Systems are Systems, People are People

Your PTS Quality Assurance Manager here checking-in post maternity leave. And what a strange maternity leave this has been! I promise, I will not overuse the term ‘unprecedented times’ but….you know.

My pregnancy and the birth of my first child initially threw me into a ‘system of systems’ before I was unceremoniously chucked back out as soon as the dreaded ‘C’ word hit. And the turmoil caused by being part of a process-led system and then having that system removed led me to question my real understanding of systems damage on individuals.

Through working in partnership with allies to develop the New System Alliance, and my seven years working with all of our colleagues to progress the Person-Led, Transitional, Strength-based response (PTS), I learnt a lot about the systems damage and barriers people experience as they transition through their tough time. People are labelled and syphoned into the corresponding silo of services, turning their understandable, human responses into over-pathologised and medicalised issues.

These ‘system-led’ responses create internalised system failures; the quiet and pervasive destroyers of hope and aspiration. People wear the labels assigned to them and they internalise the diagnoses. Without realising it, people develop internal barriers based on this evidence of perceived ‘failure’ which prevents them from seeing the choices, control and personal transitions which are within their reach. I saw this happening to those we work with but I didn’t see when it was happening to me.

Let me make absolutely clear that this is in no way a negative commentary on the NHS and the fabulous doctors and nurses. We all agree that we can never repay the debt of gratitude we owe to them. What I wish to reflect on is system-led responses to human situations and the effect these have on all people locked within those processes – including fantastic frontline teams.

I suffer from a medical condition that prevented me from becoming pregnant. My medical records described this as ‘failing’ to get pregnant. I was ‘unresponsive’ and I had ‘abnormal’ test results. I was categorised as infertile. All negative, derogatory and labelling language which is accepted as part and parcel of fertility conversations – and medicalised language in general. My doctor explained that it was ‘just language’ which they ‘had to use’ and he didn’t see my situation as anywhere near as hopeless as it sounded. But seeing myself described in such negative terms felt like a physical blow in an already emotionally painful situation.

At the ripe ‘old’ age of 33 I became pregnant and the immediate happiness was somewhat undermined by the term ‘geriatric mother’ which was added to my medical records (‘Sorry – it is just a standard term. We know you are not geriatric at 33’). I was immediately categorised as ‘high risk’ due to my medical history despite being the fittest I had been in my adult life. From then on, every conversation I had with a doctor or nurse, or even the doctor’s receptionist, started with me having to recant my full medical history without any consideration of the effect this might have on my mental wellbeing. In return, I was told what tests, medicines and interventions I would have rather than being asked what would help me or what I might like to do. There were no choices, only the best ways to ‘manage’ my pregnancy.

It was all done with good intentions; the NHS were going to throw the kitchen sink at me to ensure a safe, controlled, happy ending to my medical journey. And I began to accept that reassurance, along with all the labels and interventions that came with it. I started to act as if I was ill, rather than pregnant. I accepted that the services were in charge because, after all, I had ‘failed’ to get pregnant to begin with so what did I know about anything? People wanted to help me; they wanted to manage my risks for me. It seemed for the best to let the services take over when I wasn’t at my strongest.

At an emergency scan, which was automatically triggered by my high-risk status, I met a wonderful midwife who opened my eyes to the fact that I was travelling through a system. She explained that I was not being measured against any of my personal attributes. My pregnancy ‘success’ was being measured against national averages. The extra treatment had nothing to do with me as a person because the system is not designed to see individuals. She apologised because, in all likelihood, I would be referred to see her again but if so, I should remember that I was a person overcoming previous medical trauma quite successfully and I could decide how I wanted to proceed.

The flood of relief and hope I felt is indescribable. I had forgotten that I was an individual in charge of my life. I had forgotten that I was pregnant and not ill. I had become comfortable in the new, medicalised community of the doctors and nurses I saw at the emergency appointments and I had forgotten the wider community of support that surrounded me. I had lost myself temporarily in the system. But thanks to this wonderful midwife, who took a person-led, humane approach, I was back.

My son was born two weeks before full lockdown was implemented. I was told to start shielding the week we took him home. And that was it – no system. No midwife visits, no health visitor, no 6-week check-up. From all to nothing. The system is so large and complex that the ability to adapt quickly to changing situations and personal circumstances was impossible despite the best efforts of individuals to try to keep some form of personalised support available. I could hear the frustration of caring people who wanted to offer more individual support relevant to the unique situation but who were restrained by the lack of flexibility to utilise options such as Zoom to respond in real-time. Even in such unprecedented (sorry, I said the obvious again!) times, Midwives and Health Visitors still had to follow the same mandatory schedule of contact and standard checks, responding on a risk measurement basis rather than on an individual level. And this was hitting them hard too – I know this because they told me during our limited contact. They do their job because they care, and the small elements of individualised care they can offer during face-face visits was gone leaving just ‘the system’ in its place.

