Design Lab — how co-production can instigate systems change (Part 3)
In Post 01 and Post 02 I shared how the Care Journeys team worked with care-experienced young people to co-produce services to reduce loneliness and social isolation for other care-experienced young people.
To achieve our ambition of changing the care journey, so that everyone who interacts with it — whether young person, professional, parent or carer, or something else — feels loved, supported, and given opportunities which matter to them, we need to test and embed relationship-centred models of working.
The current model is geared towards risk management — case recording, compliance and the need to have decisions signed off by layers of management.
In this post we’ll focus on how setting up self-managed, empowered teams is core to social care professionals being able to get care-experienced young people into positive destinations.
What can we do to change the system?
Systems change is an extremely broad and overarching term that’s the ambition of so many organisations today. Sometimes the term itself is a distraction from the work, as we debate what it means and get lost in the bigness of it all.
Working at the intersection of local government and the charity sector it’s easy to feel powerless. We see the impact of broken systems first hand on an undervalued workforce who are continuously asked to deliver more with less. In Care Journeys we’re using practical experiments that start with what we can change.
In Hilary Cottam’s report, Welfare 5.0: Why we need a social revolution and how to make it happen, we see glimpses of local people and local governments creating change for themselves.
“Outside of centralised institutions revolutionary experiments have been taking root — from new forms of local politics in Frome to new forms of service design and organisation in Plymouth; from radical new relationships with communities in Wigan and East Ayrshire to a new conception of public health in Morecambe Bay and public wealth in North Ayrshire. Re-using what is to hand — the skills and energies of local people, the resource within often depleted local economies, deep local knowledge and the generative energy of history, the 5th Revolution is taking shape.”
– Hilary Cottam, Welfare 5.0, Sept 2020, page 35
In the case of the Design Lab we noticed how creating the conditions for professionals to co-produce services with care-experienced young people is a ‘trojan horse’ for creating systems change. Co-production requires reshaping teams, building a culture of learning and re-shaping relationships and power dynamics with care-experienced young people. Through showing how a different way of working is possible and how this can be transformational for young people and professionals alike, we are building the momentum needed for bigger change.
The Care Journeys Model of Support: creating conditions for innovation to come from the front
For the Design Lab to authentically support co-production with care-experienced young people they needed a flexible, caring and ambitious team of children’s services professionals to work alongside them.
1. Care-experienced young people are at the centre of everything we do
This is a basic principle for many young people-centred services today. In the Plymouth Care Journeys context, it means that we flex our team’s time and resources around the needs of care-experienced young people and work with them to shape and improve services. This applies to every part of Care Journeys, from our hiring process where care-experienced young people are part of interview panels, through to prioritising our research focus areas.
“You could see at the very beginning and then during, and then probably even more so at the end that the young people involved felt genuinely empowered. Also, something by young people, for young people was powerful in its conception and then its execution and I think that became even more evident when we went back and did the evaluation with some of the things they were saying to us about what it had achieved, how it felt and what it meant to them.”
2. We build peer-to-peer and informal networks of care-experienced young people so they have a range of strong, supportive relationships in their lives
To reduce loneliness and social isolation we must create opportunities for care-experienced young people to build healthy informal networks of friends, colleagues, mentors and even romantic partners. Informal networks influence so many parts of our lives, from hearing about job opportunities, to meeting life partners to having friends we can rely on when things get tough. Informal networks also reduce dependency on ‘the system’ by allowing young people to reach independence in a supportive community where a good friend helps make their house a home or a mentor maybe encourages giving a paid internship a go.
We also try to link care-experienced young people up with care-experienced peers through shared interests. In the case of Alpha Lab, this was through cooking or being interested in nature. This is what we call ‘peer-to-peer’ support, and it gives care-experienced young people the opportunity to talk about shared experiences or simply to know that they aren’t alone.
3. We operate in self managed teams
“I haven’t worked on similar projects to this. I would say it isn’t top down, there was definitely an equal sense of ownership in the project and it was really up to young people to design and run it with us.”
To support young people in this way we set a team that could flex around the needs of young people and be trusted to manage their own budget. The team is made up of three project workers, some of whom are care-experienced themselves, a team admin and a team enabler who all work closely together every day. The team is also supported by service/social designers in Barnardo’s Innovation team, like me. Key differences in the running of the team include:
With self managed budgets to allow workers to support young people here and now
During winter we were running the Design Lab in Plymouth, and one of our project workers noticed that a young person had been arriving at the lab wet all week. She found out that the young person didn’t own a coat and she discreetly arranged to go to the mall together after lab to get one for her. The young person was beaming, and cosy and dry, the next day.
