Councils across the country are adopting strengths-based practice and asset-based approaches to the delivery of social care with several different models and practices being utilised. One such example is the Partners4Change’s ‘Three conversations’ model, (http://partners4change.co.uk/ the-three-conversations/) which has received much praise in the UK.
Adoption of strengths-based practices has been promoted at the national level by the Care Act (2014)1 and supported by the Department for Health and Social Care, which has developed a Practice Framework and Practice Handbook.2 The handbook sets out clearly what good practice looks like and gives useful examples of strengths-based interventions.
The strengths-based practice is about focusing on what matters to people, what personalised outcomes they want to achieve and enabling them to find the best solutions for themselves, drawing on their own natural and community resources. It’s about self-determination and enabling people to live the lives they want to lead.
Questions and conversations
At the heart of the strengths-based practice is the assumption that the questions we ask and the conversations have an impact on results and the achievement of outcomes. Until recently, a council’s social care assessment focused on deficits and problems, needs, solutions and “how to fix things”. These questions and conversations were based on a deficiency model, predominantly asking questions such as “what’s wrong”, “what is the problem”, “what needs sorting out” and, “how can I help you?”.
Back in the 1980s, Appreciative Inquiry3 started to refocus conversations on what works, what is possible and what people really care about, and this has undoubtedly formed the basis of current-day thinking around strengths-based approaches in social care.
Appreciative Inquiry focuses on identifying and doing more of what is already working, rather than looking for deficits, issues and problems, and trying to fix them. It makes change possible by focusing on the core strengths of an organisation and then using those strengths to reshape the future for those individuals who access and use services.
The basic idea behind Appreciative Inquiry is that an organisation will grow in whichever direction the people in the company focus their attention.4 Consider their four-phase model (page 26) and how it relates to current thinking and strengths-based practice in social care.
A quality conversation starts first with focussing on what matters to the person and listening to fully understand. Where appropriate, these questions can be sent in advance, so the person can think about and prepare their responses.
The use of open questions is vitally important, as these can help in exploring, clarifying and understanding another person’s viewpoint. A conversation will be much easier for the client if there are few interruptions, or if professional opinions aren’t expressed too early by the practitioner.
Listening plays a major role in the conversation, so the professional should listen to understand and summarise the key points they have heard. In the end, they should ask the person about what they can do themselves to bring about the changes they want to make, before offering advice, exploring the available options and looking at what needs to be put in place. Once this stage has been completed, the professional can offer advice, explore the available options and look at what needs to be put in place to enable the person to achieve their goals.
Throughout the entire process, social workers should ask strengths-based questions. Models such as Partners4Change’s ‘Three Conversations’ are really useful tools for helping to frame questions. However, it’s also important not to spin struggles into strengths,5 so exploring needs will also be important.
At Peopletoo we talk about the 4 P’s:
- Person-centred – ensuring the conversation focusses on what matters to the person, their wishes, preferences and personalised outcomes, and is strengths based
- Process – ensuring the conversation supports due legal process
- Proportionate – ensuring the conversation is appropriate and proportionate, and
- Professional view – ensuing the conversation informs professional analysis.
Old wine, new bottles
Yet this is much more than ‘old wine in new bottles’. Having practiced as a social worker in the 80s, I can speak from my own experience when I say we worked in a person-centred, proportionate and strengths-based way, with a real focus on what mattered to the person, what they could do for themselves and what wider strengths and assets they had that could be built on. Community development also featured heavily.
Given this, we should respect and appreciate the ‘old wine’, but at the same time see why it has had to be put in ‘new bottles’. Social care in the 21st century has evolved, meaning strengths-based practice now means so much more – it is about whole organisational change and requires a whole-systems approach and radical re-think. It is transformational in nature, and for that reason, it is entirely different to what has gone before. It demands a shift in culture and mindset and a radical shift in practice.