I owe NHS staff so much which is why I want to acknowledge the burden of systems that they and most frontline teams have to navigate every day. Everyone I met had nothing but good intentions for my health and that of my baby but they could only help within the constraints of the system;

  • The deficit language they have to use because it is recognisable
  • The pathway of standardised responses they had to send me down because it was the only way for me to access some of the resources I needed
  • The risk assessments they are mandated to carry out on everyone and the standard triggers for indicating high risk based on past experience
  • The lack of a person-led or active response they can provide because the current system cannot accommodate it

The problem is the system response, and the systems damage this creates, for all of us who want to work with people experiencing tough times so that they can transition to achieving their aspirations.

It is the culture – the language of deficits, the process-led policies, the hierarchical structures, the lack of autonomy to provide a human response and choice.

It is the focus on the wrong outcomes – the way people are measured and evaluated, needs and risks and hard outcomes defined by the system being the primary objective over personal achievement.

It is the approach to working with people within this environment – ‘fixing’ people’s problems, prescribing and ascribing until you find the ‘label’ that fits, the label that captures the essence of that person’s problem and opens up the ‘right’ service pathway of standardised responses which segregates people from real-world experiences and opportunities.

Passionate New System Allies, who see the people at the end of service responses and understand the damage that can be caused, like the wonderful doctors and nurses who have supported me, can feel just as trapped by the system without the culture, approach and change in mindset to allow them to deliver a person-led response.

And this is why a paradigm shift in how the UK responds to people experiencing tough times is needed. Because we all experience the systems damage if things don’t change.

This blog was written by Ciara Killeen, PTS Quality Assurance Manager at Mayday. Intrigued? Why not read more PTS Blogs?

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House of Fun..?

Richard Boylan, PTS Coach, explores the impact of the use of labels and deficit language on people accessing help through a tough time.

Read more

A Move for Change

Mayday welcomes Robert White to the team.

“Are you nervous?” “Are you scared?” “That’s quite a change, what will you actually be doing?” These were all valid questions, but all they really did was make me increasingly concerned that I hadn’t made the right decision. Leaving the Local Authority and joining an organisation that is constantly evolving in major ways to lead on an ambitious vision across London and the ‘South East’ (a geographical term I found myself Googling the night before) – what was I thinking?!

Hello. My name is Robert White and I have just joined Mayday Trust as their Director of Change. I did start as the Director of Change and Innovation but on my second day, a colleague told me that the term innovation was wrong and the whole thing sounded “a bit wanky” – Director of Change it is, then.

I have just left Westminster City Council where I was the Lead Commissioner for Supported Housing and Rough Sleeper Services (I know). I had been at Westminster for six years, working my way through various versions of commissioner roles. I joined the Local Authority after a couple of years leading a team in a high support, 40-bed hostel for rough sleepers. As long as you could prove to me that you smoked enough crack, drank enough vodka, heard loud enough voices and that a commissioned outreach worker had seen you “sleeping, or readying for a nights’ sleep on the street”, you could stay in my hostel and I would fix you right up. You’re welcome. I knew at that point that something wasn’t right and that we could do better, and I figured if I joined the team that designed these services I could change these services.

I think we changed services for the better…No, we definitely did. We worked hard at making sure that trauma-informed practice, person-centred support, and psychologically-informed environments were at the heart of our service provision. As a team, we balanced the expectations of residents and businesses in Westminster with the ever-growing demand for houses, places of safety, and support that was right for the individual.  The scale at which we had to do this puts our country to shame. During some of our most challenging times, outreach services could expect to meet at least six new people a day, every day. Systems, pathways, hostels, support services were all creaking at the seams with demand. During my time at Westminster, we removed over £2m from the system due to the austerity agenda and, with the invention of the Rough Sleeper Initiative, we drip-fed £3m back in.

It wasn’t until 2018 that I began to recognise that, politics and policy aside, there was something about the system that had to change. That year, we had received an effectively blank cheque from the Ministry of Housing, Communities and Local Government.  They had been clear with us: do whatever you can, focus on the numbers on the street and reduce rough sleeping. The idea was, ‘if we can nail it in Westminster, the rest will follow’. The pressure was intense. We doubled the size of our night centre, housing 80 people instead of 40, we increased the size of our outreach team to reach more people, faster, we increased the capacity of the mental health team to assess and diagnose more people and get them into treatment. Housing First opportunities were doubled, and we continued to develop our assessment centre to process more and more people, as quickly as possible. All was leading to the annual street count, the questionable measure of success, a litmus test of progress; in 2017 we had seen 217 people, all services were full, teams working overtime to get people off the street, over £500k was thrust into the system to make it work…

The morning after the street count I remember feeling sad, overwhelmed and confused. We had found 306 people that night, a 30% increase in the numbers. All that work, all that time, all that money and it had made no difference. What followed was a lot of soul searching, involving, amongst other things: an inspirational trip to Scotland, a fact-finding mission to Bratislava, having a second child, a period of Parental Leave, and, dare I mention it 704 words in…coronavirus.

