Asset Learning Programme

- An introduction to assets

March 6th 2012

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Asset Based Working

Jude Robinson, John Lucy

6th March 2012

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What this workshop is

• Introduction and chance to reflect

• Chance to plan asset based work

• Chance to learn from each other

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Our approach to asset based work

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Our approach to asset based work

Creating Health

“Communities have never been built upon their deficiencies. Building communities has always depended upon mobilising

the capacities and assets of people and place” (Kretzman and McKnight 1993)

“Many of the key assets required for creating the conditions for health lie within the social context of people’s lives and

therefore [the asset model] has the potential to contribute to reducing health inequities.”

(Morgan & Ziglio, 2007)

Assets for Health & Wellbeing

Asset based approaches are concerned with identifying the protective factors that create health and well-being. They offer the potential to enhance both the quality and longevity of life through focusing on the resources that promote the self-esteem and coping abilities of individuals and communities.

Drawing on concepts that include salutogenesis, resilience and social capital, asset approaches create the potential for unlocking some of the existing barriers to effective action on health inequities, so far characterised by more risk-based or deficit approaches.

(International Conference, London 2011)

The Asset Approach

investigates key assets that support the creation of health rather than the prevention of disease

enables a community to use its assets around a vision or plan that solves local issues sustainably and uses outside support more meaningfully and efficiently.

Traditional needs assessment

Identifies problems and deficits in individuals and communities Health as disease prevention, often single disease causality

focused Allocates resources based on deficit/ needs assessment/ IMD Focus on individual level interventions Responds with more or different/ re-configured services Identifies the community as a problem area The value of services as the answer Belief that wellbeing depends on being a client Dependence on outside services No incentive to be producers, only consumers, passive

recipients Survival motivated challenge of outwitting the system Dissolves community empowerment and networks

Asset focus

Salutogenic understanding of health as wellness, not as disease or its absence;

Focus on a multiple dynamic model of health and its determinants; Maps the skills, capacity, knowledge of individuals and the social capital,

networks and connections in a community. Provides a different story of place; positive and outcome focussed picture,

valuing what works well; Builds community empowerment and solution focussed responses that are

sustainable; More community based and system level interventions; Enables co-production of health & wellbeing, citizens as empowered

producers, active participants; Enables more efficient provision of services;

The Asset Model: Morgan & Ziglio, 2010

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A glass half-full

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• The asset approach values the capacity, skills, knowledge, connections and potential in a community. In an asset approach, the glass is half-full rather than half-empty.

• Fundamentally, it requires a

shift in attitudes and values, and a shift in power

A glass half-full

An asset is any of the following: The practical skills, capacity and knowledge of local residents The passions and interests of local residents that give them energy

for change The networks and connections - know as ‘social capital’ - in the

community, including friendships and neighbourliness The effectiveness of local community and voluntary associations The resources of public, private and third sector organisations that

are available to support a community The physical and economic resources of a place that enhance

wellbeing

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Living Well North West

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The contribution of the asset approach (NHS NW 2010)

Tackling the social determinants of health and reducing health inequalities

Focusing on health and wellbeing outcomes Strengthening the Joint Strategic Needs Assessment Fostering co-production of health and provision of health and social

care Building the Big Society vision of empowered communities Supporting systematic engagement of communities in partnership Maximising the role of the voluntary and community sector Enabling greater condition management, self care and care closer

to home Improving individual and community resilience in challenging times Improving demand management and service efficiency

Reducing Health Inequalities

Marmot Review “puts empowerment of individuals and communities at the centre of action to reduce inequalities”

This requires Social action Creating conditions for individuals to take control of their

lives Removing structural barriers to participation Facilitating and developing capacity and capability

through personal and community development

“Traditional epidemiological risk factor approaches to health development such as programmes on smoking

cessation, healthy eating and physical activity are insufficient on their own to ensure the health and well-

being of populations”

(Morgan & Ziglio, 2007)

Social Care Transformation: Building Community Capacity (DH 2010)

“What would it look like if, in this area, people and local organisations were all operating in such a way as to make the most effective use of, and further develop social capital, in a way that includes those who are often the most isolated and marginalised?”

