I had a letter from an old friend last week.  Old as in long-standing; chronologically she is the same age as myself as we were at college together, and as we all should know ‘old’ in terms of years is a fairly meaningless term.  But I digress.  She had written to me because she knew I was interested in the ways we provide housing and support for older people and wanted to share her experience of looking for a care home for her mother-in-law.

Her mother-in-law had been supported in her own home with three visits a day from paid carers, regular visits from doctors and nurses, and friends and family staying with her three weeks out of four.  It was becoming evident that this was not sufficient so they started looking for residential care (geographically we are in the East Midlands). In her own words, ‘We researched homes on the internet using CQC reports, we managed to dismiss ones without having to see them, even so there were more homes that were dirty or depressing, which we dismissed immediately or were where people were left to die.  Eventually, we came up with two, one seemed far better than the other and we managed to get her into it.’

The chosen destination is a relatively new development, purpose built to include both a 62 bed care home providing residential, nursing and dementia care and 22 apartments for purchase or rent by older individuals or couples.  For the latter, access to personal care and support is available as required.  ‘What impressed us immediately was a beautiful airy space, with a coffee shop, which anybody could come to and sit with their relative and friend and how much people could personalise their rooms.’  She reported that her mother-in-law has become much more perky from eating three meals a day and has begun to walk a lot more as the activities which take place three or four times a week are held in the coffee area – ‘but it still has space for others to read the paper or just chat’.

She also described another resident who could probably live independently but had been persuaded to move in by her children.  ‘She goes out on the mini-bus to town and to meet her friends, but loves being in the home as everyone knows she is cared for and not a burden.’  She concludes, ‘they don’t have a bar, but you can have drinks in your room’, perhaps a reference to an earlier conversation I half remember when I was no doubt advocating (to some surprise) such practice.

As I finished that sentence a new email popped up – the Housing LIN Viewpoint 23 on Building Mutual Support and Social Capital in Retirement Communities.  Some will know I have been heavily influenced by my experience while at Dartington where they plan to create a community for older people on the site of the former radical school. In the course of planning for this initiative we were privileged to visit a number of inspiring developments across England including those of the Extracare Charitable Housing Trust, St Monicas in Bristol and the JRF schemes.  The aspiration was (and is) for a community that builds on the best evidence, for example on design, on support of those with dementia, on community integration, and on equity.

I was disappointed to see relatively little detail on different models of housing for older people in the Strategy for Housing for Scotland’s Older People 2012-2021 released by the Scottish Government just before Christmas.  There is reference in the section on Innovation to co-housing and retirement villages and to the Quarries (re)development by Dunedin Canmore HA in Edinburgh but very much a sense that such options are the exception rather than mainstream.

It is of course all about choice – many would regard living in a community with others as anathema.  For some however there will come a point when the choice is more constrained and, as for my friend’s mother-in-law, we want options that generate such enthusiasm as to write an unsolicited testimonial such as I received last week.

Courtesy of a free place (thank you Anna…), I spent two days last week at the Guardian Public Services Summit in St Albans.  This is designed to challenge thinking on the future landscape for public services and encourages identification of issues generic to all public services.  I often struggle with broad strategy talk as it can spiral off into meaningless generalities; the discussion over the two days however was sufficiently grounded to give a satisfying mix of breadth and depth.

As an irregular tweeter, I find one of the most useful features of the 140 character message is that during events of this type it focuses the mind on distilling one or two key messages from each presentation.  So the following is in turn a distillation from those (very) brief responses on the day.

It was reassuring to hear familiar messages from the very start: the Chief Executive of the Local Government Association declaring that integration is the key to the resolution of public services challenges, and that tackling the funding of adult social care must be the starting point.  Within a very short time themes central to the interests of IRISS were tumbling out: assets based approaches, community capacity, partnership with independent providers.  Resonance continued with discussion of ‘what is innovation anyway’ (according to one great soundbite, ‘innovation lies in the shift from victim to architect’), and a suggestion that public services leaders are despondent at the lack of evidence-based policy making and the rise of an overt ideological base (not of course in Scotland; this was a primarily English perspective with only six of us venturing south from north of the border).

David Walker (erstwhile Social Affairs Editor at the Guardian) gave a refreshing input to a session titled ‘are we overly influenced by fashions in public service design’.  He called for evidence-inflected (at least) public management, a term that competes well with our ‘evidence-informed’ and introduced many of use to a new word, neophilia.  He expanded on this condition in a column on 7 February – ‘During the past two decades the public sector has succumbed to neophilia. It’s a condition defined as fixation with the new, the fashionable, the trendy … and soundbites from imported gurus.’  Social impact bonds, discussed as a potential option for families with complex needs, may for some have fallen into this category.