Where I arrived at was this.  It all boils down to one point: “change the system and not the person”. Until we truly challenge the status quo, until we collectively recognise that we are not here to fix people’s problems but to facilitate their strengths and work with them to grow in the way they want to grow, then we will continue to see numbers rise, more and more people institutionalised in a system of mass fixing and a revolving door of challenge and frustration.

I am proud of the work we achieved at Westminster, and the tenacity, passion and belief of my former colleagues is unquestionable.  But moving to Mayday Trust is a move of activism, a move to a place of true change, surrounding myself with the most incredible people who believe in a world where systems work for people going through tough times. Yes, I am nervous, yes, I am scared and yes, it is quite a change. Deep breath.

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People Just Do Nothing

Reflections on COVID-19 Lockdown from Rebecca Nelson, Mayday PTS Manager

Last week after restrictions were lifted, I emerged from my house, with my bad COVID-19 hair, which has strangely grown into a 1980s style mullet and I went on a social distance walk with someone who lives in a Mayday property.

While we were walking and chatting he said to me “Becks, I’ll tell you what, I love this COVID.”I enquired why and received the following response; “because up until all the COVID stuff people have been telling me that I’ve got to go out more and stop watching so much TV, now everyone is saying well done for doing nothing, also I’m getting free food delivered every day so I’ve got loads more money to spend on blow.”

I have missed out a few of the expletives and his delivery carried far more humour, but it was a really interesting statement which led me to reflect on what has happened over the last few months.

About 10 weeks ago I became ill – I suspect it was COVID-19 based, but can’t know for definite. As soon as people were aware we were self-isolating I was inundated with offers of assistance. People I wouldn’t normally hear from were phoning and messaging their support. I also noticed that a friend of mine, who is usually very morose, was suddenly alive she had a purpose, she felt needed, she was happy. I am incredibly grateful for everything everyone did during that time and feel very lucky that I have such a great support network, but the truth is I felt uncomfortable accepting help and at times accepted it when I didn’t need it so that I didn’t appear ungrateful or rude. When I finally started to recover from my illness, I was delighted, but also extremely pleased to take back full control of my life again.

When I returned to work I began to open my extensive, unread emails, as I worked my way through them it was full of services offering resolutions to a variety of COVID-19 related issues, some examples being:

  • home food deliveries
  • Collecting and delivering medicines
  • Funding solutions for a variety of equipment

The list went on. My initial thought was this was great; people had access to various support requirements, where they had, like me, had fallen ill and needed to self-isolate. Particularly people who did not have access to the support networks that I did.

During the early days of my return to work, I started talking to people I coached and responded to some of the messages I had received from them. The majority of people I engaged with were bright and healthy, and most of them were more worried about me! One person, in fact, the man I went on the social distance walk with, said: “I think I had better stay in touch Becks – I mean I’m used to being isolated; I’ve been doing this for years, but I think you might go mad!” He had a very good point. I started to realise that maybe what was happening to me felt different from the people I coach. I needed to ensure I responded to the people I worked with, and not to the Crisis.

Due to lock down we are forced to work from home, therefore unable to meet with people face to face. We needed to work out how to do this effectively, how best do we coach virtually? This is where we had to be creative. We tried to ensure everyone had access to a phone. We then had a conversation to resolve the best way to keep in contact, should this be desired. We have used FB Messenger, WhatsApp, phone calls, whatever contact method that the individual felt comfortable with. We then reviewed constructive things we could still share with people, even though we weren’t meeting with them:

  • Online games
  • Facetime walks
  • Reading the same book

Within those examples, some were more successful than others.

I am lucky as I am not a full-time coach I have other roles within Mayday to make me feel purposeful and useful. Even with that added variety, this has not been an easy time to be a coach. People like to help others, which can manifest in a sense of satisfaction during a crisis. It’s natural to want to do something to help fix a problem. Coaches do this job because they love working with people and enjoy that direct interaction. Unfortunately, due to lockdown, they’ve found themselves stuck at home trying to find creative ways to connect with people. It has been difficult, but they have managed to achieve it, and at the same time always put the people they work with first and listened to what was happening within their lives.

What has been even more difficult is to watch how other organisations and support agencies have responded; being busy, rushing around responding to things that were happening during lockdown. Delivering food and completing a variety of other tasks for people, even when it wasn’t required.

During the first few months of lockdown, although it was strange, I was hopeful that when we got through this, we would see change for the better. I saw it as an opportunity to rethink the way we deliver services. As a society, we were experiencing what it was like to be isolated. I thought COVID-19 was going to be a leveller and we could take our experiences and start to resolve the “us” and “them” we have created within the services we provide. We could stop “doing for” and we would gain practical experience from what was happening around us. My hope was there would be change and that we could rebuild services that actually work for the people using them.

The conversations with some of the people I coach have changed and those who have had lots of experience of social isolation have called me asking “are you ok, I’m worried about you?” This has provided me with a support outlet to stay sane in a situation that was alien to me but is a way of life for the individuals we work with.

Unfortunately out of kindness, a slight knee jerk reaction and desire to help, I think that services may have just pushed people even further away, into the realms of “them” and “us.” So for coaches to sit back, remain calm and remain person-led has become more important than ever.

