Community Capacity & Social CareDraft Discussion Paper - Version 1.0

John Gillespie & Simon DuffyWith thanks to Nic Crosby & Andrew Tyson21st October 2008

IntroductionIn Control believes that each and every person can be an active citizen. However we need to learn more about what it takes to encourage and sustain citizenship and to build communities that welcome and foster citizenship. This paper describes a model of community capacity building which can be used to promote and test a range of possible strategies for building stronger communities and stronger citizenship.It is hoped that our Community Capacity Model will provide an early framework for the work that in Control will be undertaking with its local authority members over the coming months. We will use the Model and test out some practical approaches to developing a greater role for communities in supporting peopleʼs active citizenship by:• Supporting local authorities as they invest in their own local approach• Locating such approaches within a holistic model• Supporting local authorities to test these approaches• Sharing lessons, learning and data with members and wider networksThis paper is not a definitive statement of our Model. It provides the initial framework which will be tested for coherence and effectiveness. The Model will be refined as we work with the Government, our membership and the wider community.

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We need to find the right language to

describe these approaches -

‘Community Capacity’ may not be the right

term.

Is there a better term to describe this way of

thinking?

Economic Sustainability & Community CapacityThere is a tendency within Social Care to see a focus on community capacity as both highly desirable and yet as somewhat marginal and aspirational. The focus on prevention and community does not seem to help local authorities with hard short-term decisions on expenditure. Instead the primary focus has often been to control cost-inflation in services.Yet a focus on community capacity may be the only real and meaningful way to make Social Care economically affordable in the long-run. For, if we think through our economic options, we find that there are broadly only three options:• Input-focused efficiency - reducing the costs associated with support services -

primarily this will mean reducing the growth in salary levels.• Process-focused efficiency - identifying more creative and appropriate ways of

delivering support for any given level of funding.• Needs-focused efficiency - reducing the need for paid support - primarily this will

mean increasing capacities of citizens and communities.In Controlʼs early work showed the advantage of shifting decision-making towards people in order to improve process-focused efficiency. We have found that people can make much better use of resources they control. We have also seen some evidence that Self-Directed Support can also reduce needs - fostering capacity and community. However, on its own, Self-Directed Support will not be sufficient to maximise the economic sustainability of Social Care. In addition it will also be necessary to pay attention to:• How those people and families, who are currently not eligible for Self-Directed

Support, might be supported to increase individual capacities.• How the delivery of public services can be made more enabling and more focused

on strengthening capacities and connecting people to community.• How family, community and other social structures can be strengthened in order

to meet needs without any use of individualised funding.Needs are not simple or absolute. Our needs grow to the extent that we lack resources, skills, family, friends and a sense of our own personal capacity. Our needs grow to the extent our communities are fragmented, weak, prejudiced and impoverished. Welfare services are often very necessary; but they do not the offer the most efficient way of meeting needs in the long run. In an era when most observers believe that the welfare state will no longer grow as a proportion of the economy it is increasingly important that we shift our approach away from merely providing support. Instead we must start to find strategies that minimise need and increase community capacity. The aim must be to shift spending from a remedial approach to one that invests in community capacity in such a way that future on-going spending commitments are reduced.

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The Policy ContextToday the Government is, quite rightly, encouraging Social Care departments to reach out beyond their traditional boundaries. In particular the concordat Putting People First encouraged local authorities to promote strategies for:• Prevention and early intervention• Growing social capital and strengthening community• Improving access to mainstream servicesFurthermore, there is increasing evidence that the tightening eligibility criteria for Social Care is excluding growing numbers of people from Social Care services - whether these be traditional services or Self-Directed Support. There is a danger that this will create more crisis-led interventions rather than strengthening communities.At the same time, outside Social Care, there are many important initiatives that have questioned the tendency towards undue centralisation and have encouraged local government to be more confident in exerting its own authority and solving local problems with local solutions. The following terms give a flavour of current trends:• Double Devolution - the idea that power needs to shift from Central Government

towards local Government and further downwards towards citizens. See for example the Local Government White Paper, ʻStrong and Prosperous Communities.ʼ1

• Place Shaping - which has focussed on the idea that Local Government and people who live in an area should become actively involved in making it a place they want to live.2

• Empowerment – The recent Empowerment white paper3 is an important statement of the Governmentʼs intention to put more power in the hands of citizens – through citizenʼs juries, community kitties and participatory budgeting, though the relevance of Personal Budgets to this agenda has not always been well recognised.

