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I wish I could blog more. And even more than that I wish I could make more comments to other peoples blogs. I am fortunate enough to live in one of the country’s most gobsmackingly beautiful areas, but sadly this rural little town is a no go for broadband. The only wireless connection I can get is in the local pub! And my dongle connection seems to depend on clear skies!
But I am compelled to jot down some thoughts, specifically around tendering, commissioning and Recovery.
I have been involved in the drugs field for over 20 years, starting as a volunteer. I have done drugs social work, worked with families and children and have managed a young persons drug project. In this time I have met many different kinds of workers.
There are some of us, who live and breathe the work, there are some who do the job well enough and go home to their lives, there are some who should never be let loose in public let alone provide care and support to vulnerable people. But I believe they are the minority and usually don’t hang around too long anyway.
Most people who choose this work, or who find themselves in it, do it ‘cos they care and because they give a damn. Some people don’t manage to do it as well as they would hope, because of the systems within which they work. Consider this, for every hour that you spend with a person, you will spend at least another hour or hour and a half completing paper work and imputing data to two or three separate systems
But I have been shocked recently to see people who I know to be good workers so disillusioned, angry, and upset. And leaving! And do you know what they are blaming it on – Recovery!
Now of course its not Recovery that has made their jobs intolerable. That’s just the word that they see and blame for the changes they have been subjected to.
For example a person who has worked for 15/20 years plus, has done their work effectively, sometimes innovatively, caringly, empathetically and even compassionately. They have worked alongside and have helped support any number of new initiatives that were thrust upon them. From supervised consumption, DTTOs, custody interventions, new pape work, new data systems etc etc. And then one day they hear, often not from their employers but from the back pages of the DDN, that the service they have worked within, sometimes have developed from scratch… is up for tender!
Does any body anywhere ever go and say to these often dedicated workers, “Thanks for every thing you’ve done, the extra mile you’ve gone, the work you’ve put in, the initiatives you’ve developed, the knowledge you’ve shared?” No. They are simply treated like a piece of office furniture and told that they will have a job (probably) within the new Recovery focused service.
And then the new service, which invariably costs less than the old service but has higher target numbers and has new and different KPIs, has new and different paper work new and more data systems to learn, tells them that every thing they did in the past was wrong and that this new way of working is the way forward. And they tell them that this is called ‘Recovery’.
Do they adequately train or raise awareness with them? Do they give them time to build community networks? Do they explain that many of the skills they already have will be invaluable? No! They are just expected to hit he floor running, but with a new name on the pay cheque and a new word ‘Recovery’ put above the door.
But do you know what? Many of these same hurt and disrespected people were always working with recovery in mind. Maybe they didn’t name it, maybe they had no framework within which to place their beliefs and practices. But many were doing it intuitively, ‘cos they gave a damn.
And what worries me about this appalling process is that if services and commissioners can not treat these workers with dignity and respect, how can we trust that consumers of these new services will be treated with the dignity and respect that they deserve? Also I fear that many of these services will loose good and experienced workers because this whole process devalues them.
So would it be too much to ask in future tenders that commissioners ask chosen providers to consider how they will effectively and sensitively manage the change for existing workers?
And finally I would like to say to all those good workers and that wealth of experience that is now lost to our services, “Good luck guys, and enjoy your early retirements, new ventures and redundancies.” And to those that are staying, I hope that you can be enabled to embrace ‘Recovery’ for what it really is, or should be or could be with your continued dedication and passion.
Oh! I’m not suggesting they were all perfect, ‘Cos they were not! Or that old systems were good, ‘cos they certainly were not! But lets not throw the baby out with the bath water.
Hi Melody – good to hear from you.
I think that you are right and that some areas have not exactly taken a model approach to introducing recovery. Plus the wholesale re-branding (rather than thought through change) of some services has left a great deal to be desired.
Hence the need, as the UKRF believe, for an accreditation process. But I digress.
To add something to the mix I am not sure how much of the problem lies at the door of the commissioning process.
Recovery is not new and I have seen more time spent by some established services thwarting Recovery rather than planning for change. More effort expended in attacking proponents of recovery that investing in the improvement of their own systems.
On the other hand I have seen some fantastic examples of large organisations (like Pennine Care here in Tameside) grasp the nettle and begin to lay the groundwork for new approaches.
So if I had to put some of the blame for that poor thrown out baby at someone’s door, I would lay it at those who chose to close ranks rather than engage.
Oh Michela!! you are a wonderful, lubby lubby laydee!!!!! you corrected my spelling…………. thank you!