Building on people’s existing capabilities Reciprocity and mutuality Building support networks Blurring distinctions: Facilitating rather than delivering Recognising people as assets

Three main contributors to outcomes for people who might need social care: People, Organisations, Social Capital

www.puttingpeoplefirst.org.uk/BCC

JSNA guidance

From April 2013 “the local authority and the clinical commissioning groups, together with local HealthWatch, will be required to prepare the JSNA through the health and wellbeing board, undertaking a comprehensive analysis of the current and future needs and assets of their area”

“In the context of the JSNA an asset could be anything that can be used to improve outcomes and impact on the wider determinants of health.”

(JSNA & JHWS explained, 2011, DH)

Public Health Commissioning Responsibilities

“[Commissioning] underpinned by a robust analysis of the needs and assets of the local population” (Public Health in Local Government Commissioning Responsibilities, 2011,

DH)

What is an asset?

An asset could be formal or informal resources, including capacity within other organisations or the community that can be used to improve health and wellbeing outcomes and impact on the wider determinants of health, such as the ability of population groups to take greater control of their own health and manage their long-term conditions.

(JSNA & JHWS draft guidance, 2012, DH)

Principles of JSNAs and Joint H&WB Strategies

Real gains can be made if health and wellbeing boards look beyond needs to examine how local assets, including the local community itself can be used to meet identified needs. Not only does this approach generate energy and make the best use of all available resources, but it also stimulates innovation, for example through joining up services, to find truly local solutions to address local issues.

(JSNA & JHWS draft guidance, 2012, DH)

Example: Wakefield

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Wakefield - developing a rich and vibrant JSNA

Work with key players to gain ‘buy in’

Trial 2 asset mapping methods

Improve use of existing hard and soft data - assets and needs

Trial asset mapping as community capacity building process

Lever in more meaningful participation

Growing Communities from the inside out. Trialling an asset based approach to JSNAs within the Wakefield District : Methods and Findings

Wakefield - how they did it

Project manager and steering group

Identified priority - Mental health

Extensive preliminary community development

‘Careful’ training of staff

Briefing sessions for managers/ commissioners

Extensive partner discussions

Discussions with datahub

Community events - 5 ways to wellbeing framework

Wakefield - findings

A purely asset focus was probably only possible because of extensive prior work on needs

Difficult for some communities to stay positive and focus only on assets Asset based approach to solve a need Meaningful use of asset data by commissioners

— Not just ‘what asset?’

— Why is that an asset? How does that help? Why did that have an impact? What was the impact?

Participation is extremely empowering and rewarding Massive organisational culture change - long term Different stages of development - ‘the gulf of understanding between analysts

preparing the JSNA and frontline workers operating in the communities being served.’

Smarter data collection & sharing precudres and protocols

Wakefield - action

..lots…

Training programme for non community development specialists including elected members

Intensive work with commissioners on utilisation of the JSNA

Integrate assets and needs collection - toolkit

Ongoing CD work with communities with the least assets

An asset framework for JSNA ?

1. The factors creating health & wellbeing

2. The valued assets that help alleviate need

Data on assets can be drawn from:— Community asset mapping

— Community consultations and engagement processes

— Local surveys

— Routine service data collection

— Regional and national surveys

— ?

Asset mapping

Mapping assets =— Self esteem

— Sense of belonging

— Social connectedness

— WELLBEING

— Asset Based Community Development

— SUSTAINABLE WELLBEING

— Community Exchange/ Timebanking

— Befriending

— Community champions/ advocates/ mentors/ navigators/ leaders

— JSNA & Commissioning

Types of assets examples: Mapping question area Community Development focus

Commissioning outcome focus

Places and spaces (environmental assets)

green and blue space/ natural environments – parks, beach, canals, woods, rural landscape shared public space – squares, markets

What public spaces do people use? What makes these attractive/ usable?

Creating community-led green space e.g. gardens. Participation in improving the physical environment e.g. clean-ups. Taking action on climate change.

Increasing access to green space/ natural environments within communities (and hospitals, schools, workplaces, prisons etc) as this impacts on health, education, crime & cohesion outcomes

Facilities and services

GP, school, community centre, advice centre, job centre, leisure centre

Which services do people value most? Why?

Increasing awareness of the facilities and services available and supporting people in need to access and use them. User participation in decision-making, service re-design, evaluation and management.

