I’ve been increasingly occupied in my work life thinking about plans in our world of social care. You might not be surprised to hear me say that the different experiences and perspectives of a whole range of people I hear from, who draw upon and work in social care, don’t really stack up with what I understand from my policy work is meant to happen, to be our direction of travel. I am more and more of the opinion that plans are at the root of this discord.
We use the term ‘plan’ loosely and interchangeably. A care and support plan, a person-centred plan, a care plan. The context and people involved are important in understanding exactly which sort of plan is being talked about. It seems to me, they all get a bit muddled.
I wonder if a building analogy might throw some light on what I mean.
We love watching grand designs and amazing spaces on channel 4, though I’m not sure my wife’s motives for watching the latter are all about what happens to the properties. I love watching the journey unfold with its twists and turns and, in most cases, amazing end reveal, often plucked from the jaws of defeat and adversity.
Anyone who’s had a building project will know, if it’s a big project the first job is to get planning permission. You can draw up some plans yourself, but most folk get an architect to prepare some plans ready for the planning approval process. We found this really helpful as ours had some great ideas and helped us shape them into something he knew would work in getting them agreed. The drawings usually include some specifications of building materials to be used and methods to be employed, which give a sense of assurance to the planners that the building regulations will be complied with and it will be structurally sound.
Permission granted. Fabulous.
Then, we hit the real world, as is often the case storied in the channel 4 programmes. Actually, the grounds not as expected, so the foundations have to be made differently, the steel girders that arrive on site were made a metre too long and have to be cut to size, and new fixings engineered on site. Since the foundations had to change and cost more, there’s not enough money in the budget now to fit the super large sliding patio doors envisaged, so a cheaper option has to be found.
When we were doing our home extension project, it was particularly interesting to me that the builder was keen that I wasn’t around when such snags had to be negotiated with Building Control. They knew what to say, how to handle this layer of bureaucracy with my interests at heart (maybe they just wanted to get finished and to the next job though!).
Project complete, all shiny and new…and then you live in it…and you realise that some of the things you thought were going to be fantastic, aren’t all that fantastic. We didn’t really need that swish racking that comes swinging out of the corner unit in the kitchen. That lovely clean run of wall we fought for isn’t very practical, and we could do with more storage space (you can never have enough storage space, can you?). You do a bit of feng shui in the lounge and hey presto, it’s just so much more zen than that design you came up with in Ikea was.
I guess my point is that we seem to have got a bit rigid in our thinking about what is and isn’t possible and lost the sense of the ideas that were behind the evolution of the planning process in social care. Oversight of plans is stifling people’s flair to think about the art of the possible.
I think we need to reset and get back to processes that are helpful to everyone in the spirit of personalisation.
A care and support plan that creates a broad framework for what the person wants to achieve with support and gives them a green light to get on with building a good life. A person-centred plan that vividly brings to life and stories the twists and turns from early ideas through learning about what works and what doesn’t, crossings out, lines with arrows drawn on afterwards, cut-outs from magazines and fabric swatches stuck on comprising a mood board. It’s personal and owned by them. It’s not for policing, though it does give a clear sense of what’s being achieved, how it’s enabling a good life. There are helpful folk around to talk to and help make sure this evolution stays within the broad framework given the green light, or advise if some significant changes need to be renegotiated.
I don’t think this is how we currently use plans, but I do think it’s very much in the spirit of all the policy stuff I’ve read. I think we should talk about it. What do you think?