I received a call from a young person I coached last week “I’ve got myself in a mess; I don’t know what to do, I’ve been an idiot, sold all my furniture and now I need to go back to my flat and have nothing. I’ve got loads of bills to sort; you’ve got to help.” She is a lovely young woman and every bit of me wanted to say – don’t worry I will sort it out, but I didn’t. We chatted and I reminded her how much she had achieved since I first met with her, we talked about how she might be able to resolve this problem on her own; yesterday I received a phone call from the same person, and a very excited voice said “Oh I’m so glad to speak to you, I wanted to tell you, I have sorted it all out, I did it all myself. I am so happy.”

Of course, we applaud front-line workers, who have been out delivering key services and fixing issues during these times, for their efforts and bravery.

However, I would also like to applaud all the people who just do nothing – those who show warmth and kindness by listening and responding and remembering that we are just all muddling through this together. I would like to applaud everyone delivering services which are truly led by the people they work with. Most of all, I would like to applaud my colleagues the PTS Coaches who have been frustrated and at times, felt trapped and scared by this themselves, but have never failed to remember why they do what they do. They have trusted that ALL people have skills and abilities, and with the right support, these strengths will manifest themselves to assist them through this pandemic.

So, thank you for responding to the people you work with rather than the crisis.

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The Epidemic of Mass Fixing

By Pat McArdle, CEO of Mayday Trust

The instant that you say ‘a woman with a drug problem’, a ‘man with a mental health problem’ you have failed. You have become part of a systemic problem; you are on a very slippery slope to becoming a problem fixer and are embarking on a journey where you remove power, control, and choice from another human being. The end result for the person is seldom positive, and for a generation, it has created mass dependency upon ‘state fixing’.

The mass expectation is that everything from noisy neighbours, exam stress, misbehaving kids, sadness, unhappiness, everything that we experience as negative in our life, must either be solved by a service, state intervention, or a drug. If you are unwilling to go down this path you are choosing not to help yourself and must live with the consequences.

The biggest disability in our society is the removal of agency, power, choice, and responsibility from people and from communities. In Dublin mothers on an estate said no to drug gangs and services played only a small support role. This worked. In a town in the North East of England people living in estates looked to the police, social services, and schools to save their children. Sadly the evidence shows that services, with their fixing approaches, restricted interventions, rigid timelines, and their lack of understanding of the real problems, will never be as successful as a community response; communities with decent housing, secure employment opportunities, and happy residents.

Stopping young people carrying knives misses the point; how do we stop young people from being afraid?

Quick fixes are rarely effective. What we need are investments directly into people and healthy environments, which facilitate and nurture positive connections and opportunities for people to contribute. This is what it will take in order to stop young people from becoming disenfranchised, vulnerable to criminality and drugs. Young people need to feel they belong and have purpose and connections that are strong and positive in their lives. Connection means we have people to go to during the tough times and purpose gives us the confidence to cope. We become less dependent on ‘fixing’ and more internally and externally able to deal with life, and importantly to understand the wider context and barriers we face.

But if we can individualise and quantify the problem, we can target resources to where they are most needed, right? Wrong.  A woman may have a drug problem because of personal trauma caused by living in poverty, because of a lack of opportunity to have a real purpose, or as a result of surviving homelessness. A multitude of possible reasons – so to start with a drug intervention may work as a temporary sticking plaster for some, but won’t have a long term effect and misses the point. How can solving an individual’s drug problem-solve their poverty or give them hope or motivation that life could be different? The only thing you have done in stopping their drug use is to take away their survival strategy, coping mechanism, only pleasure or release.

Money and resources are being channelled into industrial-sized charities, services and mental health provision to cure the ills of individuals, whilst the problem today is more often structural.

Systems have been established to focus on the individuals’ complex needs with mindsets firmly on finding ever-growing ways to ‘fix’ these multiple needs. The most illustrative, crazy example I read recently was a council who hired Pastors to help people who were being evicted from their homes with ‘their stress’, as the council was selling the land off to developers. People didn’t need the church or help with stress, they needed a good lawyer and a right to remain in their home and community. But while this is an extreme example it demonstrates how our focus is not on the real problem, which is a broken system, but on the symptoms experienced by individuals which appear easier and less costly to fix.

We have evolved cultures and systems that are only designed to solve problems and categories of misery. As a result, people have internalised feelings of blame, hopelessness, and weakness through the continual and persistent failure of ‘fixing’ or failure to offer real-world explanations and solutions for their experiences.

Only when we say to people: it’s perfectly understandable that you will feel anxious, you are living in a scary hostel; everyone makes mistakes and so that doesn’t mean you aren’t entitled to your own flat; I would react in the same way if I was told at 45 years old to be in bed by 10 pm; only when we actually walk alongside people, deeply listening and seeing life through their eyes; only then will we learn that it is not their failure, but a system failure. There is no way to fix this broken system, instead, we must embark on the challenge of building a new one.

