The pandemic has had a big impact on day services and support for people with learning disabilities across many regions. The Royal Borough of Greenwich (RBG) wanted to transform their learning disabilities day opportunities through a collaborative design process, with a particular interest in moving away from building-based services to community-level solutions. Ideas Alliance spent nine months supporting collaboration and innovation between the council, people with learning disabilities and their families, providers and supporters to kickstart change and action in the borough.

This started with a scoping phase, where we learnt more about people’s needs and desires, which then led into a 100 Day Challenge. A 100 Day Challenge is a rapid-results, action-based way of collaborative working which puts the people with the most knowledge about a problem in charge of the solutions. It’s a model we’ve used before in Bromley with great results, so we knew that it was a method that worked. However, the ongoing disruption and challenges of COVID meant that this time, the project had to be almost entirely delivered online. The scope of the work in Greenwich also meant that we needed to run an expanded version – with three teams working in parallel tackling slightly different aspects of the problem, including one team led by people with learning disabilities. Read on to find out more about the project and how RBG have transformed their relationships and ways of working and carved a path for new, innovative and collaborative ways to run their services and support people with learning disabilities in the borough.

Getting started – scoping phase

We wanted to understand more about the current picture of learning disability services in Greenwich, so we began the project with a scoping phase. This involved: mapping existing provision, working to understand the current context, and, most importantly, hearing from local stakeholders. This included people who use Day Opportunities’ services, their families and advocates; those who might use these services in the future; and groups of staff.

During this stage, we heard about the commitment of staff, providers and carers to supporting people with learning disabilities to live fulfilling lives, but we also uncovered a lot of anxiety, exhaustion, anger and cynicism. People were worried about the timing and speed of the change, and there was a legacy of mistrust between the council and its stakeholders, particularly after the way in which the pandemic had impacted on the provision of services. We found several points that were important to people:

• the transition from education to adult services;
• a focus on individual enjoyments and the whole day experience;
• transport;
• mixing abilities;
• balancing the ambitions of and for people with learning disabilities and the realities of day-to-day capacity.

Ideas and action: 100 Day Challenge

All of these groups of people were then invited to get involved in the next stage of our project – the 100 Day Challenge. We wanted people to work collaboratively in teams to answer the following questions:

1) what is important to us? (a team led by people with learning disabilities but including others)

2) what is the life we want to lead?

3) how will we make that happen?

We opened the process up to anyone with an interest in shaping future provision, and saw an overwhelming response from people who wanted to get involved and get on with things. Over 70 people attended the launch and each challenge team had an average of 15 people consistently attending meetings every fortnight. The people who took part included: adults with learning disabilities; family carers of adults with learning disabilities and parents of young people at the transition stage; potential and existing service providers; voluntary and community groups; advocacy and support organisations; RGB staff from senior management to frontline workers; and other interested parties.

The challenge teams met every two weeks and were facilitated by Ideas Alliance to be self-managing. The first half of the 100 days was spent properly defining the question and developing ideas. The second half was focused on action with members of the group following their plans and connecting with others outside the group, and then returning to the challenge sessions to report on their progress, be appreciated for their efforts and head off again with revised plans or next steps.

The three challenge teams worked in parallel and in collaboration to generate ideas for future activities and support to improve the lives that people with learning disabilities and their families would like to lead.

The results

One of the most transformative parts of the challenge was the shift in ideas, action, relationships and mindsets from where we started to where the 100 days ended. Scepticism and cynicism began to shift as people communicated honestly from their different perspectives and relationships and understanding developed. Ongoing, open communication between people with learning disabilities, providers, families, council officers and support organisations became a significant force for change in this challenge, and will serve as a strong foundation for the ongoing transformation process. As one person from team 1 noted, “we are not leaving it here; we are taking it further”, with a member of RBG staff feeling like the challenge has brought them “a step closer to co-production”.

These discussions and the freedom to innovate made space in the teams for several new ideas and actions around the topic of activities and support for people with learning disabilities in Greenwich. In particular, people said they wanted to see an improved range of inclusive leisure activities, as well as work and social opportunities. Some new ideas that emerged from the challenge were:

• Using a hub and spoke model for day support, where there is a “home base” for all to explore community activities as they are able.
• An ongoing calendar of taster days run by providers for families.
• Four “One Stop Shops” visibly hosted within GLL leisure centres, run collaboratively by providers, third sector partners, people with learning disabilities and their families and council officers.
• Transport options and travel support to be developed alongside the activities and included in taster sessions.
• High-level discussions with local business and an employment group to develop more and better opportunities for paid work and volunteering.

Underpinning all these ideas are transformed relationships and energy for ongoing collaboration including:

• a carer-led family carers’ forum;
• a provider-led provider forum;
• a user-led engagement group, hosted by a local service user support organisation which looks beyond Day Opportunities;
• further engagement by those people with learning disabilities involved in the challenge themselves including an upcoming citizen’s forum;
• videos and other materials which can be used as a tool for staff training, and in commissioning materials and processes;
• co-creation of a charter, building on the work of Oxleas in 2018 and working alongside the Heart and Soul group – based on what’s important that services can sign up to.

The 100 days was enough time to devise, have conversations about, and perform some initial testing of the ideas, but detailed planning and consultation will be the next step, facilitated by agreement from teams to continue meeting to progress ideas into completion. Overall, the challenge has led the borough to a shift from ‘centre based services’ being limited to those with complex needs, to a recognition that most people with learning disabilities would benefit from a mixed ability home base or ‘hub’ from which to explore community activities. There’s also been a culture shift within: from adversarial, risk-averse communication and ‘doing for’ to an experience of the benefits of connecting as humans, open dialogue and enabling people to do things for themselves where possible. And finally, a potential future, already begun, where RBG play a facilitative, connecting role that enables others to design and run activities and inform and support each other to lead the lives they want to.

What’s next for Greenwich?

The proposals developed through the design process are now undergoing a formal consultation.

We’ve encouraged the council to take on the role of facilitator – assisting the collaboration of the community. Ideas and action need stimulating but not controlling. A facilitation role for the council will entail bringing people together and assisting the process but not project managing.

For our part as facilitators of the challenges, it was incredible to work alongside committed and passionate people – those that use services, those that care for them and staff that support them. Witnessing the change in relationships, the lightbulb moments and the frustrations. It is testament to the work and will of everyone involved that people felt “inspired”, “listened to for the first time” and that there is so much appetite to go further, do more and get others involved. For Greenwich, it’s clear, this is just the beginning. As one member of team 1 put it so eloquently: “it’s what we do after this that matters.”

Click here to find out more about the project.