Developing a Recovery Orientated System of Care

1. Developing a Recovery Orientated System of Care Our experience so far…… February 2019

2. Recovery Orientated System of Care • ROSC is a co-ordinated network of community based services and support that is person-centred and builds on strengths and resilience of individuals, families and communities…..it recognises there are many pathways to recovery, including treatment (which also at times includes hospital and/or residential based treatment interventions), mutual aid groups, faith-based recovery, cultural recovery, natural recovery, medication-assisted recovery, amongst others…..It offers choice by providing a flexible menu of services and supports designed to meet each individual’s specific needs….it builds on assets rather than emphasising deficits and pathologies…. (Bill White)

3. Scottish Government’s Quality Principles • “Recovery is a process through which a person addresses their problem drug and/or alcohol use to become an active and contributing member of society. This concept of recovery and a belief that people can and do recover from drug and alcohol problems/dependency are at the heart of the Scottish Govt strategies on drugs and alcohol.” (the new strategy: Rights, Respect & Recovery is central to ROSC)

4. Quality Principles continued • “There is no single path to recovery. It can begin anywhere; in a GP surgery, a hospital, care and treatment service, church, prison, through peer support or in someone’s own home. Recovery happens every day across Scotland and there are effective solutions for people still struggling . Whatever the pathway to recovery, the journey will be far easier to travel when people are treated with dignity and respect.” • “In practice, people can best be empowered to recovery through the establishment of a recovery orientated system of care (ROSC). The underlying philosophy of a ROSC is that treatment, review and aftercare are integrated and priority if given to empowering people to sustain their recovery.” • (HAND OUTS AVAILABLE)

7. The Model • Care & Treatment: statutory service provision, Tier 3 and above, delivering a range of evidence based interventions with individuals who are drug and/or alcohol dependent with a range of other challenges, for example: mental health issues, physical health issues, homelessness, child or adult protection concerns • Recovery Hubs: third sector commissioned services to work across the alcohol and drugs service tiers to promote recovery, provide exit strategies from care and treatment, increase community capacity, provide opportunities for sustained recovery • Recovery Communities: organic, community based developments, delivering recovery volunteer led drop in opportunities in partnership with services and others, groupwork programmes, large scale events, training and development, promoting employability, building community assets and making connections with hard to reach individuals and communities across North West Glasgow

8. What do we need to bring these elements together into a “system”? • Encourage a “recovery is possible” culture • Emphasis on lived experience at frontline with service provision • Willingness to make small changes, adaptability • Investment in Workforce Development – recognise that the workforce extends way beyond the salaried workforce-joint training, joint planning meetings, moving forward together (co-production in the most genuine way possible) • To build on the evidence base – explore new and different ways of gathering the experience of service users and incorporating views/experiences in developments – support people to become part of the solution • To adopt an Asset Based Approach (ABA) – starting with Asset Based Thinking • Incorporate ABA into existing roles of staff, volunteers, stakeholders/partners • Invest in Recovery Communities in respect of volunteer development, infrastructure, equality – recognise all contributors as equal partners

9. Benefits of Asset Building • Promotes independence and a belief that the situation can improve • Involves individuals and families in the discussions at the very outset that looks at their skills, knowledge, qualities and abilities to affect change in their own circumstances • Helps increase confidence and self belief • Reduces demand on high cost treatment interventions • Provides a landscape where the correct intervention is made available rather than a one size fits all approach • Deepens resilience amongst communities, builds local resources and determination to make improvements

10. Benefits of Asset Building II • Shares responsibility for achieving outcomes and shares the achievements • Cost effective, it utilises a mixture of resources • Due to personal investment has more chance of success and sustainability • Improves the general well being of communities, people working together, sharing, supporting each other • Creates an environment people want to be part of, be integrated with, rather than foster a sense of social exclusion • Increases motivation, improves staff morale, promotes a sharing of the challenges, reduces isolation

11. How did we begin to make this happen? • 5TH Year Anniversary of NWRC (June 2017) was exploring the “better than well” effect, promoted by David Best…NWRC 5 year achievement, moving to the next level - move away from working as separate entities, albeit in partnership • Scheduled a series of Seminars within the NW area, publicised them widely amongst services, service users, local people, third sector, private sector • Get into the culture of the community – last Tuesday morning of the month, Whiteinch Centre, All Welcome! • Remove barriers to participation – don’t need to represent an organisation, don’t need to attend every single session, can just turn up and join in – bring your family, friends, contacts • Make the sessions interactive, welcoming, provide hospitality, nurture relationships with all stakeholders, achieve an agreement of what we all have in common • Deliver a standardised format – make it clear what folk are turning up to…this is the Developing a ROSC Seminar programme

12. How did we begin to make this happen? • Over the first 4 – 6 sessions develop the Action Plan – what do participants want to achieve. Appeal to self interest – make sure there is space for everyone’s ideas • Proposal to NW ADP to adopt the Seminar Programme as their main forum for directing the work of NW ADP. This involved dissolving previous Sub Groups and including key strategic elements within the Seminar Programme – this was embraced and by this time had proven its effectiveness! • Develop the overarching framework for ROSC and find ways of connecting the Recovery system within it

13. Important Features • Admin Support required • Needs paid for….currently funded from Recovery Budget • Promoting ownership rather than just attendance…it’s a work in progress though-being inclusive can sometimes lead to a set back • Pressures placed upon Recovery Communities Volunteers – so many opportunities, so many providers looking for Volunteer input, can cause instability in so many ways • Freeing up busy staff and volunteers for training and development • Making this part of the job, has to be meaningful for the Recovery Workforce • Incorporating Prevention & Education has been challenging • Lived Experience – regular SEEDS – Recovery Stories – promote well being and positive outcomes – utilise social media

14. A citywide approach • 3 X Sectors • 3 x ADP Strategic Groups • Various Sub Groups operational (these should be considered on an area by area basis. NW have ceased to support sub groups in favour of Seminar Programme however both structures could co-exist) • Seminar Programme reports into ADP Strategic Group, Seminar programme lead attends ADP SG • Identify a local lead to co-ordinate and take forward – personnel will vary from area to area • Identify a suitable local venue, one that is well respected/utilised by local people and is relatively central for the sector, somewhere there is inhouse catering for refreshments/light lunch; a venue where there is a powerpoint set up and where a crèche can be arranged if required. Cost out for the year and set the funds aside.

15. A Citywide Approach (continued) • Devise local/citywide branding for ROSC-call our provision a Recovery Orientated System of Care • Use common language • Recovery Communities existent in all three Sectors, slightly different set up in each area however all receive formal financial resources from Glasgow’s ADP and there are certain things ROSC can request from each RCs construct • Recovery Communities whilst self determining require to be officially asked to become members of the Recovery Orientated System of care. This is the same for all stakeholders including non ADRS provision eg. DWP, Health Improvement Teams, Family Support Services etc.

16. NEXT STEPS • Map out the structures currently underway in each Sector (Recovery Leads) • Set up some Engagement Events across the City – get people involved in discussion/development, expose participants/stakeholders to the model, develop it (ROSC Working Group) • Develop role of lived experience representatives • Develop a Performance Structure based on the Quality Principles & Key Objectives of the Strategy (Jackie & Michael) • Set SMART goals, measure outcomes over six month period (Recovey Sub Group membership) • KEEP IT SIMPLE!!