Adult Social Care South Front Door Team Celebrates Personalised Care

As part of Personalised Care Week, colleagues from the Adult Social Care South Front Door team came together to share stories that demonstrated the real impact of person-centred, strengths-based practice and Alison was invited along by Lou England, the Team Manager of Community Wellbeing South, to hear these. A clear theme emerged throughout the discussion: taking time to listen, understanding what matters most to people, and working alongside people to achieve outcomes that reflect their wishes and circumstances is what people really want and need from the team, which was fantastic to hear. 

One story involved an older woman who had suffered a fall and was experiencing severe pain. Although the initial request was for respite care, Emma, the Community Care Officer (CCO), felt something more serious might be wrong. Through persistence, collaboration with health professionals and ongoing communication with the family, further assessments revealed an undetected fracture. The family said that up until the involvement of adult social care they felt she was  “just going around in circles and being batted from one place to another,” and they later expressed their gratitude for having a single point of contact who helped them navigate a complex and stressful situation.  Everyone agreed that this was a really good, clear example of multi agency working to get the best outcome for the lady and her family. 

Another example from Hayleigh, another CCO from Spalding, highlighted how personalised support helped a man with Parkinson's disease remain in his own home after his main carer was unexpectedly admitted to hospital. Rather than moving directly to residential care, staff focused on what mattered most to him: staying at home. Immediate practical support was arranged, including help with shopping and meal prep which had the added complication of the man not being able to read and write, so took more time.  While an urgent assessment secured a care package within days and a referral to St Barnabas supported him with finances.   A fantastic example of finding out what matters to a person and working together to arrange support, rather than pushing someone to do something they don’t want to. 

The team also reflected on its role in helping people and families navigate unfamiliar and often overwhelming systems. By working closely with health professionals, care providers and relatives, staff provide reassurance, explain options, and support people to make informed decisions at difficult times.  The team recognised the importance of having “healthy conversations with our other professional colleagues.”

Partnership working was identified throughout the discussions as a key factor in achieving positive outcomes with people. Gaynor, a CCO from Stamford talked about working with a lady who had a mild learning disability and who felt unable to attend an important medical procedure. The lady had lost her mum recently and was doing everything on her own.  Through strong relationships with the local specialist neighbourhood nursing team, as well as conversations with the lady, Gaynor brought together the right support.  This helped the lady to understand the medical process and build the confidence needed to attend an appointment that would significantly benefit her health and wellbeing.  She was also aware of a local befriending service who could visit the lady, demonstrating the importance of making the most of what is available locally.  

Other stories shared during the session also demonstrated the team's determination to go the extra mile. Colleagues described supporting a family living in temporary accommodation while seeking asylum, coordinating support across health, education, children's services and the voluntary sector. Another worker spoke about building trust with a man experiencing homelessness and living in a camper van, helping him take small but important steps towards improved wellbeing and future support.

Throughout the session, colleagues emphasised the importance of seeing the person, not the problem. Often it comes down to helping people maintain their independence by drawing on their own strengths, family networks, community connections and local resources.  They also discussed some of the challenges such as communities and society working together to support people.  For example where a man needed support for some time however it was only when a family member visited that she realised this, where as there must have been other people witnessing this, the bin men, the post man, people walking by who did nothing.

In Lou’s words “I think it’s about recognising that we all have a part to play and that responsibility doesn’t sit with Adult Social Care alone. Rather than focusing on whose responsibility something is, we should be able to have a positive conversation with someone, ask “Do you need any help?”, and consider what we can do or who might be best placed to support them. It’s about moving away from working in silos and towards a more joined-up approach.”

The stories shared during Personalised Care Week showcased the breadth of the Adult Social Care South Front Door team's work, from crisis response and safeguarding to prevention, advocacy and care coordination. Above all, they highlighted a dedicated workforce committed to working together and helping people across Grantham, Sleaford, Stamford and Spalding achieve the outcomes that matter most to them through personalised, strengths-based support.