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Mission Impossible

Pat McArdle CEO of Mayday Trust shares a raw account of navigating COVID-19 as an organisation offering supported accommodation and working alongside people experiencing tough times.

On March 11th Mayday Trust transformed from being an accommodation provider, an advocate for system change, walking alongside people going through tough times discovering system barriers, to JUST keeping people safe from COVID-19.

This required a change of mind-set, an understanding of working to a different purpose, a different environment and new processes – a fundamental shift, whilst staying true to our ethos of being person-led.

It required instant, not a gradual change. We didn’t have a six month plan to introduce a new virtual communication strategy, we didn’t have a focus group to explore the best ways to work with people with ‘complex needs’ online (not that we believe we work with people who have complex needs, but still you get my drift).

Our accountability became about keeping people alive and Coronavirus free. The three day turnaround to fill an empty flat or room and the discussions on managing arrears faded away. People began to refuse accommodation in shared houses, terrified of becoming infected. People were also struggling to pay service charges as limited funds had to be spent anywhere food was available, usually in more expensive shops.

The things that are making this change easier are:

The passionate people that make up Mayday. We were once described as the ‘Mayday Brand’ but Mayday isn’t a brand – it’s better described as a group of passionate individuals who often have the characteristics of a dysfunctional family, but when the heat is on, everyone comes together to go many, many extra miles. Team before self.

But not just the teams, the people living in Mayday accommodation and working alongside PTS Coaches stepped up, many calling and checking in to see how we are. People living in shared housing explaining how they are getting on better as they have the opportunity to get to know each other and individuals keeping an eye on neighbours and telling us how things are going.

We have a leadership team that ‘got it’. In a few short hours we had named it our ‘Mayday Creative Phase’. We needed to, at speed, get teams to understand it wasn’t business as usual. New rules now applied!

Mayday made the decision that teams needed to limit face to face contact, but at the same time needed to increase the level of contact. The Personal Transitions Service (PTS) is led by the individuals we work with and many chose to contact their Coach through social media, gaming, or by text and phone. By providing people with phones, laptops and top up credit, connecting with people virtually wasn’t the task it could have been.

Our strong relationships with a small number of people in Trusts and Foundations who have known us long enough to know we would be ‘doing the right thing’ not just ‘covering our backsides’, offered some financial support to help us through. I honestly don’t think we would be surviving without their support. While emergency funds pour out money for individual essentials and for organisations that are working at scale, although much needed, equally no one is out there listening to what we really need.

Coronavirus has meant our income is down because we have more empty rooms. Security costs are increasing as teams have to tackle people and property being targeted for cuckooing, at a time when police have limited and stretched resources. Contracts due to start have been suspended, leaving income down and fundraising activities at a standstill.

Even with a lot of support on our side, it still isn’t easy

This is an extract from my daily diary (informal log) and gives a flavour of a day in the life of the Mayday Housing Team (incidents are anonymised to protect the identity of the individuals):

Sexual assault of a disabled woman. Team managing this but obviously distressing. Police involved.

Failed attempts to contact female tenant. Police now in attendance and two arrests made from flat. Two males, likely to be cuckooing, taken away by police due to possession of Class A drugs along with a stolen bike. 

Trying to find accommodation for woman due to give birth. Advice from council to either evict to emergency accommodation or source private rented sector. No estate agents open so answers on a postcard. 

Recent non-related COVID-19 deaths. Team managing reporting requirements, internal investigation and compassionate response to families, who are in pain with not being able to be there. Team facing their own distress in losing people they have connected with. 

Urgent need to re-house people from Travel Lodge. Housing Officer concerned that as Mayday has referrals from those going through their most chaotic time, the stretch on resources may be too much with two team members down and managing a high level of incidents while having to produce more and more reports for commissioners. 

Of course, these are only some of the situations that I am aware of from talking to the team and yes generally Mayday sees a lot of activity as we seldom say no to anyone going through a tough time within a very broken system. But the adjective the team used to describe the current situation is ‘relentless’. One team member took 75 phone calls yesterday, statutory services are on skeleton cover and asking the team to maintain contact when they aren’t around. Charity shops aren’t open so those who could move into their own accommodation are finding it hard to buy the basics to do so. The challenges are endless, the work scary, terrifying, physically and emotionally exhausting, stressful and hard.

As CEO, I can tick all the boxes of how we are providing extra support, online counselling, PPE etc. I could and do tell people to stop working so hard (and I know I’m being ignored), I could pay tribute to the great work going on and I certainly do, but in true Mayday way, with honesty and integrity, I can only say it’s a crap time and we need to work together to somehow get through.

(Here’s to a team of nine Mayday Housing staff currently doing the impossible)

Through the Eye of the Storm

Sarah Tully, PTS Manager at Cherrytree shares a personal account of her own tough time, the realisation of what is really needed from people, organisations and the system during these times.

So, the last few weeks of Coronavirus has been one long.. I hesitate to say rollercoaster ride, because that is actually fun. No, it’s been one long spiralling ball of loss, plummeting down a depreciating hillside.