Yes your right, these issues are more complicated and dificult than my one dimensional blog may have suggested. And yes there certainly are examples of good practices and models being developed.
But i know sometimes i do sound like some old hippy, but you know what, i think that even as you say when people have closed ranks… that happens because they feel under attack.. and i think instead of attacking we, whoever needs to negociate, smoke a peace pipe! and try again to get them on board. Because the thing is… its the generals that close the ranks.. and the skilled and expierienced workers are trapped within them, they are the foot soldiers… the cannon fodder!
i agree that the accredidation process will be invaluable in the shared learning expieriences, but lets also not forget that many of these workers have done CBT, MI, SFTS and NLP DANOS this and DANOS that and yet within the systems within which they have worked they havent had time to practice these interventions …. so they are feeling a tad sceptical already with what they know, let alone what they dont know.
Anyway… they are not all a load of super sensitive prima donnas.. so thay can fight their own battles, but i am sad to see some of them go.
This is a Pucker blog, only last week I was talking to my dear old councilor about the same issues, I call her my “Mother Hen”
She is still in the field and the above comments have summoned up all if not more of what we both discussed. Pucker Michaela and Melody comments. A lift to the end of my mad day in London.
sorry it’s so long, but now i have melody great blog ! and so balanced
i feel this is what’s needed so all can come together ….
The little event
Chapter 1 – the managers
Talk to any manager in treatment services and they will tell you very quietly of a secret wish, one morning they would like to come in to their office and find a solution rather than a problem. Talk to the drug services and they will say that there door is always open and they would love for someone to come and talk to them.
The trouble is everybody’s heard of recovery but no one has ever seen it – and if you talk to services and NTA/DATS they tell you they are confused. They know that services include hard working decent people including the managers, they also want more successful outcomes of which everyone can be proud.
Yet it still feels difficult to improve things, to change things and make things happen.
Managers often complain that all they do is wheelbarrow management, that is if they are not taking the strain and pushing like hell nothing moves – the higher up managers are the more they complain about this. But then if you talk to the people that work on the front line they will tell you a different story.
Chapter 2 – the workers
Staff often believe they are the helpless victim of change in the services, they think they aren’t listened to and they don’t think initative is a part of their job. This is not surprising – many services have taken a lot of costs out of the services, the biggest cost is always people and staff are reduced to the absolute minimum.
What is left are some very hard working and efficient staff who are slightly scared. Given enough time these staff would tell you what works within services and what does not work. But normally they won’t tell you because they are no longer inspired by their job.
They no longer feel engaged and don’t feel they have the power to change things for the better, they have survived by being efficient and they know that ideas generally look like costs, and that anything that looks like a cost has a very short life span. Even worse, they believe that having ideas will only increase their workload.
The relationship between staff and management has become ‘tell me what you want and I will do it’, which does not make either party happy. Management increasingly recognises this problem, which is good news. The bad news is they then make a big mistake – they call in the research consultants.
Chapter 3 – the evidence base experts
There are two types of experts. The first are the good experts that have the skills that you do not have in your workplace. And then there are the bad experts, who have skills you already have in the services but who claim to do things better than you. Calling in the first set of experts is good for the services, employing the second is normally bad.
Bad experts feed on ignorance and the insecurity of management. The worst experts know only two things, they know how to look clever and they know how to make the people who fund them look clever – such experts claim to add value.
This generally means that their research is not up to much and to get the money they want to do your thinking for you. These experts give the impression that they have better people, better clothes, better education, better cars, better offices and better danish pastries with their better coffee.
You can choose to be impressed by this or you could ask three simple questions:
Why can’t the staff do that thinking for themselves?
Do we have that kind of expertise in our service already?
If we haven’t, can we locate it ourselves?
What all experts know about is how to play the internal politics of the services, they know how decisions are made, they know how budgets are allocated, but most of all they know how senior management behave.
Bad experts wouldn’t exist if it wasn’t for senior mangers willing to pay for them, so what is wrong with senior managers?
Chapter 4 – the service directors
When people make it to the top they start thinking, because they are at the top, they must be in some way better than the people below them. In truth they are probably better at the kind of things that get you promotion. Sadly the skills that are needed to get you to the top are not always the ones needed when you are at the top.
One skill all managers have these days is the ability to speak fluent business jargon, so much so that words like communication and learning and recovery have become meaningless. In some services the secret to rapid promotion is to take the initiative and the credit and then move on before the consequences become clear.