Improving quality and efficiency of services e.g. reducing DNA, improving relationships, person-centred and user-friendly services

Social capital assets http://www.ons.gov.uk/ons/guide-method/user-guidance/social-capital-guide/the-social-capital-project/guide-to-social-capital.html

trust social networks & interation social support civic participation reciprocity neighbourliness cohesion

Community asset mapping www.abcdinstitute.org www.altogetherbetter.org.uk ONS social capital indicators http://www.ons.gov.uk/ons/rel/environmental/social-capital-indicators/review-paper/index.html

Increasing opportunities for people to meet with each other, join groups and clubs. Increasing cohesion within and between communities e.g. cross-community initiatives. Empowering citizens to have a voice and take collective action. Schemes to enhance neighbourliness and support isolated citizens.

Higher levels of social capital are associated with better health, higher educational achievement, better employment outcomes and lower crime rates. Cost-effective interventions include befriending, timebanking, community navigators.

Draft 1 Jude Stansfield

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Learning from a Liverpool Approach:Liverpool PCT - Alt Valley Neighborhood

Community Asset Mapping Project

Shane Knott, Neighbourhood Manager (North CCG), Shane Knott, Neighbourhood Manager (North CCG), Public Health Unit, Liverpool NHS Primary Care Trust,Public Health Unit, Liverpool NHS Primary Care Trust,

Shane.knott@liverpoolpct.nhs.uk

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1. What are we trying to achieve?2. FYI… some context3. In reality – the problem and a common sense

solution4. What we did (and how we did it)5. Development of the Asset Mapping Approach6. What does it look like?7. How has it been used?

Road Map

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Community Asset MappingSelected Summary Objectives

•“To adopt a systematic approach…”•“…through our commissioned 3rd sector organisations…”•“To specify a framework for action that includes promotion, earlier intervention, prevention and protection as the collective means to address mental health inequalities.”

Liverpool PCT. The Joint Strategic Framework for Public Mental health 2009 -12.

•Development of a Social Prescribing pathway…

•AV NPWG Priority to support GP Neighbourhoods

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Alt Valley District

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13 Team members

•LPCT Public Health Neighbourhood Manager•LPCT North CCG General Manager•LPCT Community Engagement Officer•LCH Neighbourhood Lead, Community Food Worker Team Leader•PSS/Age Concern - Health Trainer & Community Health Ambassador•Cobalt Housing - Community Development Officer•RC Fagends – Smoking Cessation Team Leader•LCC – Neighbourhood Officer, Sports Alliance Manager, Extended Schools Officers, Active City Coordinator

Health Delivery Team

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NHS Health Trainers Service

• Support patients to achieve health improvement goals

• Targeted to receive referrals from primary care

• Barriers to success for patients

• Onward signposting

Issues:Awareness of services1:91000Under-used service in Alt Valley

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GG

Social Prescribing

NHS

Public Services

and Housing

3rd Sector

Community Asset MapCommunity Asset Map

(Health Trainer)

(Primary Care)

(Patient)

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• Need for “Community Asset Mapping”

• Empower the HT!

• Social Prescribing…

• Wider benefits

• Community Resilience

The Common Sense Solution

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Method• Alt Valley Health Improvement Team • What do we need to know?

What, Where, When, Who, How to contact and How much!• How will we find out? • Who will do the work?• How long will it take?

6 Officers X 2 hrs pw x 6 wks = 72 work hours • Equivalent time costs?

c.22k/52wks/36hrs X 12 hrs X 6 Officers = £846 (+costs)

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First issue• Completed October 2010

– 482 weekly activities – 80 different providers

• Family Services Directory & Advocacy Rights Hub • Learning

– User friendliness, – placement of the asset mapping – Comprehensive? – Timeliness/Relevance

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2nd issue• June 2011 – reviewed information.

– 685 sessions

• Search codes and filter• Published via FSD & ARH• Learning:

– Mapping Patient population – LCVS cross reference– Lack of input from social services

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What does it look like?

