The paper on Local Area Coordination in England and Wales, “From Service Users to Citizens” (Broad, 2012), is soon to be published.
The paper explores the impact and opportunities arising from LAC forming the new “primary source of support” (as per Vision For Adult Social Care, DH, 2010) or new “Front End” of the service system, placing greater emphasis on local solutions, individual and community strengths and citizenship and less on deficit based assessment, funding and services.
Local Area Co-ordination (LAC) was originally developed in Western Australia in 1988 by Eddie Bartnik and the Disability Services Commission, with assumptions and beliefs around the inherent expertise and strengths of people, irrespective of service labels, to plan, control and contribute to their own lives and the well-being of their community.
It also acted as a catalyst for service and systems reform, making services more personal, flexible, accountable and efficient, nurturing practical, local solutions as the “primary source of support” and pushing services back a level.
It has subsequently been developed across Australia and internationally, including sites now developing in England and conversations underway in Wales as part of social care and health reform.
In England, it is also part of the Think Local Act Personal (TLAP) Building Community Capacity workstream.
LAC is underpinned by 10 core principles and values relating to:
- The right to citizenship, responsibilities and opportunities
- The importance of valued relationships and personal networks
- The importance of access to relevant, timely and accessible information to inform decision making
- Recognising and nurturing individual, family and community gifts and assets
- Recognising the natural expertise and leadership people labelled as vulnerable and their families
- The right to plan, choose and control supports and resources
- The value and complementary nature of formal services as a back up to natural supports and practical solutions
It is supported by the LAC Framework which provides guidance, clarity and maintains integrity, focus and outcomes.
It has a substantial evidence base, with over 20 international studies plus many further international and local publications.
It’s about supporting people to build their vision for a good life and finding a range of ways of getting there – and becoming less dependent on services wherever possible.
It gives space to think about the role of services and specialist teams, in the context of LAC and strength based approaches at the front end, embedded in the community.
In England, Inclusive Neighbourhoods Ltd and the Local Area Coordination Network are leading and coordinating the design and development of Local Area Coordination in England and Wales.
Turning the System Upside Down – Reforming the “Front End”
LAC moves the “front end” of the service system from crisis/assessment/eligibility/services (for those who meet criteria), with resulting ever-increasing unmet need, to supporting people to stay strong, building long-term trusting relationships with local people and the community, local solutions, valuing and nurturing individual/family/community assets, supporting mutually supportive and inclusive communities.
It also contributes to wider reform and integration of the service system.
Local Area Coordination is already developing in Middlesbrough, Derby City, Stroud and Cumbria. Developments are due to start in East Midlands in August 2012 and conversations are underway in the SE, NW and in Wales
From Service Users to Citizens (Broad, 2012)
Below is an extract from Chapter 1 of the paper “From Service Users to Citizens” (Broad, 2012. p.17), exploring some of the core principles, approaches and opportunities of Local Area Coordination, including the value and abundance of individual and community assets, focusing on helping people to stay strong, rather than waiting for crises and reforming, simplifying and integrating the service system.
1. Starting at the start
Local Area Coordination is a systematic effort, organised and led by public bodies in partnership with local people and communities, to ensure that people can prevent their ordinary needs from becoming major problems, avoid crises and support themselves to maintain and strengthen their everyday citizenship.
The Local Area Coordinator supports 50-65 individuals and their families who live in a defined local area. They provide a local, accessible and single point of contact for people of all ages who may be vulnerable due to age, disability or mental illness. They are the “front end” of the service system. They work by helping people to identify their own vision for a good life and ways to achieve it.
Local Area Coordination is an approach that recognises and supports the value of individual gifts, skills and assets, the powerful and positive role of families and relationships and the contribution that local communities can make as alternatives to professional health and social care services.
It provides a foundation for helping people to stay strong and to be as valued members of their local community.
Local Area Coordination turns the existing system on its head and drives positive cultural change across the whole system; for it puts a greater emphasis on:
• Recognising the gifts, assets and contributions of local people
• Building stronger and more inclusive communities
• Promoting citizen and family leadership
• Working with communities to support inclusion and mutual contribution
• Planning for the future, staying resilient and well-connected
• Supporting people to achieve their fundamental aspirations
This is a fundamental change in both organisation and values. It is based on carefully developed models and practices. It is not achieved by simple renaming existing systems or by organisational restructuring.
A new and focused role
Local Area Coordination is an innovative approach that integrates a range of existing roles (usually provided by a range of different people) and delivers them locally in partnership with local people and communities.
Too often the current system:
1. leaves people in isolation as problems grow
2. only reacts when there is a crisis
3. waits until people’s needs climb above the eligibility threshold
4. segregates people within services, cut-off from their community
This system drives up costs and reduces the chances of good solutions that build citizenship and stronger communities.
Local Area Coordination reverses the standard pattern of delayed response. Instead, the Local Area Coordinator focuses on developing a trusting, ongoing relationship with local people (person by person) and with their community. They work pro-actively to support people to stay strong and support the development of solutions that don’t require professional services.
Building on a real relationship and a real presence within the local community the Local Area Coordinator will:
1. help people identify their strengths and capacities to solve their own problems
2. provide practical assistance to ensure crises are overcome or avoided
3. help ensure people achieve their legitimate entitlements
4. support people to maximise their contribution as citizens
Eddie Bartnik, who originally developed Local Area Coordination in Western Australia, described it as an approach that “turns the traditional system on its head and changes the power balance. Rather than fitting people into a predetermined menu of services, support is built one person at a time, in the context of their family, friends and community. The focus is on choice and control for individuals in decision making” (Bartnik, 2008).
“From Service Users to Citizens” will be out soon – watch this space!
For more information about Local Area Coordination (LAC), or if you are interested in being involved as a “learning site” for Local Area Coordination and Asset Based Community Development (ABCD), contact Ralph at Inclusive Neighbourhoods Ltd (email@example.com or 07927056164) or Cormac Russell, Director of Nurture development and the ABCD Institute (Cormac@nurturedevelopment.ie ).