A Revolution in Care Requires a Revolution in Thinking

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It would appear that a revolution is required in our thinking of older people as a ‘demographic time bomb’,
‘burden’, ‘bed blockers’ and an economic liability all of which engender ageist attitudes. We’ need to recognise
the contribution of older people in the workplace, supporting families, friends, neighbours and society. We also
need to radically rethink how different services and sectors collaborate to identify innovative solutions.

Shirley AyresThe Long-Term Care Revolution , A Provocation Paper

Many of you will know of the famous experiment by Ellen Ranger and Judith Rodin in which a number of older people in a care home were split into two groups.

The first group were given a speech by staff which emphasised that residents should have more responsibility for their lives. To demonstrate this new choice a film night would be held twice each week, and it was up to residents to decide which night they wanted to attend. Each resident was given a gift of a small plant. It was strongly emphasised that it was up to the residents to take care of it.

The second group had exactly the same speech. Except all references of taking responsibility and making decisions were omitted. They were told which movie night to go to and that a member of staff would look after the plant.

After 18 months 15% of the first group had died compared to 30% in the second.

This small exercise in recognising the importance of individual decision making and giving people a little more control over their lives had a dramatic effect. As well as living longer , the residents in the first group became happier and more fulfilled.

One of my earliest experiences of working in housing was being asked to manage a brand new older persons scheme. They were purpose built bungalows for people who had reached the ripe old age of 55+.

“You’ve got it really easy now” a colleague told me. “You move them in , get their rent or housing benefit sorted – and you’ll never hear from them again. It’s much better than housing young people.”

They were right.  The only contact I had was because of an occasional death and the subsequent reletting of a property.  Demand wasn’t an issue as there was an endless conveyor belt of people eager to get a bungalow. As a model of business efficiency it would have made Amazon proud.

We never asked those people what their skills were. What they dreamed of. Where they were going. They were people society deemed to have served their purpose. They could now be placed in the quiet and polite customer demographic –  living out their days in peace and rarely complaining about anything.

In 2014 Morrissey , Kevin Spacey and Simon Cowell could all qualify for older persons housing and services.  Next year they’ll be joined by Nigella Lawson, Daryl Hannah and Tilda Swinton. I don’t know any of them personally but I imagine they have aspirations beyond the occasional game of bingo.

As Shirley Ayres pointed out at the launch of her paper (which I urge you to read) the default position is to view older people as an economic drain on society rather than a source of skills and potential.

Two weeks ago as part of the work of Bromford Lab we began to revisit our Older Persons offer. The first thing colleagues decided to do was to stop calling it an older persons offer. It’s ageless.

Older people do not exist as one homogenous group. They have the same skills , aspirations and dreams as the rest of us and the current lowest common denominator service provision is unfit for this generation.

At Bromford we are putting a lot of focus on how we unlock the skills and potential of all ages. There is a unique opportunity to unleash the experience and wisdom of older people across communities at time when they are needed more than ever.

This will take radical new thinking. It will involve reimagining the housing , health and care sectors that have a long history of doing things to and for people rather than promoting autonomy , connectivity and self determination.

Old age is a social construct. It essentially means a person older than yourself. Nobody stops dreaming when they hit 65, 75, 85 or 95.

Nobody dreams of ending up in a care home. And nobody dreams of being warehoused in a community where the knowledge they have built up is left to slowly dissipate.

The long term revolution we need calls for a radically different view of age and skills.

Don’t Listen To Your Sector: Be More Weird

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Had a bit of drama over the past week. I’ll recap it for you as quickly as possible – as most readers of this blog don’t work in the same sector as I do.

Essentially Mick Kent, my CEO, wrote a challenging piece setting out why we have embarked upon a different service vision. Bromford are celebrating 50 years in business – so you wouldn’t think it particularly controversial to reflect on the past and consider the future.

Not so. The piece sparked some astonishing responses – especially on social media. Many in the sector expressed derision and even outright contempt. How could one of their own say such things?

But experience suggests this is just a natural crowd reaction to someone stepping out of line and being different.

You’ll never see a sector – be it Housing, Care, Support or Health, drive innovation. It’s simply not in the interests of the majority to reward disruptive behaviour.

It’s one of the eternal challenges for industry bodies – they have to reflect the views of their average member. And the views of the average member are, by definition, average.

You’ll never find a sector that is wholly admirable either. Be it banking, retail, travel or charitable – you will find the good, the indifferent, and the bad.

And you’ll also find a few disruptors – pacesetters who are pushing forward with a bold new vision. Often that vision will be treated with initial scepticism – sometimes by customers as well as industry peers.

In the last month the 2013 UK Customer Experience Excellence Top 20 was announced. You’ll see that it’s made up of companies who have faced criticism precisely because they challenged the accepted order of things.

Let’s glance at the Top 10 :

10 – Waitrose – Broke out of their southeast heartland despite people saying, “It’ll never work in the north”.

9 – M+S – Launched Plan A (“because there is no Plan B”)  a programme to instil innovation across 81,000 employees and lose their old fashioned image.

8 – Ocado – A High St store “without any stores “ founded by three guys with no experience of retail. “A disaster waiting to happen” said critics.

7 – Lush – Showed cosmetics can be ethical and environmentally responsible, whist also being super indulgent and pleasurable. ” We hire for values , not skills”.

6 – M+S Simply Food – Darling of the middle classes opens branches in railway stations , airports and hospitals. Critics predict failure – “People will resist the idea of carrying high cost food shopping around with them.”

5 – Virgin Atlantic – Challenging the establishment, improving service and astounding its customers: “We’ve never been afraid to upset people”.

4- Amazon – From “destroyer of Book Shops” to “destroyer of the High Street”. Adored by their customers.

3 – First Direct – The only bank people love. Launched with two ad campaigns:  a negative one showing the everyday aspects of normal banking. A positive one showing how good First Direct would be. The banking sector was appalled. Customers applauded.

2 – QVC – Almost universally derided on its UK launch in 1993. Now a global leader in video and eCommerce retail. Just launched QVC Sprouts, a crowdsourced competition to search for the best up-and-coming entrepreneurs and new products

In first place? John Lewis.

A few years ago I was talking to John Lewis employees at a conference where they had been speaking. They told me that far from being lauded by their own sector they were often criticised. People said it was arrogant and pretentious they had their own language (colleagues as “Partners” for example). Their recruitment practices and culture had been described as “a cult”.

“People just think we are a bit weird,” they told me. “But we’re not bothered by what the industry thinks. Just the customers.”

I imagine the retail sector were cynical about the fuss around The Bear and The Hare , the Christmas advert by John Lewis . As was I.

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Nearly 8 million YouTube views. Number 1 in overall UK Customer Experience. Profits of 415 million.

A lesson for innovators – don’t listen to your sector: Be Different. Be More Weird.