It does not look good on your CV that you are responsible for slow and steady growth, bold high profile initiatives look better – especially if they include communication, learning and recovery. That’s why you should beware of people that change their tack with every political agenda, often they have got to the top by moving fast enough to keep ahead of their mistakes.
Once they are at the top they are in a position to make really big mistakes. People at the top forget that services like 12 step recovery generally looks after themselves. They think that they can improve on 12 step recovery and they wonder if it would be a good idea to change things.
Often they think change is expected of them and they can’t ask anyone below them, so ask someone who’s opinion they can respect, they ask experts in 12 step treatment – because 12 step treatment does not get paid for unless they find something that needs changing.
Chapter 5 – the big recovery plan
In a normal service you would have thought that the people at the bottom would look up and that the people at the top would look down. In fact the reverse is often true. People at the bottom sometimes never look up because they think their natural place is at the bottom.
At the other end of the services, people who made it to the top sometime can’t break their habit of looking upwards. They continually look up to polictians, media, funders, and other leaders. Even at the very top they still want approval – and when people need approval they start doing things to get attention.
Analysts and journalists don’t like small print, they like big stories, and that means big plans. This explains why big bosses jump to big solutions without clearly finding out what the big problem was – if indeed there was one at all.
Services reorganise, re-plan, restructure and engineer because they can and because they feel they should. All of these things are necessary sometimes, but they are the exception rather that the rule. Ocasionally the big plan is amazingly successful and become a case study of good practice or schools of training.
More often than not the plan fails and the services only survive by more blood letting and heavy handed butchery thinly disguised as restructuring. Two groups of people leave during these upheavals – your best people and the people that best use the services.
Chapter 6 – after the changes
Service cultures are stubborn things and you can’t change them overnight, but they can be changed! Service cultures can grow up in the same way people in 12 step treatment can grow up, a service or treatment will grow up in the same way as recovery communities grow up.
How it grows up depends on its role models, recovery communities and its environment. The role of the big bosses is absolutely critical, the big boss only has two vital functions, they must decide the vision and strategies for the services/recovery treatment then they must make sure the entire service delivers that vision.
The big boss must have two core skills – the ability to have a strategic vision and to deliver that vision and the ability to communicate that vision to those who make it happen! In short they need to direct and they need to manage, that’s why they are called managing directors.
If you want a grown up recovery service you need a grown up recovery managing director in charge of recovery grown management.
This requires less command and control and more boundary setting and facilitation. Ironically only a very strong, very confident, very disciplined manager can do this, for many managers this mean a very personal change which is a lot harder than having a big plan.
Chapter 7 – sweeping recovery
Getting people to take the initiative requires two essential elements – they need permission and then they need trust. Even when people are given permission to take the initiative and be creative and generally take responsibility for their actions they won’t do any of these things unless there is a basis of trust.
People must have trust that when they have a idea or take the initiative their actions will be welcomed, encouraged and supported by management – that trust needs to be earned!
It is trust that is not built by mission statements, experts or big speeches – it is a trust that is earned by a continual process of the right things done at the right time in the right way. It is the building of a pattern of trust until the work force understand and of course accept it without having to question it.
Sometimes when there is a history of mistrust there needs to be a clear signal that things have changed, but this signal must be a concrete management action. In services, as in politics, people have seen too many signals and not enough trains.
Investing money in the ideas and concerns of people is the clearest possible sign, trying to put everything right at once generally creates more problems than it solves, but putting a few small things right has very big impact!
Once you have straightened out the things that frustrate people you then can concentrate on the very things that inspire and engage people.
Chapter 8 – recovery landmarks
Healthy organic growth comes from a few fundamentals and one of them is that the whole organisation knows what they are doing and feel able to do it. Sadly mission statements are generally a collection of cliches that have had the meaning beaten out of them long ago.
People need two things in life to be happy, they need to have some sort of meaningful purpose and they need rules for what they can and can’t do. Services are no different, their goals should be very ambitious – so that they are a real challenge – but also very simple to understand. Naturally goals will change over time, but they should always be clear enough and far enough away to make the direction obvious.
Values have become even more hollow and meaningless than mission statements, real values are those that you are prepared to enforce, in other words they are the rules, just like rehab – break them and you’re out! This how recovery cultures are forged and maintained.
When the purpose is clear and the rules are straight, the effort and the initiative of everyone will naturally align. Processes, structures and habits inconsistent with this purpose and that break the rules will either be actively discarded or passively ignored.