• Citizen Engagement and Partnership Working - Local Area Agreements, Community Safety Partnerships, and neighbourhood management are all examples of attempts to address issues in a joined up way and involve local people.

• Social Enterprise - There is a general trend towards an increased role for the voluntary and community sector in delivering government contracts. Government has provided support for capacity building of community organisations through funds such as Capacity Builders,4 and Futurebuilders.5 The Third Sector Review made a commitment to help give third sector organisations a greater voice and to work with the sector to strengthen communities, transform public services, encourage social enterprise and support the conditions for the sector to thrive.6

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The Challenge for Social CareThis is a fast-changing time for Social Care and a number of demographic trends are putting pressure on the current system:• Rising populations, especially the impact of ageing, leading to tightening budgets

and restricted eligibility• Poor incentives for people to stay well, reduce need and avoid crisis• Inefficient allocation of funding over the lifetime of someoneʼs support journey,

crisis interventions can end up costing more than well timed prevention• High eligibility thresholds that separating those who qualify for Social Care and

those who donʼt• Severe means-testing leading to increasing numbers of ʻself-fundersʼ who pay for

their own care - some of whom may be at greater risk of social isolation• Increased awareness of the need to be sensitive to the challenges faced by people

form rural communities, and those from the black and minority ethnic communities.The Government has made clear that it is time that prevention and re-ablement must become central to the effective delivery of Social Care:• The Concordat - Putting People First - calls for every authority to have a ʻsingle

community based support system... binding together local Government, primary care, community based health provision, public health, social care and the wider issues of housing, employment, benefits advice and education training. There are examples cited of joined up working between Social Care and the NHS, and Social Care and Supporting People funding.

• The Local Authority Circular - Transforming Social Care - describes the expectation that councils should balance investment in, ʻprevention, early intervention, re-ablementʼ alongside traditional support for those with complex needs.

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Beyond Self Directed SupportSome people have imagined that Self-Directed Support is in conflict with strategies to support community - but this is the reverse of the truth. Self-Directed Support is just one strategy for promoting stronger communities.In Controlʼs model of Self-Directed Support is about giving people more control of their lives by making clear their entitlement to a certain amount of funding - the Personal Budget. This process is not just about control for the sake of control, rather as is set out in Keys to Citizenship (by Simon Duffy) control of the budget is just one helpful element within a wider process for promoting citizenship.Moreover citizenship itself should not be seen as a dry or abstract property. Citizenship is about real life and the keys to citizenship are also the keys to a stronger community:• Self-determination - being able to make your

own decisions• Direction - being able to define your own

unique role• Money - having enough independence to

strive for oneʼs goals• Home - having a safe and private place,

where you belong• Support - being needed by others, being

interdependent not self-sufficient• Community life - contributing, giving and

supporting communitySelf-Directed Support has been important because it enables a fundamental shift of power to families and communities for the over 1 million people who rely directly on Social Care services. One of the positive consequences of the introduction of Self-Directed Support has been significant and measurable improvements in peopleʼs social capital. In the latest report on Self-Directed Support, from a sample of 200 people, 64% of people had taken a greater part in their community, while only 2% had become less involved (see figure below).Moreover the successful implementation of Self-Directed Support is about more than making systemic change within Social Care; it also involves:• Co-production - learning new ways of collaborative working on support planning,

risk management and service delivery• Service development - fostering new models of support, encouraging social

enterprise and skills development• Community capacity building - creating new networks of family, peer and

professional support, encouraging learning and sharing of information and skills• Cultural change - helping people to develop their understanding of the richness

and capacity of communities, especially those people whom they serve

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Shifting power is not a naive promotion of consumerism. Instead it is a mutually productive process of power sharing, a process where the unlocked capacities of individuals and families can be increasingly realised in more productive partnerships with supporters and Government.

