Using community workers to help people build resilience and get more involved in their localities would ease the pressure on adult social care and deliver big savings, according to a report to be published tomorrow.
The Centre for Welfare Reform’s People, Places, Possibilities report argues that the local area coordination model, first tried in western Australia in 1988, is an “idea whose time has come” in Britain.
The approach involves creating a network of practitioners – known as local area coordinators – who work at ward level to help people find ways to meet their needs within the community before they fall into crisis and need help from adults’ services.
They are generally not social workers, while LAC services do not tend to operate eligibility criteria.
Core social work
“Local area coordination is core social work skills in a way,” says Simon Duffy, director of the Centre for Welfare Reform. “You need to build relationships, understand what the real issues are, focus on what people’s capacities are, be aware of the community in which they live and spot opportunities. Those are things social workers are trained to do but often don’t do because the system doesn’t need them to.
“In a funny way the system almost discourages social workers from doing that – you go in, do a very quick assessment, you’re in, you’re out, your job is to connect them with services. You don’t need to know the local community, you need to know what services are available. That’s the opposite of local area coordination.”
The report was written by Ralph Broad, director of the Local Area Coordination Network, which is working to develop LAC provision in England and Wales. To make its case for the approach, the report includes new data from Derby University about how the model benefited Derby City Council.
Derby’s experiment saw local area coordinators working with approximately 50 individuals in two localities over a 10-month period. Despite only working at 40% capacity as the role was developed, the coordinators delivered health and social care savings worth an estimated £800,000 to £880,000.
On top of the reduced costs, the initiative also recorded people feeling more in control of their lives, being better informed, more confident about their future and better connected with their local communities.
The speed at which savings are realised is a big plus too, says Duffy: “Because of personalisation, demand gets converted into cash quite directly. If people aren’t needing to demand or to ask for that kind of support because they’ve identified low-cost or no-cost solutions themselves in the community, the journey from investment to saving is now much smaller and the transparency of that saving is much clearer.”
But despite these benefits and the model being backed by more than 25 years of positive data from across the world, the model is still relatively unknown in England and Wales?
Lack of awareness
Duffy said a lack of awareness about local area coordination and organisational resistance as among the reasons.
“Historically that system defensiveness has been the challenge. You describe to people in a system that is fairly static a model like this and people’s eyes glaze over – ‘oh gosh, another reform?’. That’s where I think local area coordination has come unstuck in this country.”
But the report suggests that with austerity bearing down on public services openness to the model is increasing. As well as Derby, Thurrock council has tried the approach and other authorities – including Isle of Wight, Suffolk and Swansea – are now embracing it.
The impact on social services is less clear, however. While the early results have pointed to there being reduced caseloads for social workers, increased local knowledge and faster, more personal access to specialist social work services, the longer term implications are an unknown, said Duffy.
“I’m not sure anyone’s very clear about that,” he said. “In the report you have social workers saying this is fantastic and really helping us, but what does that mean for the long run? I hope that is being consistent with this approach we will see a greater focus on the local and that it will make social work as a service more focused on local communities and services.
“But there is a danger that local authorities may, in their desperation to make further savings, pool social work teams for the whole area into one little block so that you have local area coordinators in the community and one social work team dealing with people on an emergency basis. I think that would be unfortunate response.”