First it was the small inconveniences. No pasta, or at least only yucky wholemeal pasta! The possibility of no loo roll – I warned my kids we might have to cut up newspaper like in the “olden days,” but the need never really materialised. Then it was “don’t mingle.”  I was a bit reticent to give up my right to gather, after all it’s my human right isn’t it?

At that stage it was still almost fun, novel even.  A group of us went into the woods with some bevvies to celebrate my daughter’s birthday- yeah look at us being resourceful but still managing to enjoy ourselves!

And at work it became how to navigate the changing unknown and create policies to make us feel in control.

In the background we had the uncomfortable facts coming from China – that’s a long way away.  Italy is a bit closer, but maybe it’s just because they’ve managed it wrong.

Then my dream family holiday got cancelled and I grieved that. Three weeks in Sri Lanka; a special time for my family to get together. I’d been planning it for the best part of a year.  I was devastated.  This was more than inconvenient.

And then the schools shut – WTF!

And then my dad got ill.

He wouldn’t go to hospital and the paramedics wouldn’t take him.  I tried to stay away for fear of bringing him an unwelcome present, but last Friday it became too much to bear listening to his and his wife’s distress, so I pegged it down the motorway to London to find him close to death in his bed.

“I don’t feel well enough to go to hospital,” his words barely audible.

“Dad, you’re not supposed to feel well when you go to hospital.  Don’t worry I’ll stay with you dad,” I reassured him.

I went with him in the ambulance kitted up like anonymous cybermen.  He was sat up on the trolley, but I had to hold onto him on the bends for fear of him falling off, he was so frail.

When we got to the hospital we waited in a queue.  It was like a scene from the Handmaid’s tale.  Men with walkie talkies in charge of our liberty.  And then came the news that I wasn’t allowed in.

I haven’t seen him since and that was Friday and it’s Monday now.  The only news we’ve had was yesterday on the 100th call we made someone answered and clumsily told us that dad had Coronavirus and is on oxygen.

We wept for him and for what it means for us.

The hardest part is thinking of him on his own.

So, we visualise him comfortable and warm and getting the help that he needs.  That’s all we have.

I find myself waiting to hear of my father’s lonely death.  I am worried my step- mother will also fall ill, or me.  I can’t say I’m not afraid.

I am confined to this small flat, sleeping on the sofa without my things, without my food and without my children and family.  And I can’t go home.

I am on my knees.

I could say that this is a living nightmare and it is, but that wouldn’t be the whole picture.

In between the grief and worry I have got to know my step mum better…like really better. We’ve laughed a lot and I’ve had the opportunity to wait on her for a change.  Her having looked after my dad these last few years and her mum before that.  I’ve discovered Wanstead flats where the blossom’s out.  I’ve made two new friends, downstairs-virtually- who have offered to get us things and an amazing ex-military male nurse who has fully taken this on, organising rotas etc.

What I thought I needed to get through this was to close my front door and baton down the hatches and hope for the best.

I thought I just needed it to all be over, quickly, so I could have my friends round and get drunk again.  I thought I needed a three week holiday on a tropical island to get close to my family – It would still be nice, but this has made us closer, if not physically.  Even my 15-year-old has been texting me and he rang me to ask about his pocket money –  I think he’s grieving his old life!

My friends and family have been fantastic.  Really empathetic and sympathetic and there for me.

But through all of this these are the things that I want and from people and systems:

  • For someone to hear me say I’m not ok
  • For someone to believe me when I say I am ok
  • Information
  • For people to send me funny stories/videos
  • To hear about other people’s stories
  • For people not to feel so sorry for me they can’t tell me about them
  • To ask me what I need
  • To be real
  • Dark humour, especially about death
  • Those texts which say you are amazing/ you are strong/ you can do it
  • For people not to transfer their own grief onto me
  • Expertise and connection from professionals
  • Practical help
  • Not having to keep repeating my story
  • Exercise
  • Nature
  • Activity
  • Counting my blessings
  • Acknowledging that there are people worse off around the globe e.g. In Syria
  • For people to not need “updating,” if I don’t want to
  • If I break down, to not think that’s the only way I am
  • For me to help others too
  • Netflix
  • Love
  • Music

Yesterday I felt shite.  Really shite.

Today my new London neighbour has bought me an avocado (I know, poncy under the circumstances but this reminds me of my old life).

For now I have chosen to reframe my situation.  I am on a reading and writing retreat and a holiday from the daily load of washing my family produces.  My dad has gone away to the best place possible for the best treatment in the world to give him the best possible chance.

Reflecting on what I need during this time has reinforced how important it is for us, as individuals and organisations working alongside people experiencing tough times, to be person-led, to listen, to be real and do our best to provide the support that a person needs, rather than the support the system predicts is needed.

(Ring any bells PTS?)

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The Impact of COVID-19 – The New Normal

Sarah Tully, PTS Manager at Innovation Partner Cherrytree Support Services, looks at the impact of COVID-19, broken systems and the new restrictions on how we live our lives – but is this ‘new’ for everyone?

We’re all struggling with the impact of COVID-19, but don’t underestimate the people we are working with..