2%

34%

64%

Taking part in community ImprovedSameWorse

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In ControlIn Control believes that these issues are directly relevant to the issues that Social Care departments are seeking to address and that it is time to explore how older people, disabled people, children and all anyone who needs extra support needs can not just be included in the community but that can actually lead the process of community development.Sometimes there has been a perception that In Controlʼs only interest has been in changing the delivery systems for Social Care - care management, commissioning and service provision. And it is certainly true that much of In Controlʼs attention has focused on these very practical issues. But In Controlʼs work has always been motivated by an understanding of the need to attend not just to the conditions of active citizenship but also the conditions for stronger community - in a healthy system each will support the other. As In Controlʼs Ethical Values statement says:... We believe that people truly flourish not as lone individuals but when they are part of communities: families, friendships, neighbourhoods and all the organisations of civil society.

In the past in part because so much of in Controlʼs focus has been on changing the system, we havenʼt perhaps said as much as we could have done about the role of community in empowering people, and so it may appear that we are only concerned with one particular problem about the way the system worked. Actually this has never been the case, rather In Control has supported a range of practical approaches to promote Community Development:• Partners in Policy-Making - a national peer support network that promotes

learning and mutual support• Plan UK - a federative system of focused peer support groups• Community Connecting - publications focused on the development of skills in

building friendship and community• Small Sparks - a small grants programme focused on community development

activity• In Control Jobs - support to help people find and keep work• Manavodaya Institute - a partnership with one of the worldʼs leading sources of

expertise on community-based development and facilitation• Shop4Support - a internet site offering advice and information to allAll of this work suggests now is the right time to refocus our efforts on community. In Control has recently made the community strand central to its Total Transformation programme. This will give us a way of trying out some new and practical approaches and laying the foundations for some larger research. That programme has a modest budget and will be led by the Simon Duffy (CEO of In Control) with support from John Gillespie (who is seconded to In Control from the Community Development organisation Novas Scarman). We will also be working to identify other resources that can support work in this field.

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The larger value underpinning all of in Controlʼs work, is one of an ʻempowered societyʼ, less dependent on the State for external support, and more ready to embrace its own resources – family, friends and community for mutual support. So our practical work with authorities will set out to develop and augment this by focussing on three things;• How the agencies of the state can turn themselves

around from being creators of dependence, to becoming agencies of empowerment.

• Better modelling of the elements in peopleʼs lives that are important for achieving ʻactiveʼ citizenship – which presumes they are meaningful, independent and interdependent.

• How interventions of Social Care departments can move beyond the domain of Self-Directed Support to other ways of empowerment.

There is increased interest in exploring the use of mini personal budgets and one off payments for people on the margins, and some authorities are exploring models such as Local Area Coordination, a community connecting role developed in Western Australia and now also used in Scotland and Northern Ireland.

Building a shared model

In developing an holistic and useful model of community development it is already possible to see that we will need to pay close attention to the different experiences that drive policy and broader thinking about community. It will be important to attend to:• There needs to be attention to the full population, with special emphasis on those

most at risk of Social Exclusion - which will include some Self-Funders and those falling just short of eligibility.

• The model needs to connect to the wider Empowerment agenda with its focus on developing individual, family and community capacities

• The idea of Place Shaping, which asks what does there need to be in communities with a view to maximising connectivity and building on existing resources and leadership

• Current Community Development activity and the perception that much of the current activity does not include people who have social care needs

• The Personalisation agenda for Social Care departments to reach out beyond traditional boundaries and partner with other agencies to build stronger communities

• Increasingly concepts like Budget Holding Lead Professionals and the use of mini-personal budgets are connecting the work around adults and children.7

We need to find the right language to

describe ‘empowerment’ - this term may have been

over-used to the point of redundancy.