Day Time Activity Location Contact Telephone Cost Code

Monday Morning Drop in Centre- Fazakerley advice, Informationand resource centre Fazakerley Federation, Formosa Drive Angie Rogers 0151 525 5051 Free £Monday 9.00am Get into reading - reader organisation reading group Fazakerley Federation, Formosa Drive Emma McGordon 0151 7942830 Free WMonday 9.00am Mass Holy Name Church, Moss Pits Lane Father Kevin McLoughlin 0151 4760289 Free WMonday 9.15am Mass St. Philomenas Church, Sparrow Hall Road Father Kevin McLoughlin 0151 4760289 Free WMonday 9.30-11.30 Credit Union Fazakelrey Federation, Formosa Drive Angie Rogers 0151 5231073 Free £Monday 9.30-11.30 Childminder drop in Fazakerley childrens centre, Barlows Lane Fazakerley Children Centre 0151 2333705 Free PMonday 10.30-11.30 Top tots St. Philomenas Church, Sparrow Hall Road Father Kevin McLoughlin 0151 4760289 Free PMonday 13.30-14.30- Chatterbox (songs, rhymes, craft etc Fazakerley childrens centre, Barlows Lane Carla McSherry/ Lynne Pollard 0151 2333710 Free PMonday 13.30-15.30 Cook and Taste sessions Fazakerley Federation, Formosa Drive Angie Rogers 0151 523 1073 Free FMonday 13.30-15.00 Baby Peep Fazakerley childrens centre, Barlows Lane Fazakerley Children Centre 0151 233 3705 Free PMonday 13.00-14.00 Toddler Swimmning (1-3yrs) St Phils Church (please contact children centre) Fazakerley Children Centre 0151 233 3705 Free PMonday 13.00- 15.00 Twins Group Fazakerley childrens centre, Barlows Lane Fazakerley Children Centre 0151 233 3705 Free PMonday 15.45-17.45 Multi-Sports sessions (6-13 yrs); Football, Pool, Wii etc Adlam Park Pavillion, Aldam Park Cliff Howarth 07917 753098 £2.50 PAMonday 16.00-20.00 Sing Along with Charlie Royal British Legion, Longmoor Lane British Legion Club 0151 5254747 Free WTuesday Morning Drop in Centre- Fazakerley advice, Informationand resource centre Fazakerley Federation, formosa drive Angie Rogers 0151 5255051 free £Tuesday 9.00-11.00 faz tots(parent & toddler) term time only fazakerley primary school, formosa drive School Reception 0151 4743060 £1.50 PTuesday 9.00am Mass Holy Name Church, Moss Pits Lane Father Kevin McLoughlin 0151 4760289 free WTuesday 9.15am Mass St. Philomenas Church, Sparrow Hall Road Father Kevin McLoughlin 0151 4760289 Free WTuesday 10.00-11.00 Storytime Fazakerley Library, Formosa Drive Fazakerley Children Centre 0151 233 3705 Free PTuesday 10.30-11.30 Kids Kitchen (with Health Visitors) Fazakerley childrens centre, Barlows Lane Fazakerley Children Centre 0151 233 3705 free P

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Pilot session of Delivering Health Messages (July 11)

Pilot session of Delivering Health Messages (July 11)

Additional Project Work

Community Resilience Analysis workshop (July 11)

Community Resilience Analysis workshop (July 11)

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3rd Issue??• June 2012• Include

– Kirkdale– Anfield– Everton

• Include Social Services• Include IT contact points

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How has it been used?• Case Study Examples

– Health Trainers• 4 case studies

– Community Health Ambassador– Cobalt Housing– Community Organisations

“The asset map is really effective in

helping me work with my clients, even now

that I am more familiar with the area,

I still use it to get contact details…”Nichola, Health Trainer

“The asset map is really effective in

helping me work with my clients, even now

that I am more familiar with the area,

I still use it to get contact details…”Nichola, Health Trainer

…the asset map is a worthwhile tool and an asset for our community. It

has developed our centre's network of organisations whom we now work in-partnership with and not just in

Croxteth, but for other areas in Liverpool as well.

Gerry, Manager, Porchfield Centre.

…the asset map is a worthwhile tool and an asset for our community. It

has developed our centre's network of organisations whom we now work in-partnership with and not just in

Croxteth, but for other areas in Liverpool as well.

Gerry, Manager, Porchfield Centre.

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Health TrainersCaseload 1•“Phil from Fazakerley was referred from a CHATS event and was wishing to lose weight. We set goals to alter his poor eating habits and lack of physical activity. I referred to him to cycle for health group and although he enjoyed it the session time was unsuitable for him due to work commitments. Using the Asset map I identified the cycle group held at Fazakerley federation which he began to attend on a regular basis and motivated him to buy his own bike which he uses to travel to and from work now. As well as making new friends and improving his social & mental wellbeing, he has lost 13lbs in weight over a period of 6 months.”

