The Strengths Revolution’ weekly podcast show was launched on 22nd April 2014. Just go into iTunes Store, click the ‘Podcast’ link on the top menu, then put ‘The Strengths Revolution’ into the search box.

Listen, subscribe, and add a review if you feel able to. Remember… listening, downloading or subscribing to the show is FREE!

'Working with Strengths' was published in May 2014 as a comprehensive resource for reviewing the literature and reflecting on strengths-based practice as applied to people in contact with services, as well as the strengths-focused development of practitioners, teams and organisations. It draws on the wider business literature as well as health and social care references to broaden the applicability of the ideas.

'Risk Decision-Making' was published in 2013 to help shift the focus from a tick-box culture to the realities of what good practice should be about. The manual and cd-rom provide the resources that should engage senior management in organisations, as well as the practitioners and multidisciplinary teams.

June 2007 saw the publication of the Working With Risk Trainers Manual and Practitioner Manual through Pavilion Publishing. The Trainers Manual provides a flexible two-day training programme, with the option of using any of the individual sessions as stand-alone training resources. The Practitioner Manual provides a set of practice-based risk tools with supporting guidance on how and when to use each. These materials also aim to discuss some of the wider risk issues and identify a key part of current research and literature. The practice-based tools are also supported by completed case examples.

To make contact either send me a message via the 'Contact Me' form or (if it's urgent) you can call me on 07733 105264.

Practice Based Evidence commenced business in October 2001. Promoting the value of the messages from service users, carers and practitioners experiences. These are often marginalised by the emphasis placed on research.


 

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  • The Art of Co-ordinating Care: A Handbook of Best Practice for Everyone Involved in Care and Support
    The Art of Co-ordinating Care: A Handbook of Best Practice for Everyone Involved in Care and Support

    Jointly written by Practice Based Evidence & ARW, this resource is of importance to everyone in mental health, social care and learning disability services, including primary care.

  • Assertive Outreach: A Strengths Approach to Policy and Practice
    Assertive Outreach: A Strengths Approach to Policy and Practice

    Primarily aimed at developing assertive outreach, but its focus on a strengths approach is applicable to all parts of the mental health system.

Friday
Jun282013

Playing with numbers

I am often mindful of the need to criticize the quality of leadership and management in health and social care services; particularly the obsession with numbers, the tick-box mentality, and the blind faith placed in targets for driving change and daily practice across services. I am surely not a lone voice in this critique, but is it valid or just a reaction against the sound of the pips squeaking?

I do believe that an absence of targets or defined outcomes, and a failure to establish high standards for provision of services only leads to inconsistencies between practitioners and teams… what is often referred to as a postcode lottery. Service users don’t deserve to be on the receiving end of either stressed out practitioners fearful of constant criticism, or laid-back practitioners doing their own thing. Audit and regulation have a place, but surely they need to be clearly joined up to practice, not existing in a vacuum somewhat disconnected from the realities within which good practice has to operate.

The ever-growing chasm between person-centred practice and business-focused managerialism does little to promote a culture of organizational collaboration that may encourage a more engaging form of audit and regulation across services. My solution would be to eliminate most of the current audit requirements imposed on practitioners and teams, particularly that which they experience as wholly time-consuming and unhelpful. So far so good, say the practitioners amongst you; please do share your thoughts, but read on before you do…

Over the last 12 years, through the Practice Based Evidence initiative, I have been developing tools designed specifically for use by practitioners and teams. These tools have flexible uses: personal reflection, individual supervision, team development and team evaluation. Used diligently they should be able to provide a host of qualitative and quantitative data, which in turn should offer useful feedback to practitioners and teams for practice development purposes. The Risk Decision-Making publication includes examples of these tools, and a specific example of data emerging from their use in a specific organization to help identify good practice and priorities for further development.

So, the sting in this tail is that practitioners and teams need to own the processes of audit and regulation if they are to reflect and develop good practice. For those auditors and managers fearful of losing their jobs if Practice Based Evidence emerged as the norm, you could always make use of the data to tick your boxes; better still, you could prioritise your time more effectively by getting in and alongside practitioners and teams to support a quality revolution. You might then be in a stronger position to challenge and inform the thinking of the inter-galactic warlords from distant planets a.k.a. commissioners, Department of Health, Care Quality Commission…

These are just a few thoughts I am passing on as I reflect on years of connections with so many people who are desperately trying to do good work despite rather than because of their masters. Do feel free to offer your thoughts and ideas (with an accompanying dictionary from those of you who find ordinary language an alien concept… with all due respect to the demands of the Plain Language Association).

