applying behavioural insights to adult social care...stephen beet, head of service –adults care...
TRANSCRIPT
Applying behavioural insights to adult social care
It isn't rocket science but do it consciously
15th March 2018
Behaviour change is implicit to managing demand
17 x 24 = ?We respond instinctively to the cues provided
But more challenging to have sustained impact
It can be easy to achieve a quick impact…
21%
30%
0% 20% 40% 60% 80% 100%
Control Group
Participants
Outcome of the first iteration of the interventions at ASC reviews
More Expensive No Change Less Expensive
Bristol City Council’s experience of applying behavioural science consciously
Promoting Wellbeing
Early Help and Prevention, enabling people to live more
independently for longer
Directing people to lower cost options and
solutions
Delaying or avoiding the need for more intensive,
higher cost care and support
The 3 Tier Model for Care and Support
Help to Help Yourself (Tier 1)
Accessible, friendly, quick, information, advice, advocacy, universal services to the whole community, prevention
Help to Live Your Life (Tier 3)
Self directed, personal budget based, choice and control, highly individualised
Safe
guar
din
gR
ight skills, righ
t pe
op
le
Help when you need it (Tier 2)Immediate help, could be short term, avoiding admission or longer
term, transition from child to adult services or disabled adult leaving parental home. Minimal delays, no presumption about long-term
support, goal focussed
Bristol City Council’s journey
Phase 1 Phase 2 Phase 3• Development of
practice methodology – three tier model and strengths based conversations
• Testing of practice methodology through innovation sites
• All staff culture change workshops
• Developing tier 1 offer
• Understanding demand throughout whole customer journey
• Formation and delivery of Better Lives Programme
• Embedding of culture change through innovation sites and leadership programme
• Targeted Front Door and Reviews interventionsConsciously thinking
about behavioural science has been essential to successful delivery.
And reinforcement has been key!
What we were aiming to achieve
Phase 1
Current state
High Demand and long waiting lists Citizens not sure what’s happening and
their situation may change while waiting All cases defaulting to full Care Act
assessment Following assessment many people not
eligible for service Assessments are deficit rather than
strength based Too many people receiving tier 3 service
who may not have needed it Inconsistent approaches between
practitioners Not fully compliant with Care Act Overspending
Future desired state
Our staff’s behaviours have changed resulting in:• More people living independently at
home for longer• Consistent use of strengths based
‘support conversations’ with citizens• Not defaulting to full Care Act
assessment• Three tier model being fully embedded• More people accessing tier 1 or 2
support• No waiting list – people get clear &
proportionate response shortly after initial contact
• Consistent practice with shared tools• Compliance with the Care Act• Make agreed cost savings
Understanding the desired future state is vital
Barriers to success
Identifying and unpicking barriers to change will lead to more impactful results
‘Similar changes in
the past which didn’t
work’
‘We covered Strength Based Approaches the
first few months of social work
training’
‘To suggest that we are not working this way is
patronising’
‘This is just a way of cutting
services for people and I don’t agree
with it’
‘We already do this’
Leadership is key to embedding the changes
Phase 1 Achievements
• Ability to meet savings target of £1.6m to 3.5m or 1.5 to 3%. Largely attributed to the effectiveness of the Support Conversation
• 52% of new users are not requiring any RAS assessment.
Positive impact
• An efficient and productive team
• Fast and responsive duty system
• Consistent low waiting list using the model
• Continued reduction in the number of referrals closed with tier 1 offer
• Reduction in spend on social care budget using the model
First team outcomes
2 years on
Outcomes of the Support Conversation
31%
1%
68%
46%
4%
50%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Tier 1 Tier 2 Tier 3
Comparison of baseline and Innovation sites by % spread of services
Baseline data innovation sites
|
What worked well
Co-production with frontline
staff
Practitioner Lead involved
throughout
Management leadership
Easy to sell principles to staff
due to value base
Testing through innovation sites
Positive feedback from citizens
Learning
Behaviours need to be reinforced
Need to invest in long term impact –
hold your nerve and convince others
Full roll out harder to achieve results with less project
resource
Activity
In groups consider a change scenario in which you would want to influence the behaviours of your colleagues.
How would you establish their behavioural baseline?
What information would need to be gathered?
How would you gather this?
How would you share the findings to your colleagues?
‘We covered Strength Based Approaches the
first few months of social work training’
‘To suggest that we are not
working this way is patronising’
Applying behavioural insights to adult social care - it isn't rocket science but do it consciously
CONTACT
Stephen Beet, Head of Service – Adults Care & Support, Bristol City [email protected]
Henrietta Curzon, Senior Manager, [email protected]
Debbie Crossan, Manager, [email protected]