For many other children’s services professionals a situation like this would require them to jump through multiple hoops to get permission to buy that young person a coat…during which time this young person may have become sick and the children’s services professional may have given up or been discouraged from asking again in the future.
“The workers supporting the lab would meet before and after every session to check-in and debrief. It never felt like we were alone in this…. we were able to gather support from the wider team”
In our Care Journeys model, self-managed teams work together in small groups (3–8 people) to support young people in a specific local patch. More experienced direct workers will guide and support newer workers through regular supervision. Everyone, including the care-experienced young people, is involved in decision making, from hiring panels through to how money is spent, deciding together on the best approach in day-to-day working.
Professionals don’t have to stop working directly with young people to progress
A fundamental, systemic failing in the care sector is that ‘moving up’ and pay progression often means moving away from direct work with service users, who in this case, are care-experienced young people and their families.
Managing and supporting teams is an important skill, which is of course required in the care system. But how do we ensure that organisational structures don’t disincentive talented professionals from doing the direct work so that they can gain professional respect and status? If pay scales were flatter we could instead focus professional enrichment on roles that are needed, and building strong, diverse §teams.
Frontline professionals are the front-runners for innovation
“The thing that was different about this way of working was that we didn’t have pre-determined outcomes so we could focus on relationship building and personal growth and that meant we could put young people’s needs first and be more flexible and responsive to what they needed.”
In this case co-production is working with care-experienced young people to produce and deliver services. Co-design is designing ideas with care-experienced young people.
While we were running the Care Journeys Design Lab I noticed that children’s services professionals embodied all the key qualities to facilitate co-production; they’re creative, good listeners, practical and adaptable. Day to day this meant that they brought a great energy to the work, where they were excited to try new things and were able to problem solve with young people through the testing period.
4. Enablers/regional coaches
Enablers/coaches are people who support the team with problem solving. They don’t tell the team what to do, they coach them through tough decisions and enable them to work in the best conditions possible to support young people.
5. Strategy team
The only management tier is a broader overarching strategy team to offer checks and balances on decisions, sign off high-cost interventions and take responsibility for overall culture. For example, setting up things like a 7 year partnership like Care Journeys.
In short, this entire model is about strong relationships. It builds on the well known Buurtzorg model of social care, whose motto is “first coffee, then care.”
Buurtzorg has proven that self-managed, relationship-centred models of social care can save money and scale whilst delivering high quality care. It was established 13 years ago to ‘put humanity above bureaucracy’.
Buurtzorg now employs more than 10,000 professionals in hundreds of self-managed teams but only one small office with 50 people, plus 20 coaches and 2 directors who support the teams. The self-managing teams work independently. They can always contact coaches or head office for help but they bear ultimate responsibility.
A few things we learned
On creating joint ownership in our partnership
Setting up and running the Design Lab was a completely new experience for the Plymouth Care Journeys Barnardo’s team. Although there was encouragement and interest from Plymouth City council, our local partners were not directly involved in running the Design Lab. Moving forward, Plymouth City Council are involved in planning and shaping the next phase of this work (to be announced soon) with a focus on joint ownership, responsibility and impact. We have also shared learnings with our Care Journeys colleagues in Brent, London who are involving Brent Council professionals from the beginning of their equivalent of the Design Lab.
On managing the intensity of the work
The Design Lab ran over the course of the first lockdown in the UK, from March until the end of June so the intensity of the work was understandably challenging for professionals. Unexpected challenges included a reduction of staff due to furlough and providing lots of emotional support for young people online. In the future we’ll be ensuring we have the right ratio of professionals to young people and make sure that taking breaks and asking for help is seen as part of the work.
‘The emotional labour was taxing at times as we were navigating group dynamics, supporting young people with mental health and trying to run the tests as part of the research. In the future I would build in ‘sprints’ with breaks in between or resource the lab with 2 Service Design workers and 2 youth workers, who can switch out when needed.
Reaching young people
Engaging young people remotely was a challenge before and during lockdown. Due to GDPR restrictions we weren’t able to directly reach out to young people to tell them about what we were doing or how to get involved. We posted opportunities, flyered on the streets and relied on information being relayed through direct support workers. In the future we will be working much more closely with statutory services to directly reach out to young people.
Alongside this we’ve been growing our online presence with a Plymouth Care Journeys Instagram, Twitter feed and a new website (coming soon!). We have also set up a new Care Journeys space in Plymouth which all care-experienced young people will be welcome in, COVID policy permitting of course!
What’s next?
We’ve used the learnings from the Design Lab to develop a plan for the next phase of this work with Plymouth City Council. Hear about it in upcoming posts.
Irit is a Social Designer in the #FutureBarnardos team on the Plymouth Care Journeys programme.
To get the latest updates from the #FutureBarnardos team, subscribe to blog.barnar.do on Medium.