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Social Justice and Community CapacityThe welfare state is rightly shaped by our assumptions about how to achieve greater social justice. However it is not uncommon to see some assumptions being made by policy-makers and political theorists which betray some misunderstandings of the reality of service delivery and the factors which shape the achievement of a good life. It is common to see it assumed that:• More money will lead to better outcomes• Services and supports are always good things• People with needs are naturally dependent upon others and require guidanceThese assumptions may be rooted in the paternalistic nature of early welfare provision. However there are good reasons to be suspicious of these assumptions. As we have already suggested:• More money is poorly correlated with good outcomes• People can become so dependent upon services that they become disconnected

from opportunities in their community• Many people have capacities for creativity and productivity which just need to be

unleashedAt In Control we are interested in how these lessons might inform a deeper understanding of the factors which really determine how people have a good life and what a society should do to offer support to its members and promote greater social justice.

Integrated Budgets

To begin with its important to see that Individual Budgets or other forms of state funding or benefits are only one part of the picture. Integrated Individual Budget should be seen in the context of the individualʼs benefits and personal income. All the individualʼs financial assets need to be considered.

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Moreover there is currently insufficient attention paid to the diverse disincentives for individuals and families to improve their income and savings. Means-testing and poverty traps are also an important factor in determining the real value of those assets.

Real Wealth

In fact we could even go further. What we are learning is that what it actually takes for people to achieve a good life is more dependent upon a number of factors, each of which is logically independent:• Capacity - Abilities, skills, health, communication abilities• Connection - Family, extended family, friends, work colleagues, peers,

organisations, clubs, groups networks• Information - Knowledge of possibilities, best value and community resources• Money - income, benefits, tax credits, capital assets and where eligible an

Individual BudgetThis is real wealth, the resources that enable individuals and families to achieve a good life.

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This part of the Model helps us understand how someone who is poor by the norms of society can still be very wealthy if they have a vibrant sense of their own capacity, if they have family and friends and if they know where and how to connect to the community opportunities that they value. This part of the Model also helps us to explain how someone with a lot of money can feel incapable, can be socially isolated and can lack any awareness of what is possible.

Richer communities

Of course wealth, even ʻreal wealthʼ is, in itself, not the only factor determining the outcomes we can achieve. It is the way in which we use our wealth in the context of the wider community with which we are situated which will shape the outcomes we achieve:• The quality of family life in the community• The associations, clubs, circles available• Social enterprises, charities, faith organisations• Business, commerce and economic environment• Public services, hospitals, schools and emergency

services• Law, regulations, democratic and judicial structuresIt is important that we learn more about how wider communities can enable or inhibit the extent of opportunities available for individuals, and how interventions also impact on communities.ʻCommunity Capacityʼ is a useful concept for thinking about the ability of communities to offer support and respond to challenges. Interventions need to be understood not only in the context of how they directly support outcomes for individuals, but also by how they contribute to developing the capacity of communities.

Supporting Community Capacity

Interestingly, if this analysis is correct it suggests that the modern welfare state will need to become more sensitive to the value and tension between three broad strategies:• Developing richer communities• Increasing family wealth• Offering effective supportThis framework helps us to see that if our primary responsibility is to help people have good lives then we need to learn how we establish the conditions for success. We need then to see how best to invest in our own society to ensure that we genuinely support success. It is important to see that this a whole-system model where a change in one part of the model will require changes at other points:• Increased money in public services necessarily reduces the money that can be

invested in family wealth.

Communities can be defined in many

ways - around shared interests,

political structures, physical

environments, ethnicity, religion or

work.

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• It is important to invest in the most effective support strategies - and this may not be how resources are currently invested -

• It is important to invest in those aspects of community will be which be most productive - and this may not be how resources are currently invested.

There is still much to learn about how to enhance social justice - but this model may offer the basis for a genuinely empirical approach for promoting greater justice and better lives for everyone - however complex their needs.

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Next Steps - Mapping interventionsIn seeking to explore how some of these different approaches play out, local authorities will need to understand the value of the different interventions that are currently in place. Local authorities will be able to map the different approaches. The table offers an early and primitive example of what such a map might look like for one authority:

Intervention Strategy

Examples in Social Care

Examples outside Social

Care

New Opportunities for Innovation

Current SC Spending Patterns

Family & Friends Information Directories After-School Clubs Partners in Policy-

Making

Peer Support Centre for Independent Living

Expert Patient Programmes PLAN Network

Local Services Advocacy Project Libraries Local Area Coordination

Supporters Service Providers Local Businesses Time Banking

Specialists Care Managers District Nursing Redesigned Care Management

Regulators CSCI Inspectors Trading Standards

This map can be extended to capture the different intervention strategies, which can then be used to explore how greater investment can be made in Community Capacity Building.