- Power Shift – build relationships based on trust and respect and move away from the ‘professional gift model’6 to one where people have power and control over their lives
- Control – the importance of self-directed support and people living the life they want to lead
- Risk – align with risk enablement and positive risk-taking, appreciating the benefits as well as risks and weighing up “the risk of doing something versus the risk of doing nothing”
- Outcomes – a strong focus on people determining their own personalised outcomes and empowering and enabling them to achieve these
- Appreciation – appreciate strengths and “what is” and generate new possibilities for action
- Conversations – understand that questions and conversations are never neutral. For example, questions about strengths are more likely to result in a person appreciating what they already have
- Motivation – put effort into motivating, mobilising and bringing out the best in people
- Positivity – encourage hope and optimism and use a person’s image of the future as a mobilising agent
- Connections – promote strong connections and relationships between people/communities
- Results – focus on the “whole system” to bring about sustainable and positive change
- Reality – whilst focussing on “what is strong not what is wrong” don’t lose sight of the needs that people have and the difficulties they are experiencing.
Secrets of success
What makes certain councils more successful in creating the right environment for this approach to flourish?
In our experience, the potential is maximised when there is a strong and methodical focus on the whole system. Put simply, strengths-based practice demands a whole-system approach to change. It’s not only about having different conversations but concerns every aspect of the business.
This idea of organisational change can be traced back to McKinsey’s 7-S Framework,7 which looked to address the critical role of co-ordination in organisational effectiveness, rather than structure. The 7-S Framework was introduced in the late 1970s and looks at several interrelated factors that influence an organisation’s ability to change.
Strategy: This is about having the right strengths and asset-based vision with a focus on better lives, personalised outcomes, managing demand, community capacity building, preventing, delaying and reducing the need for care and support and using money wisely. Key to this is having the right commissioning priorities, strategies and plans. It’s also about having a positive risk-sharing agreement with other agencies to promote personalised and strengths-based approaches.
Structure: This concerns having the right structures in place that are effective and responsive, and add value to the public. Effective front door arrangements are a must here if we are to focus on what really matters to people, be responsive, and prevent delay and reduce the need for care and support.
Systems: Having the right quality assurance systems in place, the right systems on the ground regarding documentation and IT processes and focussing on what matters to the person, what their strengths and assets are as well as their needs and circumstances. Ensuring that frontline practitioners have the time to “listen to understand” rather than focus on completing paperwork and ticking boxes.
Shared values: This is about having the right positive risk-taking, respecting diversity, citizenship and community, empowerment, personalisation, partnerships, cost-effectivenesss etc. Importantly, these values need to be consistent with the structure, strategy, and systems, and are central to all other elements. Importantly, leaders and staff need to model these behaviours on a day-to-day basis, e.g. to be able to empower service users and carers staff benefit from feeling empowered themselves in an environment where they feel trusted, where their professional opinions, skills, and ideas are valued.
Style: Having leaders who “walk the talk” and model the values of the organisation, themselves working in a strengths-based way, e.g. managers who are empowering, and work with their staff in a strengths-based way, appreciating their expertise and what they have to offer; managers who build considerations of strength into everyday operations, rather than focus solely on problems, needs and deficits; and managers who coach and mentor their staff to success rather than instruct them what to do.
Staff: Having the right number of happy, fulfilled, competent and capable staff in the right place at the right time. It’s so important to have the right induction, supervision and development processes in place and the right level of support to encourage more positive risk-taking and to enable people to lead the lives they want to lead. Peer and group/team support become more important in promoting and sustaining a strengths-based culture and challenging and changing mindsets. Creating a coaching culture is a must, rather than telling and instructing people what to do and
simply answering their questions.