An interesting discussion developed around the appropriate measurement of impact, stimulated by a call from the co-founder of Southwark Circle for an intelligent approach that gets beyond crude metrics.  With the measurement of social value an element of the Public Services Bill in England, this will be an issue to watch.  A final reflection from day one, from the Director of the Clore Social Leadership Programme, was that the days of heroic leadership are over;  the requirement is for values based leadership at all levels.

Day two woke us up with a string of impressive speakers.  The leader of Suffolk county council presented their cautionary tale of the failure of a  ‘bull in the china shop’ approach and stressed the importance of understanding locality and effective partnership.  The chair of RNIB gave an inspirational and wide ranging address on how to approach reform (and likened the treatment of the voluntary sector to the shaking of a baby’s rattle) which should be widely circulated.  The Chief Constable of Greater Manchester revealed that the greatest challenge for their force is no longer crime but mental health; he also argued that getting people to break out of their job descriptions is the key to the cultural change needed for innovation.  The Director of Children and Family Services for Knowsley suggested that more than iterative improvements are required to achieve transformational change and outlined their use of the radical efficiency model to transform support for children and families through co-production.

And to end on a lighter note, two good jokes from the summit.  The new Chief Inspector of Ofsted and ex head of Mossbourne Academy described how one of his pupils had asked why he was joining Offhead, while the Bishop of London in a rousing final keynote told the story of a child in a cathedral who asked who he was and when being encouraged to guess from his vestments and staff responded ‘I know who you are, you’re the grim reaper’.

Today had a certain symmetry to it.  In the morning I was at the first meeting of the Research Advisory Group for the study of Serious Case Reviews that we are conducting with Sharon Vincent from the University of Wolverhampton, one of the experts in this field.  Members of the Advisory Group were all members of the Short life Working Group led by MARS which reported in June 2010 on developing best practice in this field and the current research is a direct result of one of their recommendations.  Their guidance is invaluable in ensuring that the study really assists with advancing good practice and in achieving the aspirations of the Group.

An essential element of the study is that it is very much designed to share the learning that has emerged and to ensure that this can be carried forward into future practice.  This should assist all those involved in child protection processes and procedures in advancing practice.  In this respect Scotland has traditionally retained a more positive perspective to child protection, with less of a blame culture, than that south of the border.  Politically there has been a recognition of the complexity that often surrounds individual cases and a reluctance to make political footballs of individual cases.

The study will produce its draft report for August this year and will feed into ongoing work by MARS and Scottish Government designed to achieve the most effective child protection procedures.  We very much hope that the study will have the full support of the Child Protection Committees in making their reports available for the study.

Tonight I watched the first episode of Protecting Our Children, the series in which Bristol children’s services have allowed filming of their activities over a period of a year.  Annie Hudson, the Director, was on the morning news programme explaining their motivation – a desire for the public to understand the extended work that takes place behind the trigger for intervention and the final headline, and a recognition that as a public service social services should be open and accountable.

The first episode featured a well chosen case, not immediate goodies and baddies but an emerging recognition of neglect that was impeding the three year old’s development.  A subsequent pregnancy added to the complex mix of factors, and a hospital admission precipitated removal of the young boy to foster care.  Inevitably some of the discussion and involvement must have been truncated in what was shown.  However like many of the reviews, whether by journalists or in the twittersphere, I was impressed by the measured approach that was taken, by the professionalism – and resilience – of the workers, and, not least, by the courage of the parents who allowed the challenges they faced to be public viewing.

In an era when the media in general, and television in particular, is lambasted for its sensationalism and hype, this sober analysis is refreshing and I look forward to the remainder of the series.  What I cannot judge of course is what those with no connection to the field would make of the programme; I hope someone will seek to find out.

I had a Sliding Doors moment today (13.12).  No, not the workshops organised by SSSC/NES/IRISS on Reshaping Care for Older People – though hopefully all those who attended will know I am referring to the film with the girl catching/missing the underground and hence the metaphor.