My dream holiday’s cancelled, my friend’s son’s new wife from USA can’t get a visa, the family down the road have got the virus – everyone has a personal story, everyone had a few facts to fling about in the last halcyon minutes of face to face communication.

Everyone feels vulnerable, everyone is vulnerable, this virus transcends class, race, borders, reason even. Every slight cough leaves everyone on tenterhooks including the cougher- have they got it? have I got it?

And yes, sure there are some people more vulnerable than others. The elderly and people with underlying health issues are two obvious categories. People living on their own are at the mercy of neighbours, friends and family if they get ill.

Never has the concept of home been so pertinent with the latest direction coming from Central Government to “stay at home,” and for people experiencing homelessness or people going through tough times this has huge implications. If they are on the street or in a hostel, they are compromised by the probability of not being able to self- isolate. There are a whole list of potential inequalities and disadvantages.

And for this reason, we have made adjustments to Cherrytree Personal Transitions Service (PTS). The PTS Coaches have made themselves more available by telephone and video link. They have tried to check in with everyone we’ve ever worked with. We have decided that if one of the young people gets ill and needs supplies in the name of support and prevention, we will deliver a bag of shopping compliments of CherrytreePTS.

But make no mistake it is not the people we work with who are panicking. They are not making bizarre knee-jerk decisions or fretting about their lives going to hell in a hand cart because systems are not working for them. They have a huge long resume of systems not working for them. So, they can only go shopping once a week- what’s new? On sanctions you can go weeks with no money to go to the supermarket.

Whilst we lament our pub gatherings with friends, our career saving childcare, our favourite artisan bread or latte made with oat milk, the people we work with are getting on with it in a way they have always had to.

So, a Coach had a call from someone she worked with. She has two small children and one on the way. She chatted and mentioned that she had no nappies. No nappies! Exclaimed the Coach immediately donning her cape and going into rescue mode in a way that is understandable, kind and familiar to us all in the “caring” sector. Within a day the young women had used her resources and connections to source four packs of nappies herself. These people are survivors. They are used to living in a social state of inequality and deprivation.

Another coach reported a sense of resigned calm from the people she works with. There is something vaguely satisfying that this shit is happening to everyone, equally!

So, I am not saying the people we work with are not vulnerable, but it is still necessary, vital even that you don’t diminish their power by going into unnecessary rescue mode. We can learn from people who have or are going through tough times about resilience, resourcefulness and patience – because let’s face it they are the experts.

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The Illusion of Choice. Person-led or just a Buzzword?

Andy Durman, PTS Coach at Mayday, reflects on what it means to be ‘person-led’ in the current system available to people experiencing homelessness.

How often do we hear that services are person-led and that if things haven’t gone to plan (the services plan that is), it was due to an individual’s poor decisions? Yet when we speak to people who have experienced these ‘person-led’ services the story sounds very different and the impact/damage of such experiences is sadly, very evident.

When you look a little closer and having worked within the system and listened to many people experiencing it, it’s easy to see how you can create the illusion of being person-led. Many organisations honestly believe that the people they work with have full control and power over their lives and direction – this might be the case, as long as someone moves through the right pathway, making the right decisions that is. If things don’t work out organisations can seek reassurance that it was the individual’s choice ‘not to engage’, rather than reflecting on the impact of the system or even their own role on that particular outcome.

The system currently dictates a person’s story, their choices and the direction that’s right for them. For example:

You find a place in a hostel, you are told you can stay here for six months. On your referral it states you have risks around alcohol intake and debt, so you will be signposted to a substance misuse service and must attend an in house budgeting course.

Once you are ready (in six months, after you have proven you are ‘tenancy ready’) you will be recommended to the local authority who will look to get you into a property. It is unlikely that you will have any control over where you are accommodated and largely felt that you should be grateful for whatever you get.

Unfortunately it’s very possible that this property will feel sterile and due to its new location away from everything you know and your networks you will also feel isolated.

However it is still your choice whether you would like to engage/do/agree with this plan that has been created for you. If you do choose to successfully ‘move on’ and understandably  you find it hard to adjust and make it work, you will have made yourself ‘intentionally homeless’ and forfeit any support in housing from the local authority. You chose to fail and the system has done everything it could to support you.

I struggle to see any person-led approach within this. I fail to see where the person and what they feel they need from the system comes through. This system will never work. That individual will re-enter the ‘cycle of homelessness’ of which so many organisations claim to break.

If you find yourself back at a hostel (probably the same one) you will be vigorously interviewed, asking what happened, why did it not work, what did you do that made it fail? And so it starts all over again, only this time probably with some additional arrears from your former sterile and isolated ‘home’ that you chose to leave. Each time you re-enter the system, more of your dignity, humanity, character, personality, talents and skills get stripped away. 10 years down the line and you are an entrenched, hard to reach, complex homeless person.

What I will say is that by some miracle this does not happen to everyone and this is 100% down to those individuals own unimaginable resilience, strength and courage and those professionals within the system who are mavericks, who see individuals as people, who focus individual context and strengths, who recognise the barriers the system creates and who walk alongside people going through tough times without an agenda.