Caseload 2•“A client in Fazakerley was referred by their GP due to stress which happened as a result from struggling to complete financial forms, applying for jobs and CV. Although I could not help him myself, I signposted him to the local CAB and job café for support and info. “

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Caseload 3•“A lady in Walton was referred by her GP as she wanted to lose weight but found it difficult due to sciatica. I referred her to a local community group that provided a chair based exercise class. She found the class helpful as it suited her needs and she could carry on the activities at home if she was having a bad day.”

Caseload 4•“A client in Croxteth was referred by their GP regarding stress. I encouraged them to attend the local Porchfield community centre to access a wide range of activities from tai chi & Zumba to card making & computer classes. The client didn’t realise they could access it as it is attached to a residential home but the centre is accessible to all adults.”

Health Trainers

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“CHAT” Worker“I staged a health event for young mums in the Salvation Army, Cavendish Drive, Walton. The aim of the event was to promote an active lifestyle. I knew from the asset map that there were no Zumba sessions available locally at that time. During the event I organised a taster Zumba session, over 30 women joined in the activity and said they would attend regular classes if they were available.With this information I funded six sessions and worked hard to secure further grant funding to make it sustainable. I also brought in an ‘NHS Health Trainer’, David, to do a presentation on the service to all the women who signed up for Zumba, Three women took advantage of the free HT service and received continued motivation and support of the Health Trainer. The Zumba class is still in action and has to date an average of twenty women in attendance. The three women who took advantage of the free Health Trainer service have all stated that their new improved lifestyle has rubbed off on the rest of their families and they feel they now have the tools to look after their health and well being. “

Lynne, Community Health Ambassador

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Community Organisations“We have made the asset map available to our tenants in their welcome pack, and will be making the asset map information available through a touch screen kiosk in the housing office.”

Manila, Cobalt Housing

“I have used it on a number of occasions to signpost some of our clients and their families to services that we are unable to offer at our centre i.e: Fag-ends, Citizens Advice, Job Cafes, Parent/Toddler Groups and other various activities for children aged 0-4 years that take place throughout the working week. We have also noticed that since this information has been available we have had a lot of referrals from Health Trainers for activities that we provide e.g Computer Classes, Social Events, Exercise Classes etc.”

Gerry, Centre Manager, Porchfield Community Centre.

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Community Organisations

We have made the asset map available to our volunteers in North Liverpool to signpost clients onto other services.

Karen, Victim Support

•I know the area well as I have worked here for a long time, so I have not really used the asset map. I have been sending people to the Fazakerley Advice Centre for debt and benefits advice, and the the childrens centre and the Fed (Fazakerley Federation) for toddler groups. We have had a lot of people sent to us by the health trainers to use the gym, including a woman who was obese and didn’t want to exercise in front of other people. She still comes even though she has stopped seeing the health trainer and she has brought the rest of the family with her as well!”

•Mark, Centre manager, Fazakerley Memorial Hall.

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Summary1. What are we trying to achieve?2. FYI… some context3. In reality – the problem and a common sense solution4. What we did (and how we did it)5. Development of the Asset Mapping Approach6. What does it look like?7. How has it been used?

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Any Questions?Shane Knott, Neighbourhood Manager (North CCG), Shane Knott, Neighbourhood Manager (North CCG), Public Health Unit, Liverpool NHS Primary Care Trust,Public Health Unit, Liverpool NHS Primary Care Trust,

Shane.knott@liverpoolpct.nhs.ukTel: 0151 285 4766Tel: 0151 285 4766

With thanks to PSS & Age Concern Liverpool, LCC, LCH, Cobalt Housing, the Roy Castle Lung Cancer Foundation, and also to the Fazakerley Memorial Hall, Victim Support, The Porchfield Centre, Fazakerley Federation , the Communiversity, LCVS, and all community organisations and partners that helped us to produce this work.

Discussion

What are you thinking of doing to take forward the asset approach?

What do you anticipate will change by doing this work?

How will change be measured?

Who needs to be involved and what will you/ they do?

What needs to happen in the next 30,60,90 days?

Working together going forward

Are there other places that are planning to do something similar- is it helpful to collaborate?

What is the specific input that will help you to achieve this that we can plan into the next two sessions?

Thank you