My Sliding Doors moment arose in the context of an invitation to speak to the Inverclyde Practitioners Forum.  IRISS has a network of Champions across local authorities and the independent sector [By the way what’s this with referring to the ‘voluntary and independent sectors’ – the purple pen came out when my students did that as I had always told them that independent = voluntary +private].  Lisa Burton is the Inverclyde Champion and had invited me to speak on the research on health and social care integration which was commissioned by ADSW earlier this year.  She rang yesterday to ask for the presentation and I had to admit I hadn’t done it yet – too busy with the Talking Points review.  Last night I started to put it together.  There had been rumours that Nicola Sturgeon would make the long awaited announcement on the route for health and social care integration on the 12^th – she had a relevant visit planned.  I had watched the Scottish News – why did I think for a moment that the rest of the nation would be grabbed by these headlines!  I had checked various websites but it looked as though the rumours were false.

So I half-prepared the presentation and got up early to finish it.  Just a final check to see whether there was any update.  Oops –there HAD been an announcement yesterday.  Rapid revision – for once being tardy had its own rewards.  Imagine my embarrassment if the door had slid the other way.  I would have turned up and been completely thrown by Rab Murphy’s reference in his input to the plans.

Enough of this.  What is my initial response to the proposals?  Relief that we are not being sent down the time-wasting diversion of structural change; a big cheer to see the word ‘evidence’ used; appreciation of the need to recognise the local context; some concern that individual personal outcomes will be lost in the traditional genuflection to delayed discharge and bed days; a hope that in the focus on older people others will not be marginalised.  Obviously we only as yet have the sketchiest of details – it will be the detail that will be decisive.  My hope is that there will be a common will to realise that the time has come to conquer this particular ‘wicked issue’.

Those who read my first blog will have sensed some uncertainty, even unease, about the whole blogging process.  An example: a week ago we held our second IRISS Forum, Designs for the Future.  It focused on service design and included our Choreography of Care and Support project in which students from Glasgow School of Art worked in partnership with older people and the organisations supporting them in Glasgow south.  Is it blowing the IRISS trumpet to tell you how it went, something a little against the grain?  Perhaps I’ll leave that to one of the delegates: ‘I genuinely think it would be unfair to rank these presentations as they all offered something different. Joe Heapy reminded me of the value of broadening the range of contributors to social care. Here’s a Hand reinforced the brilliance of a simple idea pursued with consideration. The students from the Glasgow School of Art bowled me over with their enthusiasm, honesty and creativity. They cut through the bureaucracy to design what they thought made sense for older people. Denise Stephens brought home to me again that better services support or assistive technology does not necessarily need to cost the earth. Raising our aspirations is the first challenge.’

My colleagues have been urging me to blog for IRISS (sounds like a tag line there) for some months.  I kept putting it off, waiting for the right topic.  Perhaps I would focus on health and social care integration – but the announcement kept getting postponed.  Or I could revisit yet again the funding of care for older people – but what is there new to be said.  So I’ll take a different tack.  Off to Edinburgh for a dose of art (Alison Watt) and theatre (Play, Pie and a Pint at the Traverse – not a patch on Oran Mor as a setting), I opened the paper to find an article titled ‘How to talk mandarin (even if it is drivel)’.  This referred to the blogging of Peter Housden (Permanent Secretary) and revealed tantalizing glimpses of his blog to those of us outwith the Scottish Government intranet.

People may have seen the debates as to whether hearing of his tv preferences, his shopping trips or his golf shots fully befitted his status.

This set me wondering why it is that people blog – and true to my research pedigree I offer a tentative characterisation.  It would be invidious to name specific blogs under each category; I will let the reader do this.

For some it is perhaps a desire to create a strong web-based persona – perhaps their own or an alter ego.  Some of the most engaging blogs come from those who have no qualms about asserting an identity and draw you in in successive blogs to their loves, hates and prejudices.  For many in this category, multi-faceted aspects of their lives, personal and public, spill out with little concern as to boundaries or niceties.  In this category particularly cultural markers are likely to be displayed, some subtle, some overt.

For others the blog is very much a mechanism for communication and reflection on the core business of the organisation they represent.  The persona is the collective at work, wanting to get their views heard, to be acknowledged as a key player, to develop a specific argument, or (however subliminally) to court the market.

Other bloggers (and of course these categories are not necessarily mutually exclusive) may use the blog as a mechanism for letting off steam.  Perhaps at one level a grumble about those who fail to turn up when they have booked for an event; more globally a critique of a policy that appears particularly disconnected.  Again the selection of topics no doubt provides clues to individual passions and irritants.

I’m not sure I’ve decided yet which of these identities I wish to adopt.  I suspect it may well depend on the mood of the moment and on the triggers that motivate me to rattle the keyboard.  The one thing I can guarantee is that the blog will appear on an irregular basis; other than that, watch this space.