Tuesday, 5 February 2008

‘Good practice’

Progress or palliative?

Peter Limbrick chairs the Handsell Trust, dedicated to establishing family-centered services for disabled children and their families, and more specifically the development of ‘keyworking’.
In the recent, fiftieth, issue of his e-magazine Interconnectons, he has written a thoughtful and challenging piece about a dangerous contradiction at the heart of the apparent social progress that his work is achieving.

What he wrote seems eerily familiar in respect to Conductive Education, not just in respect to the situation in the Britain and Ireland but in many countries in which people often now say that they 'have Conductive Education’.

I am taking the liberty of reproducing his short article here in full.

As you read it insert the words ‘Conductive Education’ or ‘conductors’ every time that he writes ‘keyworking’ or ‘keyworkers’.

In my consultancy work around the UK and Ireland I am often told about instances of good practice. Sometimes there are so many instances voiced by so many committed practitioners and managers that I wonder why levels of user satisfaction are not sky-high.

The answer to my dilemma lies in how we define ‘good practice’. The very many examples I am told about are usually more like ‘successful innovative work’, because good practice in my terms is that which has become embedded in local protocols, training, selection, budgets, inspection, etc. and is available to every child and family in the locality who meet the agreed criteria. (By ‘local’ I mean the area covered by a health trust or a council or by some integration of the two.)

In everyday language in this field we make the same sort of distinction when we talk about ‘pockets of good practice’ knowing that there is probably some sort of post-code lottery involved. So good practice is not good practice when some people in the locality who need it cannot have it.

This sort of pocket-sized good practice, valuable and welcome as it is, can be counter-productive in the campaign for effective support when it masks the unmet need and allows some service providers to be in denial about the real situation. Keyworking projects can be an example. It is relatively easy for a small group of committed practitioners, managers and parents to set up a keyworking project – perhaps using a short-term grant and relying on the good will of service managers who make staff time available for a limited number of non-designated or shared-role keyworkers. The result will be a very positive report with some satisfied families, practitioners who have enjoyed the expanded role and service managers basking in the warm glow. Whether this is good practice or just one more frustrating ‘pocket’ depends on whether –

- keyworking, as established in the successful project, is embedded in the locality’s multi-agency strategy

- and is therefore sustainable over the coming five, ten, twenty years…

- the keyworkers are trained, resourced, supported, etc. to meet agreed needs by providing emotional support, advocacy, co-ordination, overseeing action plans, generating TACs, [‘teams around the child] etc.

- keyworkers are readily available to everyone in the locality who meets the criteria – and at the time when they need them

In my experience it is very hard indeed to elevate innovative keyworking to sustainable good practice and the likelihood is –

- the project stays small and scratches around for funding to keep it going

- he criteria are changed to a lower level of support for a smaller group of people
- the project dies completely and keyworking goes down in local history as something ‘we tried a few years ago – but it wasn’t a success’.

When these negative outcomes happen it is a cruel disappointment for the practitioners and managers who invested their time and energy and for the families who helped to make it succeed, thinking there would be lasting benefit for other local families.

For these reasons we must be more sparing when we talk about good practice and must acknowledge the mountain we have to climb to get effective support to everyone that needs it. Small successes are the foundation stones on which to build the future, not seductive trinkets that lead us to take our eye off the ball.
Not quite a perfect fit to Conductive Education, I know, not least because many keyworking initiatives have been established in the public centre, out of existing staff and institutions. Serious food for thought nevertheless. Take the terms of his critical appreciation of his own work and apply them to conductive centres and services that you yourself know well, and find yourself reflecting very seriously upon the real social impact and sustainability of the internationalisation of Conductive Education.


Peter Limbrick, When is good practice not good practice? Or, when can ‘good practice’ be counter-productive? Interconnections Electronic Bulletin, no 50, February 2008, item 20

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