Skills: Ensuring staff are equipped and skilled to work in a strengths- and person-centred way. Importantly, it’s not simply about technical training, it’s also about having the right mindset and “winning hearts and minds”. It’s about the “softer stuff” and changing the culture of organisations
As well as the 7-S, Peopletoo has added in a further part to the framework:
Culture change: Culture change is central to the 7-S model, but is difficult to achieve and there’s no such thing as the ‘right’ culture – only a culture that is right for an organisation. Yet change can be achieved
values, the importance of self-determination, if an organisation:
Changeboard, www.changeboard.com/article-details/16042/ mentoring-the-good-the-bad-and-the-ugly/
- Has a clear organisational diagnostic of the “current state” – what’s working, what’s not working and what needs to change, focussing on all elements of the business (see McKinsey’s 7-S Framework)
- Has a clear vision as to what the future should look like
- Has a detailed organisational development plan
- Prioritises engagement, which means collaborative working from leaders, frontline staff and other key stakeholders, and takes a structured change/ programme-management approach.
Designing challenging culture-shaping programmes and working alongside staff to win hearts and minds and embed new ways of working is also crucial. In our experience, we have found "guided conversations” with staff and the use of case record analysis helps organisations to understand what their current position is. From there, a tailor-made culture-shaping programme for the organisation can be created, which focusses on the strengths and the previously-identified areas for improvement.
Personalisation and strengths-based practice
Personalisation lies at the heart of the strengths-based practice. Such practice is about reversing the power imbalance, valuing people, their experiences and their unique talents, strengths and assets. It’s also about understanding what matters to people and keeping the person at the centre of the process.
The focus is on identifying and building on natural resources, co-production, collaboration, and finding smarter solutions to meeting needs. Personalisation and strengths-based practice both have a focus on enabling people to lead the lives they want to lead.
Peopletoo have developed a model called the PiNSS model, which emphasises the importance of being person-centred, focussing first on a person’s wishes, preferences and personalised outcomes. For more information on the PiNNs model visit https:// www.peopletoo.co.uk/.
Benefits of strengths-based practice
Where strengths-based approaches have been implemented well the benefits include:
- People feeling happier and more in control as a result of living the life they want to lead
- The achievement of personalised outcomes and higher satisfaction levels
- The development of new skills and connections, nurturing resilience and promoting independence
- Positive impact on performance
- Reduction in the use of higher cost and more acute services
- The delivery of cashable savings
- Higher levels of staff morale
- Care Act (2014) compliance.1
The approach clearly has many benefits for people who use social care services and for organisations. From a personal perspective, it’s also something I would want for myself – to be listened to, to determine my own outcomes, to stay in full control, to feel hope and feel motivated and, most importantly, to feel valued.
1. The Care Act 2014. Available at: http://www.legislation.gov.uk/ ukpga/2014/23/contents/enacted [last accessed January 2021]
2. Strengths-based social work: practice framework and handbook. Department of Health and Social Care. Available at: https://www.gov.uk/government/publications/strengths- based-social-work-practice-framework-and-handbook [last accessed January 2021]
3. Bushe GR. The appreciative inquiry model. In E.H. Kessler, (ed.) Encyclopaedia of Management Theory 2013. 1:41-44
4. Cooperrider DL, Srivastva S. Appreciative inquiry in organizational life. Research in Organizational Change and Development 1987. 1:129-169
5. Iriss Strengths Based Approaches for Working with Individuals (Insight 16, May 2012)
6. Duffy S. The Professional Gift Model of Care. Centre for Welfare Reform. 2009. Available at: https://www.
centreforwelfarereform.org/library/professional-gift-model. html [last accessed January 2021]
7. Peters TJ, Waterman RH. In Search of Excellence: Lessons from America’s Best-Run Companies. Profile Books, 2nd Edition 2004.
8. Bryan L. Enduring Ideas: The 7-S Framework. McKinsey 2008. Available at: https://www.mckinsey.com/business-functions/ strategy-and-corporate-finance/our-insights/enduring-ideas- the-7-s-framework [last accessed January 2021]
*Article originally appeared in Leadership Issues in Social Care. Leadership Issues in Social Care journal presents the best in thought-leadership and opinion, helping to shape future practice and share learning. The journal focuses on the implications of new legislation, emerging technology, case studies of best practice and more.
It is provided free of charge to Directors of Social Care in the UK and a subscription can be purchased here; https://www.pavpub.com/health-and-social-care/leadership-issues-in-social-care