Departments or team structures that make no sense will go, along with the silo or smoke stack mentally that they often breed
Chapter 9 – planting growth seeds
Sometimes it is hard to remember that the aim of recovery is people and to release their potential to grow recovering communities. There is a old saying from 2 step recovery – recovery talks, bullshit walks.
If you really trust the services and recovery treatment, if you really want them to take the initiative, if you really want them to take responsibility for growing their part of the deal then you need to trust them with something else – money.
You can tell a lot about a service by how far up or down the level of budgetary responsibility sits, if the purchase of a paper clip needs the approval of the managing director we are in trouble because the managing director is spending all their time signing off expenditure and not doing there two other vital tasks i.e managing and directing.
The lower down the budgeting responsibility lies the more responsible the services will be and services will know what things cost and where the money comes from. They will also be in the best position to decide where money should be best spent, or not spent!
When services know that they will be paid their worth for improving services and managing their budgets better, you will have the best of all possible services in the world. And what happens to management when their services are looking after themselves?
They get to spend less time controlling and more time to take the initiative and think creatively for themselves, so you also have management who are free to think, free to act and free to deliver recovery.
Chapter 10 – recovery roots in communities
A service with a productive recovery commnunity network is one where top down inspiration meets bottom up energy, people in this community find a greater individual sense of belonging and productivity, greater job satisfaction and greater pride in the unity of all our recovering communities. At the same time management are freed up to think about the community and to improve it.
If you want to start the change you need to start with communication, sharing is what human beings use to inform and, crucially, motivate. Sharing is successful when it changes the way people think, feel and act.
So first of all decide what you want services and treatment recovery to think, feel and do. Once the service as decided the purpose of recovery, the services/ treatment/recovery/NTA/DATS must put this in everything they think, feel and do in communities.
And the little things will count as much as the big things – the way a meeting is run is more important than the way conferences are run. The life of a small idea is as important as the big idea. Even the way a single member of staff is managed is as important as the way the services are managed.
No recovery movement is greater than the sum of its communities, and when you think of the huge consequences that come from the smallest events you will know that in reality there are no small events.
Sorry Melody I do not share your compassion here, good people / workers will always find a way to adjust without too much effort and as for those leaving early with lovely pensions and early redundancies packages. It is a sad fact that some will not give their colleagues a second thought.
These kinds of discussions happen every day all over the UK, and some would admit that. What really gets me though is the amount of times people openly admit it’s just a job. It pays or even better, it pays the mortgage. Or “I do the bare minimum required, its just not worth trying any more.” Other another favourite is “I am losing the will to live working here” or “What’s the point nothing ever changes?” or my personal favourite “We have been doing recovery all along!”
But really what I can’t believe is how widespread, normal and acceptable these comments are, that no one even blinks an eye!
Tell me why shouldn’t individuals have to apply for a job within new services? In other sectors nobody is entitled to a job just because they have been there for 15 or 20 years.
This is probably something to do with the majority of my working life having been in the private or charity/voluntary sector where employment and wages are more of a luxury! And the ethos is often very different to that of the public sector.
I am all for saying a fond farewell to the deadwood and those unable to cope with change, in fact in the spirit of the musical theme running through the site tonight
So long farewell, auf weidersehen good-bye
I hate to go and leave this pretty sight
So long farewell, auf weidersehen adieu
Adieu, adieu, to you and you and you
So long farewell, auf weidersehen goodnight
I leave and heave a sigh and say good bye – goodbyyyyyyeeeee
if someone in recovery came to and said thoses addicts will always find a way to adjust without too much effort and as for those leaving early with lovely drugs and early rehab packages I doubt they will give the colleagues a second thought,….?or What really gets me though is the amount of times addicts openly admit its just a job sex working, it pays or even better, it paid for the drugs, or I do the bare minimum required, its just not worth trying anymore …..?I am losing the will to live my recovery here, or whats the point nothing ever changes, or my personal favourite we have been doing recovery all along!!!
if a addict came to you and said this to you what would you say?
i thought we are working some recovery here what happened to open minded approach… what’s going on here no more blame throwing please there is some kind of projection happening may be ?
i am now going to look at myself ……..
Dear Melody, of the six workers in service provision I have come into contact with in connection with my friend, four would I cross the road so as to avoid the humanitarian urge to piss on them if they were on fire.
It is not since the sixties, early seventies, that government/local government employment was a job for life.
If workers in service provision cannot cope with minor alteration in their working lives, how can we expect them to care responsibly for those whose entire lives are utter chaos?
