Changing Futures is a UK Government and TNLCF-funded programme supporting 15 local areas across England to make changes at the individual, service and system level for people facing multiple disadvantage.
Over the last year, MEAM has brought the local programme leads together for regular discussions about key aspects of the work. In this series of blog posts, we reflect on some of the topics covered, drawing on their insight and input from others in the Changing Futures programme and the wider MEAM Approach network.
In this first of several blogs, we explore the concept of risk and its implications for work on multiple disadvantage.
‘Risk is an energy, it moves around the local system’ – quote from member of System Change Together Forum
Risk is innate in local areas’ work. Experiences of trauma, compounded by complicated, inequitable systems, mean people who experience multiple disadvantage are at higher risk of exploitation, sexual and domestic abuse, poor health, early death and other harms. Some individuals’ behaviours will also present risk to themselves and to others and this needs to be managed. How does it feel to work with these high levels of risk, day in and day out? Does the system support or inhibit attempts to interact with risk in a holistic and thoughtful way?
Risk management processes
Across the Changing Futures Programme and wider MEAM Approach network there is a recognition that traditional ‘risk management’ approaches are typically about mitigating “bad things” happening. Within a system which is itself traumatised, and where resources are scarce, safeguarding procedures can focus on managing liability at practitioner, service and organisational level, potentially at the cost of more aspirational, creative and trauma informed practice around a beneficiary. This, in itself, can be understood as the local system’s response to trauma.
Such approaches place a limited focus on managing an individual’s behaviour (and perceived threat to themselves, other people who use the service, and staff), instead placing the blame for ‘poor behaviour’ on the individual and implying that only the individual can address their behaviour. All too often, service practice following a risk assessment will fail to interact with and address the underlying causes of trauma that can often be a trigger for “poor behaviours” (which can be better understood as trauma responses). This can also lead to overlooking the obvious; that a trusting relationship can be the most effective mitigating factor.
Risk assessments are often out of date or created out of “an abundance of caution,” due to sometimes valid concerns about when things have gone wrong in the past. In particular, local areas told us of the many challenges with removing unsubstantiated or historic concerns about individuals in case notes, particularly around historic arson risk which continues to affect eligibility for social housing.
This inability to “move on” from peoples’ pasts, and to focus on risk-positive, strengths-based risk assessment and management means that people are often stuck for the long-term.
What happens if services ignore the problem?
Another response to risk is to look the other way. We see this play out when services deem certain beneficiaries as “too high risk” to work with or avoid attending multiagency meetings altogether. As voluntary sector services can often be of a more flexible nature, they can often be left holding the risk without a lot of wider support. But disengagement does not make the risk go away. The risk instead moves around the local system, showing up with different symptoms at different touch points. Taking on this risk can feel scary and exhausting. It also requires resource. Of course, the resource (things like additional support time, ‘double cover’ workers, extra costs around housing, time invested in system convening) costs money. At present, there is no mechanism for the rest of the system to reimburse these costs, or share the risk, even though the system at large benefits from it. If we had a more connected system, could some sort of ‘balancing mechanism’ be developed to hold and spread risk and costs collectively?
Decisions about risk should be taken by the people best placed to decide
People experiencing multiple disadvantage need support which is responsive, person-centred and creative. These quality-driven tasks, which frontline workers endeavour to deliver, are sometimes quashed by a system which is unable to sit with uncertainty and nuance in the face of risk. Good decisions around risk are made collaboratively, by people who feel empowered and supported by the system around them. If a workforce does not feel psychologically safe and supported, they are more likely to revert to rigid, punitive risk management. Within all this work is a golden thread of trust and relationships. Trauma informed, cross-sector system convening spaces foster these trusting relationships and enable more creative, dynamic risk responses; local areas that are effective in this work are placing value on these spaces and holding them central to their work.
People are experts in their own lives, and often the practitioner supporting them intensively also has an intimate insight into the challenges they face and the strengths they possess. If we can trust this partnership, we will recognise that a co-created risk plan (between the beneficiary and their trusted practitioner) is what will optimise safety; the system needs to have the courage to enable this plan and take positive risks to help someone navigate their way forward.
What does this mean for the future?
Thinking differently, trusting differently and moving from a language of risk to a language of safety could support a better system and more creative, thoughtful responses. To create these relationships, we need to value and protect reflective learning spaces that bring professionals from different sectors together without a traditional ‘blame’ narrative, where risk can be ‘held’ jointly between different agencies which support each other. Safety plans should be co-created with the person and their trusted professional, making room for their own personal insights on managing risk to be listened to, shared and honoured.
More broadly, we need to become more comfortable with risk, accepting it is innate in the lives of the people we work with, that it doesn’t go away when we put our head in the sand, and that it is only by being bold enough to do things differently that change will happen.