East Sussex County Council worked over three months, across the council and partners, prototyping a new multidisciplinary outreach operations team. They provided intensive support to residents in temporary accommodation to enable them to live more independently.
The team successfully engaged with 24 clients in improving their health and/or housing outcomes through this prototype project. 17 clients were able to address their mental health needs through access to a specialist and medication. 10 clients were supported through a housing crisis situation. 19 clients were able to successfully sustain their temporary housing accommodation and others were able to move to private rented accommodation, social housing and supported accommodation.
The project was able to confirm the value in sharing data between multiple agencies to provide a more holistic view of each case, enabling more effective assessment and management of risk. Co-location of staff supported real-time collaboration, inter-agency learning and communication. The model affirms the value of whole system multi-agency working to support people to live independently.
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[00:00:08] So in terms of the initial challenge, what East Sussex wanted to do, our initial ambition was to redesign our approach to commissioning and partnerships and voluntary community sector to better harness community assets, tackle inequalities and improve outcomes. We held two workshops with over 60 organisations, which is very useful.
[00:00:28] But it was felt the scope was too broad and we were struggling to apply the design tools and techniques on that particular challenge. It's the work of the voluntary community sector that's continued and continues. Now with the Design Council project team at the County Council narrowed the scope to focus on an existing opportunity.
[00:00:47] So we focussed on the retender for housing related support services across the county. It's really large contract and it covers floating support and supported accommodation. So, we interviewed 35 extreme users, which were clients, staff and referrers. Together insight into what works and what we can change and improve upon. And we produced workouts on to identify key themes. We also requested a three month period of data from the five district and boroughs within our county to get a clearer picture of who clients were and we also ran two workshops for key stakeholders to feedback on the data. And we used design council tools during that to design a prototype. And interestingly, we have three tables and all of them came up with the exact same prototype. So we went and did the prototype, which we called the MOPT, which is the multidisciplinary outreach prototype type team that have a mouthful. But we had identified a cohort who was slipping through the gaps but between teams and never quite reaching threshold for statutory services. And so, the MOPT involved support workers who were co-located with the Hastings Borough Council Housing Options team for three months. And those support workers worked in a proactive, assertive and intensive manner with people living in temporary accommodation who are deemed traditionally hard to engage. We also had two project coordinators from adult social care to bring organisations together around the client and report to the wider project team, which includes the DMBs, NHS colleagues and the Department for Work and Pensions. So, we had four major challenges that we identified. The first was multiagency working, asking everyone around the table in a crisis proved quite challenging sometimes. And we found we really needed senior management by in quite an early stage of the project for it to be a success. Information sharing was hard. So, each organisation sometimes bought a completely different picture of the client. We were trying to help. Sometimes it felt like they were four clients instead of just one because everyone had different information about them, and everyone bought something different to the table. So, we found the appointments-based system that we traditionally used was also quite a challenge. This cohort doesn't respond well to appointments. So instead, working flexibly and having the support workers pop in, if they were near a temporary accommodation was invaluable for keeping clients engaged. And we also found project team continuity like the last team as well was really hard, the project team looks completely different now than how it did when we started. So, it's been a challenge to keep track of the lessons learned. So for the wow moments, we found that many of those hard to engage clients really weren’t hard to engage at all. So, we found that knocking on doors, texting them, dropping notes to their letterboxes worked where previously just ringing them, leaving voicemails. They weren't responding. So, we have 48 percent of those hard to get clients engaged within one week, which was just amazing. So, as a result, the current floating support provider has agreed to engage all clients moving forward in a more proactive and assertive way. We also found the clients have been moved into TA with no support on switching to new GP surgeries that contributed to crisis situations when they ran out of medication. So that's now part on that form where they can get assistance with that. And we also conducted 360-degree feedback with client support workers and the housing team. And it was overwhelmingly positive about the new way of working and the impact it had on client’s lives.
[00:04:12] So in terms of where we are now, in terms of embedding some the learning. Hastings Borough Council housing options team have retained co-locating support workers and are meeting monthly with our adult social care coordinators to help problem solve. And some of the principals are learning that analysts described have been embedded into the kind of new specification for the commission service. And the new model of commissioning is almost completed, and the tender date is fast approaching. So in one sense, the project's closing. We've got a final steering group next week where we'll conduct the final lessons learnt exercise to capture the key challenges, successes and learnings take forward. Learning from the process is being taken into other commissioning projects. But we want to ensure this is consistent and a process of continuous learning. And we are actively using the design tools in other areas of commissioning already to conduct services, interviews, get stakeholder feedback and identify how services are performing. But we also think about how we formalise our lessons learnt process, so the staff changes don't impact our ability to learn and improve practice going forward.
Lucy McFarlane, Project Manager, Housing and Support Solutions, Adult Social Care & Health, East Sussex County Council