Monday
Apr082013

Risk and Leadership

Leadership is often lacking, and management is all too often to the fore where considerations of risk are concerned in health and social care agencies. In this scenario fear and back-covering hold the attention, while good practice is presented as an unconvincing façade. Managers strangely play down any questions about excessive bureaucracy while still demanding all the paperwork is completed as the primary target. If something goes wrong it is the paperwork that gets sole attention, and real practice considerations are relegated to a place somewhere to the right of obscurity.

'Good paperwork is a sign of good practice' becomes the convenient smokescreen. This would be true if there was less management and more supportive leadership, as the need for paperwork would be put into perspective: as the essential minimum to support good practice not to hinder it. Good tools are a range of checklists and formats that have been shaped by good practice, and thus they are able to guide and prompt firstly, and capture good practice as a secondary function.

The Risk Decision-Making publication is the update of 17 years of working with individual practitioners and teams across countless organisations, both from within the Sainsbury Centre for Mental Health initially and through the Practice Based Evidence consultancy since 2001. The tools and guidance are informed by what we know from the national and international research, but more significantly through the practice based evidence of hundreds of practitioners across all disciplines and service sectors. Most importantly, this publication refocuses the attention on risk as everyone’s business; so it is structured throughout to address issues from the perspective of individual’s, teams and the leadership & management of organisations. Whatever systems your leaders have bought or put into place there is still a role for guidance on best practice, so look no further.

Wednesday
Mar202013

Risk Decision-Making

How many times have you been asked 'where is the risk assessment?' knowing that the quality of the work is of secondary value at best. A new manual has been produced in 2013 to focus the attention of people at all levels of organisations involved in health and social care services. We all make risk decisions, but we occasionally need guidance to support our confidence in doing so. This manual is focused on reducing bureaucracy, promoting quality, and responding to what we should really mean when we talk of being person-centred in our work.

Risk Decision-Making is available from Pavilion Publishing.

Sunday
Feb172013

Practice Based Evidence for Risk

Surrey and Borders Partnership NHS Foundation Trust recently engaged the Practice Based Evidence consultancy to undertake an organisation-wide programme of Working with Risk training. By identifying a large cohort of senior clinical staff in ‘Leadership’ roles the Trust is establishing a positive commitment to working as constructively as possible within all teams. My role was to devise a training workshop that would reflect the principles and practice issues identified in the initial Leadership workshops. In addition to adopting their locally agreed set of principles and edited filming of Leadership discussions, I used my own materials on ‘Positive Risk-Taking’ and ‘Risk Decision-Making’ to facilitate reflective practice discussions as a main focus of the workshops. With the help of colleagues in ARW Training the cumulative evaluations across 50+ workshops were overwhelmingly positive. See the following two summaries for the numerical ratings of the workshops (the narrative comments cover too many pages to include, but broadly reflect the ratings).

Cumulative summary of workshop responses

Cumulative responses of additional workshops

The summaries represent 1252 and 72 responses respectively. The main lessons to be learned are that practitioners respond best to relevant and practical content that enables them to reflect on and develop their practice. Successful training workshops start with close attention to design and detail.

 

Sunday
Nov042012

Does the whole picture fit together?

This question captures the meaning of ‘care coordination’. Are all the elements coming together in a coordinated sequence or pattern? It is a question that we apply to many aspects of our daily lives. We ask it, for example, about the colour schemes and fittings of interior design; the layout of an exhibition or gallery; the clothing we wear in particular situations. Simplicity and straight lines in a map or set of instructions often seem to help us to understand what we are doing, where we are going and how we can get there more easily. Complex pictures and plans might please people who enjoy the challenge of working out puzzles rather than having the solution given to them but, depending on how much time you have and what kind of person you are, high levels of complexity may serve only to frustrate you and turn you off.
 
The degree of creativity experienced in the smallest to the most complex of mental health tasks will largely be influenced by the attitudes, feelings and personal values that are in play at the time. For example, the simple task of arranging an appointment, and then attending it, might just be part of what a particular person does, and they might do it methodically, with little or no thought. But even a simple task like this can be subject to enormous influences, such as the availability of rooms, effective computer systems, clarity of communication, motivation to attend and transport on the day. Failure to meet the appointment, for whatever reason, has the potential to cause frustrations, fuelling deeper tensions and attributions of blame. But the successful completion of a simple task like this rarely generates the positive feelings that perhaps it deserves. Not all appointments and methods of support are creative, passionate and artful events; but the message is that we need to be more reflective about the smaller details if we are to derive more pleasure from our work routines. This message applies to all practitioners involved in care and support, as the care coordinator occupies a role of supervising the whole picture, not painting the whole picture alone!
 
Successfully coordinated care and support can be a great source of satisfaction and pleasure for providers and receivers alike. See the ‘Art of Coordinating Care’ manual for a detailed approach to capturing the creativity in the role.