The road less travelled
IPC recently undertook an evaluation of ‘One Bexley Pathways’ – a consortium of voluntary sector organisations undertaking delegated Care Act responsibilities. Dr Melanie Henwood, Visiting Research Fellow with IPC, reflects here on some of the main findings of the evaluation and highlights some considerations for other authorities interested in developing a similar model.
Introduction
Five years ago the London Borough of Bexley (LBB) took the innovative step to delegate a large element of its statutory Care Act duties for assessment and review to a voluntary sector consortium of eight ‘Trusted Partner’ organisations, known as ‘One Bexley’ and managed by a programme board (‘Pathways.)’ The model uses trained Trusted Assessors (TAs) to develop personalised and strengths-based approaches for Bexley residents, maximising the skills, resources and networks of the local voluntary and community sector (VCSE). Support draws on universal services, provides information, advice and advocacy, and finds creative ways of meeting identified care and support needs for adults and their unpaid carers, with the aspiration to prevent, reduce or delay needs by supporting independence.
Together the partnership offers:
- Care Needs Assessment
- Carer Assessment
- Support planning
- Information and Advice
- Equipment Assessments
One Bexley Pathways (OBP) commissioned IPC to undertake a focused and rapid independent evaluation of the model to-date. The findings will inform the strategic approach of OBP as it moves into a new contract, but also have wider potential to influence partnership developments between statutory services and the VCSE.
The One Bexley model
Central to the model of delegating statutory responsibilities was the expectation that the VCSE could “bring something different to the party.” In particular, the consortia organisations would build on their established networks and community relationships across the borough, with other organisations and with local citizens. It was hoped that the VCSE approach might be less bureaucratic and would also bring the benefit of resources and relationships that might not be available to statutory services, and which could offer an alternative to a statutory service response, or prevent needs escalating.
Our evaluation used a mixed methods approach including case file analysis and stakeholder interviews; we found many strengths and benefits to the approach. The model attracted considerable support across stakeholders, and was seen as a flexible and positive way of meeting statutory Care Act responsibilities for people who didn’t need intensive social worker involvement, or who were reluctant to access support from the local authority, or had specialist needs the One Bexley partners were best placed to meet, which in turn freed up social worker capacity.
The deployment of trained TAs was judged to be an effective and high quality way of working with people referred to One Bexley by the borough. TAs were highly motivated and passionate about their role, and committed to making a difference for people by spending time listening to their story and working alongside them to develop timely and creative solutions to meeting need. Personalisation and strengths-based approaches were strongly in evidence with time taken to understand needs and to provide appropriate and creative solutions, including equipment and technology to support independence. The transformational impact of providing the right support (or advice and signposting) at the right time for Bexley citizens was identified repeatedly by TAs. Being able to establish an ongoing relationship with a TA and to return to a named individual if further support was needed or circumstances changed was highly valued by Bexley citizens.
The One Bexley consortium has the advantage of being perceived by Bexley residents to have a different style and character than might be true of the local authority. The VCSE is generally viewed positively, particularly where people have knowledge of the partner organisations and previous experience of their support. The embeddedness of the partner organisations within the community further enables them to “reach out to clients that wouldn’t want to come through the local authority; that is a very good strength of theirs.” The ‘softer’ or more approachable image of the voluntary sector partners was contrasted by some stakeholders with the more negative perceptions that some might hold of the local authority:
“ The voluntary sector are seen as being the people who will hold your hand, they are gentle, they give you whatever you want and they are always on your side! They are the people who will sit with you for a long time, with a cup of tea to talk about the world.”
And:
“I’ve seen the richness of the resources and the experience of the voluntary sector (…) they abound in richness of experience and forming relationships, teasing out information from people and being empathetic.”
TAs themselves recognised the value they were able to bring to their relationships with clients, and taking the time to listen was described as “the whole point,” while also seeing the transformative difference they could make to people’s lives:
“More often than not, we are changing people’s lives. Sometimes we are the first people that they have reached out to and we look at the bigger picture, we’re not just looking at putting carers in. We’re looking at advice, support, counselling, just someone to listen – and sometimes just that conversation, you can tell it’s made a huge difference.”
However, there were also some tensions evident at times between the traditional voluntary sector role of advocacy and maximising resources and support for individuals, with acting in a delegated capacity on behalf of the Council and being mindful of the resource implications of support packages. Such tensions could largely be managed within the context of a history of trust between the consortium members and the London Borough of Bexley, but some voluntary sector bodies could find the tensions between their traditional advocacy and social democratic campaigning role, and acting as an arm of the local borough more difficult to accommodate.
Practical development
For other local authorities that might be keen to delegate parts of their Care Act responsibilities there are some clear lessons worth sharing, and we highlight some key points below:
- It takes time to develop the approach with recruiting, training and supporting TAs and establishing the governance and management structures required. The Bexley experience was further complicated by launching in the midst of the Covid pandemic which limited opportunities for face to face training, and reduced the support options available to people.
- The model is about more than delegating Care Act assessment responsibilities; it is a deliberate approach to respond to lower level or less complex needs, and has great potential to be part of an integrated strategic prevention framework.
- It is essential to establish a clear identity for the model and for its profile to be developed by outreach and creative approaches to working with diverse and traditionally under-served communities.
- Commissioners need to think carefully about the most effective contracting arrangements that will support partnership working particularly if engaging with a consortium.
- Commissioners and providers need to have a shared understanding about the mechanisms for managing TAs, but also having adequate capacity for professional supervision (consistent with Care Act responsibilities).
- Staff wellbeing must be supported: the TAs are the heart of the model and it couldn’t function without them. Supporting all staff working within the One Bexley model is essential in ensuring its durability.
- Nurturing and developing staff – particularly TAs – is likely to require attention to a career development pathway; there is also scope for exploring how the traditional volunteer base of the voluntary sector might be integrated within the model.
Conclusion
We do not think that a ‘Bexley Model’ can simply be exported to other councils and locations; much depends on local identity and ‘place’. However, we did conclude that if such a model is going to be adopted, conditions for successful transferability include:
- Strong vision, shared values and clear leadership and governance.
- A well established and diverse voluntary sector with a strong local identity.
- High profile voluntary sector organisations with good recognition and awareness among the local population.
- Excellent networking by partners across the local footprint enabling a detailed knowledge of the community and capacity for nurturing and developing social capital.
- Mature relationships and some history of joint working within and between voluntary sector partners.
- Proven history of working with statutory partners, providing a foundation of mutual trust and confidence.
- Time and investment to establish and develop the model before going live.