Testing the model - effectiveness and efficiency

The process of developing strategies and evaluating outcomes will enable better understanding of:• How authorities can intervene most effectively - defining the properties of

successful interventions• How to invest most effectively in the different interventions - finding the best

balance of interventionsThese are respectively measures of effectiveness and efficiency. Effectiveness - local authorities will want to define ʻnuts and boltsʼ elements of what successful interventions look like. A supported process of developing and testing different solutions should enable this.Efficiency - testing different approaches will allow authorities to make comparison between different interventions on a unit cost basis. Interventions that are delivering greater benefits at lower costs would be strong candidates for more investment. A significant benefit of community focussed interventions should be that savings show

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up in critical care budgets. The aim will be to realise a broadly similar marginal benefit across different interventions – in this way authorities can form a better understanding of where to allocate resources. A cost-benefit analysis will take into account opportunity costs of different interventions. As we discussed above, it is important to note that that extra spending for services takes resources away from citizens.

In Control’s Citizenship Framework

In Control has developed a citizen framework as a method of assessing the impact of Self-Directed Support against the dimensions that make up active citizenship. It is a small step to extend this framework to assess the outcomes of interventions to enhance other aspects of individual wealth. The domains currently used are:• Health and well-being• Relationships• Quality of life• Opportunities to take part in or contribute to their community• Choice and Control over the important things• Feeling of security at home• Personal dignity in Support• Economic Well-being• Life as a wholeThe framework has been used to show that Self-Directed Support is effective as a way of achieving positive outcomes for the same or reduced level of funding. However we know less about the relative efficiency of the kinds of support systems used (e.g. we know that support from a social worker and support from a family both help improve outcomes - but we do now know their relative efficiency.)Wider analysis should allow comparison with the different ways of achieving positive outcomes, and provide local authorities with a better understanding of where to deploy scarce resources. The trade off between investment spending ʻup frontʼ in developing community capacity and its impact on the cost of support services needs to become clearer.However there are a number of considerations that need to be taken into account when deploying in Controlʼs citizenship framework to understand the impact of interventions on whole communities.• The broader populations involved and the different relationships that these have

with the authority• Some interventions may have a displacement effect on existing activity.• Amount spent is not always a good measure of amount of activity in a particular

area.

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For these reasons it will be important to examine the impact of local authority interventions on wider communities and populations as well as their impact on targeted groups of citizens – not just those the authority has a relationship with.

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ConclusionThe constituents of what makes individuals and families wealthy extend far beyond money to other resources people can draw on to keep healthy, independent and lead active lives. These make up a personʼs ʻreal wealthʼ - namely their capacity, resources, connections and information they control – and an individualʼs real wealth depends on a host of other interactions with their community. Local authorities can exert influence beyond their capacity to direct resources to services. They are increasingly taking on a community capacity building role. This paper has proposed a model to enable authorities to better understand how they accomplish this through the various interventions. This will support authorities to engage with the requirements in Putting People First to develop prevention, re-ablement and community building strategies.In Control has proposed that this forms the basis of a piece of work to test innovation and evaluate outcomes against the efficiency and effectiveness by which they deliver outcomes for individuals.

Notes

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1 See DCLG 2006 ‘Strong and Prosperous Communities’ Local Government White Paper

2 See, Sir Michael Lyons’ Enquiry; HMSO 2007 ‘Place-shaping: a shared ambition for the future of local government.

3 July 2008 ‘Communities in Control’: real people, real power’, White Paper

4 See www.capacitybuilders.org.uk

5 See www.futurebuilders-england.org.uk

6 The Cabinet Office 2007 ‘The future role of the third sector in social and economic regeneration’

7 See www.opm.co.uk