Commissioning and innovation

Many, perhaps most discussions about changing care and support services have commissioning at their heart - asking commissioners to behave differently and spend the resources they control on new or currently marginalised things. In our system we give enormous power and responsibility to those that we charge with making decisions about spending our money. Many of us are frustrated at the glacial pace of introduction of innovations and the persistence of service and ownership models that don’t serve people well enough. While having sympathy with the massive challenges, we ask ourselves why better ways of providing support stay on the margins. We fantasise about new levers that might drive, support and encourage more commissioners to match the performance of the exemplars we see in some places.

At Community Circles, however, we have decided that while we will make a contribution to these debates we can’t wait for them to be resolved. We also agree with Edgar Cahn, who said:

‘No society has the money to buy, at market prices, what it takes to raise children, make a neighbourhood safe, care for the elderly…

…The only way the world is going to address social problems is by enlisting the very people who are now classified as ‘clients’...and converting them into co-workers, partners and rebuilders of the core economy.’

Community Circles is both the name of our charity and an approach to “doing care differently”. We are one of a growing number of initiatives offering ways of preventing needs arising, bringing community assets much more into play, releasing local entrepreneurial spirit and engaging people and communities as “co-producers” of sustainable support. We have been working on ways of growing Circles without being commissioned to do so in the formal sense.

What are Community Circles?

Community Circles are facilitated by volunteers who are recruited, trained and supported by Circle Connectors (who may be paid or voluntary). They bring together family, friends, community members and (in some cases) service staff to support individuals. They use person-centred methods and tools to identify the things that are important to people and then plan and act to achieve these things through the Circle membership – increasing wellbeing, combatting loneliness, building community connections and improving care outcomes. Circles can be helpful to people living in a wide range of situations and who may be using various forms of support. They are currently mostly benefitting isolated older people, people with dementia in care homes, at end of life, with mental health needs or learning disabilities. Circles aim also to reduce carer stress and prevent or reduce use of some services. Wider goals are to increase the local volunteer base and contribute to recruitment in social care as well as improve helpful connections between local VCS, businesses and service providers.

Beyond commissioning

Typically a charity/provider at this stage of development would have a growth strategy including tendering for business with commissioning organisations in order to offer more of their “service”. For us that approach presents the danger of becoming dependent on commissioners and whatever services they see as needed, using the models they see as appropriate. So we are trying to grow Circles – for anyone that wants one and at no cost to them – differently.

Some of the elements of the approach we are developing are:

Give our methods away - supporting people to use them at no or very low cost where possible. We want to be a small organisation with a big impact so we have been developing a strategy that transfers our approaches, tools and knowledge to people and partners. These might range from a family who want to develop a Circle with one of their members, through to large organisations wanting to embed at scale. We have handbooks, materials, e-learning, webinar programmes, and communications via social media, video guides and examples etc. We can share these free and for those wanting a little more support via a low cost membership site. We hope this will mean that anyone can access the type and level of support that works for them, with cost only increasing as the operating scale and support needs do.

Work in partnership with community groups, local charity organisations or service providers. Key here is to transfer and embed methods and skills including approaches to sustainability such as peer mentoring and support. A current example is a five year Lottery funded partnership with Age UK Doncaster tackling loneliness amongst local older people.

Develop new models of volunteering and corporate social responsibility. The ask of volunteer facilitators is only about 2 hours a month, they receive high quality training providing transferable skills and responsibility in the Circle is shared. With employers we want to make our ask more reciprocal than simply accepting money – supporting local employees to develop skills transferrable to their work.

Embed Circles within other initiatives. We have a partnership with Well-being Teams which offer an alternative to traditional homecare via small self-managed local staff teams – Circles are embedded to help people to build and sustain interests and connections rather than limit the offer to basic care tasks.

Partner with commissioners who share our vision (but not be traditionally commissioned). An example of this would be where enlightened commissioners like Wigan MBC use innovation fund approaches to stimulate change. We have a three year partnership to embed Circles in local care homes – where we agree the outcomes sought but where the relationship is explicitly that of partners.

Community Circles would be very interested in learning about other organisations or initiatives exploring new ways of approaching growth and sustainability in order to avoid dependence on traditional commissioning. If you want to know more about Circles, email Martin or visit the website.

The views expressed in this blog are those of the blog’s author alone and do not necessarily represent those of Independent Age. Independent Age is not responsible for the accuracy of the information supplied in blogs by external contributors.