Yes, management may well be partly to blame, but so are the meek and mild attitudes of many of those at the sharp end.
We are looking for a decent scientific evidential basis for treatment and recovery. What do we get but dubious theories of the causes of addiction, such as Hypoism (meaningless twaddle illustrated by a curious admixture of flow charts and cartoons), see also Sokal’s Hoax; “Transgressing the Boundaries: Towards a Transformative Hermeneutics of Quantum Gravity”, and calls for yet more research into the causes.
We know that addiction is, and no matter what is at its root, we are looking for means to help people out of it. Some in service provision are extremely good at their jobs, but others, who are unable to cope with a minor set-back, should not be in a position to manage, if that is the correct word, those whose entire lives are a set-back. “There are some very good teachers, but there are some I would not trust to care for a cold germ, never mind another human-being” (The Headmaster in an episode of ‘King Street Junior’ R4 ca May 1984).
Yup, I’m sorry for those who cannot cope with the realities of employment, but I am a great deal sorrier for those who have troubles with life to the degree that they become addicted.
Pucker blog once again and it is feeling to now become to political, not what I singned up for with site.
Some really great stuff here and all valid points I feel.
It is political and always will be. We have to embrace that .
Oooooh bloody hell.. this wasn’t sposed to be quite so contentious as it’s turned out to be. I was simply stating my own sadness for ‘some’ people I have known who have dedicated a lifetime to supporting others…. But I will pass on your thoughts…. One in particular wont have time to be bothered by it, as she is busier now in her early retirement …. Using her therapeutic skills and knowledge in Africa with children who have been victims of torture, but I’m sure she’ll be tickled to know that hers and others departures has bought such joy and spontaneous out breaking of song to others.
It is understandable some anger, I do understand that, but lets get it in perspective! Its just as well I didn’t spend a life time blaming and hating alcoholics after my nephew was left fatherless by a drunk driver, neither have I spent time hating every drug user after my son at 15 was mugged by knife point by somebody who used in court as his defence his addiction… its very rare, in fact I never do personalise or emotionalise disagreements. But I suppose what I’m trying to say is that we can not make sweeping judgements and that surely a factor within ‘recovery’ is seeing the individual, understanding their actions and working to change the environments, communities and societies in which those issues were created and sustained. So lets not be guilty in our enthusiasm and dedication to this of the same stereo typing , stigmatising and blaming of groups and individuals, that we are actively fighting against!?!?
Dear one and all,
I am starting to get slightly wobbly about where this is going as we appear to be straying slightly towards getting annoyed with each other. Which is not what this is about.
I think what has happened is an element of personalising what should be a debate, rather than an argument.
From my perspective you are all right – there are some utter paragons, there are some people who do a good job and then there are people who don’t. While this might be acceptable in some sectors where being OK at what you do isn’t important – I do feel that there is a heightened impact in the so called ‘caring professions’.
I suppose what I am trying to say is that it is fine for people to be OK at what they do. Wonderful is good but is not an expectation.
It does seem to me that many of the current structures ‘protect’ those who perform poorly and that this is as much of a factor in people moving on as the implementation of a Recovery focus.
Seems to me the debate should be about what the baselines are for good performance and for me, that is where something like accreditation comes in. For me those that are OK or better would have nothing to fear. In fact their abilities would be recognised – rather than thwarted – as can happen.
So good people – rather than cite our own experiences maybe we should be asking what makes a good worker?
Hi Melody, I had wondered whether I’d gone too far in my last post on this thread and whether I should post something more moderate, (I was feeling rather low at the time), but with Michaela’s post as encouragement, I now will.
Service providers can only respond to to what they know, just like the rest of us; and if what they know personally (are told) is deficient, they cannot know the proper thing to say/do.
Whoever has to deal with addiction from the outside has a very rough row to hoe!
Luv, Geph
Just before we move on to ‘what makes a good worker?’… in another blog. Can I just say… let’s not be frightened of a good argument. For me ONE of the joys of this site is that we can throw down ideas, talk them through… get emotive etc etc and come out the other side maybe understanding others more. Which is something we aint allowed to do in the work place! Cos there is a fear that what you say will be held against you, instead of it being just a process you are going through to work stuff out in your own head.
I think blogging arguments are very civilised! You can’t even see another persons finger wagging at you!
I have learnt from this, that perhaps it was naïve of me to simply blame a system and I shall be more aware and mindful in the future to seeing the individual workers who don’t respect the people they are working with and I will challenge that behaviour.
So go on somebody… next blog… what does make a good worker?