We need to change the narrative of the system so that the individual has the freedom to write their own story. To be the author of their own lives. Then we can say we are truly person-led.

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Relational Leadership in the Real World

Personal Transitions Service (PTS) Manager, Katie-Lee Moroney, reflects on what it takes to be a good manager, the role and the importance of relationships over power imbalances.

When I first got the call saying I had got the job with Mayday Trust in 2013, I remember saying to a colleague ‘I can’t believe I am going to be a Manager!’ I was so pleased that Mayday had taken the time to recognise my skills and could hopefully see that I had the potential to be a good leader. I also remember spending a significant amount of time thinking about what sort of ‘Manager’ I would be. Wondering how people would know to trust me? Questioning if I had enough knowledge to share? Worrying how people might feel about me being a bit younger?

I looked back on the different management techniques I had experienced, such as the ‘the micro-manager’, ‘the Manager who doesn’t really know you at all’ and not forgetting ‘the Manager who uses power to control’. It occurred to me that I saw these as times as being ‘managed’, rather than being led or inspired to do well in my role – this is similar to John Maxwell’s* idea of leadership through position, which doesn’t really get you anywhere! The positive experiences of leadership prior to Mayday were unfortunately in the minority, but when they did occur they stood out and positively contributed to me forming my own leadership style rather than focusing on being a ‘Manager’.

Now six years into to my role at Mayday I am very much still learning and developing but have come to realise the fundamental importance of relational leadership. My role has changed rapidly in this time and alongside this my values and beliefs in what makes a good leader have also grown. Since starting as a PTS Manager I have been lucky enough to work with some amazing leaders and they have all contributed to how I work today and how I work with my team. My style has become more representative of building strong relationships and also leading based on results and buy in.

Here are some of the things I have learned (it’s not always been the easy way!):

Know what you know and be comfortable with what you don’t – I came to Mayday Trust with transferable skills from the education sector, but I had no first-hand experience working with people experiencing homelessness. Mayday’s Personal Transitions Service prioritises working without labels and treating people as people, and luckily for me these were the same values I had bought into in previous roles. I also work with a brilliant team who have a wealth of experience working with people and help me each day to understand what this is like.

I look forward to 1-2-1’s each month as the Coaches stories, successes and challenges bring the PTS to life for me. I am comfortable with not having first-hand experience as it has made me a better listener. What I do know is that my strengths lie in project management and bringing a team together. I am a good details person and a brilliant planner, which means I am able to balance the different contracts we hold to allow the Coaches to do what they do best and that’s putting the people they work with first.

Be transparent, but also know when to act as a buffer – As a leader in an ever changing organisation I can be privy to lots of information, it’s important I know what to share and what not to share. Transparency is important, but knowing what’s best for team morale is equally as important. The PTS focuses on Coaches building trusting relationships with the people they work with and similarly in my role I need to build these relationships with the Coaches in my team. The Coaches need to trust that I will share what they need to know at the right time; allowing their entire focus to be on the person and not external pressures.

Recognition – Recognise all the extra effort your team invests in ensuring that the people they work with have a positive experience with the PTS. Recognise that flexible working shouldn’t mean working more hours than usual and having your phone on 24/7. In the difficult financial landscape we are in it is difficult to provide progression, however by recognising someone’s assets and talents and utilising them when opportunities present themselves can be a way to help a Coach feel further valued.

Nobody likes a last minute panicker! – The PTS is always changing and evolving, it hardly ever stays still at Mayday! This requires an extraordinary amount of organisation to ensure that planning, monitoring, projects, development and team sessions all take place when they should.  It’s essential I have my eye on the ball (more like balls at the moment!), the future and the unknown!

Sharing the learning – When working across a large geographical area I have discovered that it is really important that both success and challenges are recognised and shared to allow other teams, who potentially don’t directly deliver the PTS, to experience and understand things from the Coaches point of view. This could be through good news stories, shared team meetings, reflective practice and other more informal channels. It is also just as important that it goes the other way as well. Growing the PTS, working with other organisations and overcoming barriers beyond delivery are all areas that can help a Coach see the bigger picture, recognise the important part they are playing in creating that paradigm shift in the systems available to people going through tough times. Unlike many of the roles I have been in previously, the PTS is one big team – #OneTeam if we’re talking Twitter!

Strong relationships run throughout everything I have mentioned. Without trusting relationships and a like-minded team with you, it is very difficult to be a good leader. Alongside these relationships it’s crucial that I know when to let the talents of a team shine and when to refocus my attention. Due to the changeable nature of the Mayday I have no doubt that the role I have today will probably look very different in 12 months or even next week. Whatever happens I will continue to learn, develop and evolve. I have so much more to learn and I hope my experiences will continue to shape me and my leadership style. Just like the people we work with, I have the potential to do and become whatever I want!

* Maxwell, J.C., 2011, The Five Levels of Leadership – Proven steps to Maximize your Potential, New York: Centre Street

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