area, with more work to do to find the best way to achieve our public health ambitions.

In the background, I am working with HR colleagues to go out to advert for the Head of Public Health and Wellbeing position in the Communities Directorate's leadership team. The job description has to be endorsed by the Faculty of Public Health, so I'm liaising with Berkshire's interim Director of Public Health (who works across all six Berkshire unitary authorities) to secure that agreement. We will be looking for someone who has all the necessary public health knowledge and skill, as well as being able to manage people, budgets etc. at assistant director level, and who can operate within the local political context. A good challenge for the right person.

I ended my week speaking at a Public Health Symposium in Oxford about the Berkshire Child Death Overview Panel (CDOP), which I currently chair. The CDOP is formally a subgroup of Berkshire's Local Safeguarding Children's Boards (LSCBs) and is often thought of as part of children's services. Of course, the prevention of child death is also an essential public health function, so it felt important to be sharing information about the CDOP with public health registrars and other related professionals. The information is very fresh in my mind, because one of my other tasks this week has been to complete the draft of the CDOP Annual Report for 2016/17 (aided and abetted by the CDOP Coordinator and the Vice Chair). So I was able to give a bit of a preview of some of the data that the annual report will cover, including the main causes of child death among the cohort of children we have studied and the 'modifiable factors' we are trying to identify and improve and the process changes we have recommended to improve children's care.

An added bonus of attending an event like the Public Health Symposium is that I am often able to hear other excellent speakers. For example, Tim Gardner who spoke about 'Ingredients for successful partnerships' based on a new publication from The Health Foundation. Also, Dr Nigel Hewitt from Pathway talking about health services for homeless people; an inspirational example of the impact of remembering to see a whole person at the heart of the care and support that we are providing. Not for the first time, I was sorry that the housing service is no longer part of the Communities Directorate. Joining up all these dots has always been one of the great pleasures of my role.


The Main Thing (Part two) - Safeguarding Adults

Written on: 11-9-2017

Communities Director Blog - 10th Anniversary of the Mental Capacity Act advertisement

In last week's blog post I wondered whether "the main thing" in that week would turn out to be what I had expected, or whether other matters would take over in importance.

On the face of it last week's commitments were to be focused more on adult social care than on other parts of my remit. And that's how it played out. There was a Local Workforce Action Board (LWAB) meeting, a meeting (by teleconference) of the south east ADASS Workforce Network, the kick-off meeting for some telecare development we're doing across health and social care in the west of Berkshire, and a safeguarding adults board "bite sized" training session on learning from serious case reviews. There was also a multi-agency discussion about someone living in the district about whom a lot of agencies are worried.

In the end, it was this discussion that - for me - held the key to The Main Thing in that week; safeguarding adults and the link between safeguarding and mental capacity. These were live, practical issues in the multi-agency discussion, and they emerged as key issues in the safeguarding training, which used two local Safeguarding Adult Reviews (SARs) as the basis for the session.

It wouldn't be right to write in detail about the multi-agency discussion; it's someone else's story and they haven't given their consent. However, I can share that it contained all the good points and the pitfalls that these kind of discussions have. Among the good points is a group of people genuinely focused on another's wellbeing, a willingness to share and reflect on multiple perspectives, an ability to see the bigger picture and to focus holistically on a person's life, rather than hiding conveniently behind individual service boundaries. In the minus column though, there were some clear, and all-too-common, flaws. The most obvious one being that the person about whom we were all so concerned was not a participant in the discussion. There were some legitimate wellbeing reasons why this was so, but...they also did not have an advocate or other representative at the table, and it later emerged that the practitioner who - others agreed - had the best relationship with them was not involved in this particular discussion either.

"What does this person want?" is a crucial question, and it's a very different question from "what do we think this person would want?" The professional perspective is such an all-pervasive overlay that I have noticed many practitioners answer the second question, even when asked the first. I have learned that it's best to ask: "When you were talking with [the person] what did they say they wanted?" This doesn't create room for the individual's wishes and the practitioners' expectations about their wishes to be blurred.

In the safeguarding training, the two SARs that formed the core of the group work both exposed professionals' ideas and misconceptions about mental capacity, and in particular how practitioners' fears and concerns can erode their respect for a person's capacity to express their own wishes and decide how they want to live their life.

With two very sad past cases and one current worry to think about, it felt timely to receive details of our plans to mark the 10th anniversary of the 2007 implementation of the Mental Capacity Act 2005 (MCA), from our Principal Social Worker for adults. On 27 September, we will be building on recent MCA training for staff, by going into greater detail about the impact of the act on professional practice, making use of role play as a learning tool, focusing on social work values and hearing the voices of the people who use our services. We must keep on evaluating and improving our practice in this area so that we can get this right.

 


The Main Thing?

Written on: 5-9-2017

Communities Director Blog - "The Main Thing" quote image

The much-quoted Stephen Covey - author of "The Seven Habits of Highly Effective People" - apparently said: "The main thing is to keep the main thing the main thing."

This is sound advice for anyone, let alone a busy corporate director with a broad remit. Among the business of children's services, education, adult social care and public health, what is the main thing to be focusing on at any time? Add into that mix the council responsibilities that sit outside the directorate, but which a corporate director must take a share in, and the collaborative work that takes place regionally or nationally to benefit the sectors the directorate covers; it's no wonder the calendar is full of priority clashes and it becomes hard to pick out "the main thing" among so many necessary activities.

There's a couple of things I do to help me prioritise. The first is to think about my values in action. I came into public service (over twenty years ago now) hoping to help people improve their lives. Much of what the Communities Directorate does is focused on this, whether it is protecting children or vulnerable adults from harm, improving educational attainment or increasing healthy life expectancy. When I look across a crowded week with many things jostling for attention, I ask myself: "How does this make someone's life better?" (Truthfully, I am often disappointed by my answer to this question). I also remember words of wisdom from my early years' days, where a motto I came across was: "Know the children; know their families; know your colleagues; know your stuff." How does the time I spend each week help me to better understand the people I serve, the people I work with or the skills and underpinning knowledge of the work I do? Finally, like anyone else, I can be overtaken by "events" that demand a response. Then the question I ask myself is whether this thing tugging at my attention is important as well as urgent. I try only to carve out time for those activities that are both.

Already this morning I have welcomed two new members of staff to the SEN Assessment Team; one joining us from a nearby school, the other from another team in the council. The increase in staffing in that team is to help ensure that we achieve timely completion of all Education, Health and Care Plans in time for the national deadline. This was an unplanned encounter, but it fits well with "know your colleagues", and certainly if we continue to implement the SEN reforms well, we will be helping people improve their lives, by holistically supporting them to achieve their potential.

My intention in this new blog is to write about the main thing in each week, whatever that turns out to be. I will also be reflecting on whether the main thing is what I expected it would be at the start of the week, or whether other urgent and important things have derailed my good intentions. I wonder whether there will prove to be an "observer effect", and if the act of reflecting and blogging will change how I manage my time as the weeks go by. Above all I am hoping that over time the blog will provide readers with an insight into my work as director and the broad range of the Communities Directorate's work.