Thursday 22 February 2018

The Wrong Kind of Help?

No doubt connected to schools and half term breaks, there seems to be a bit of a lull in activity at the moment, so I've been looking back at stuff there wasn't time to mention over the last few weeks. First off this comment piece from the Guardian's Public Leaders Network of 7th February would seem highly relevant:- 
Too many public services provide the wrong kind of help

Public professionals can do more harm than good if they fail to motivate vulnerable people to change

Ryan had been on and off the streets for 12 years. He was dealing with addiction after being in prison and felt misunderstood by the people who were meant to help him. It wasn’t until he met Aisha from the Mayday Trust that his life started to change. She was, he says, the first person in a long time who stopped, listened and didn’t judge.

Some help, like that Aisha gave Ryan, supports people to feel hopeful, purposeful and take action confidently. This kind of support is core to the work of many community and voluntary organisations, which understand that good help, at the right time, can transform lives. In contrast, the wrong kind of help can too often undermine people’s confidence, sense of purpose and independence.

Sadly, mainstream public services often inhibit this kind of help. To deliver it, staff need to be supported and have the right balance between autonomy and accountability; they need to be able to put service users first; they need technology to make it easier to share data; and they need to feel part of something bigger – that individual and collective action are inextricably linked. This partly explains why many professionals, including nurses, social workers and teachers, are so frustrated. They have been trained in good help but aren’t able to provide it in today’s cash-strapped, target-driven, restrictive work environments, with ever-increasing workloads.

A new report from innovation foundation Nesta, and social impact lab Osca, where I’m director, has investigated the differences between good and bad help. Researchers found that many of the public services designed to help people actually undermined their ability to take action. This can exacerbate acute and obvious issues, such as homelessness or addiction, but also have chronic and more subtle effects, which erode confidence and mental health.

The probation service, for example, is failing to help people lead more positive lives and stop reoffending, with concerns recently raised about, ex-offenders being supervised by phone rather than at face-to-face meetings. Work coaches at Jobcentre Plus have been criticised for undermining claimant trust and confidence, punishing unemployed people rather than helping them find jobs. They, in turn, point to a stretched system where there is no time to provide good help.

Under the cash-strapped conditions in which many public services operate, integrating good help may seem impossible. But it can actually lead to substantial savings, not least by alleviating pressure on other services. The report highlights several projects that have succeeded, for instance, in reducing A&E attendances, avoiding the need for expensive healthcare, and reducing the number of arrests and frequency of imprisonment. 

Groundswell, which supports homeless people to deliver their own solutions to homelessness, reported a 68% reduction in missed outpatient appointments after establishing a peer health advocacy programme. Homeless people were connected with someone to help them address their health needs through new structures and habits, and who attended GP and hospital appointments with them. The scheme also led to a 42% reduction in unplanned care activity, and saved public services £2.43 for every £1 spent on the project. Other charitable organisations, including the Liverpool Waves of Hope project, AgeUK, the Mayday Trust and Community Catalysts, have reported similar savings.

Despite the difficulties, many public service professionals are applying good help methods, including GPs like Doug Hing, whose patients reported greater satisfaction after he started asking them what they wanted to get out of their consultation, and recommending actions they could take in their own time.

Other examples of good help include Brightside, which provides online mentoring to disadvantaged youths, pairing them with volunteer professionals in an industry that interests them. There’s the peer support network Club Soda, which supports people who’ve decided to make changes to their drinking; and Grapevine, which supports young people with learning disabilities to break free from service dependency and realise their full potential.

What all of these organisations and professionals have in common is their ability to use a flexible, rational approach to connect people with their own motivations for change. Our research highlights seven characteristics of good help, including the ability to recognise individuals’ own influence; encouraging people to feel safe and ready to act for themselves; and helping people define their own purpose. It also means stepping back as their confidence improves. Supporting people to develop peer support; cutting through barriers that prevent change; and sharing information between people and practitioners are also important.

The simple truth is we cannot afford to keep providing bad help. The social and financial costs of doing so are huge.

Richard Wilson is the director of Osca. Some names have been changed.

--oo00oo--

From the Executive Summary:-

How do you provide ‘good help’? 

We highlight seven characteristics of ‘good help’ that can be built into public services and social programmes:

1. Power sharing 
The relationships between professionals and people should allow power to be shared rather than ‘directing’ people to do things. An adult-to-adult relationship needs to be established, in which each person’s knowledge and ideas are considered equally. 

2.Enabling conversations 
The way that conversations are structured and that questions are asked can help people to think through what’s important to them and to come up with their own solutions. These conversations build a sense of safety, trust, ownership and motivation for action. 

3.Tailoring 
For help to be transformational, it needs to be personalised. This can be achieved by helping people to define their own purpose and goals. This might sound obvious, but many programmes offer a standardised approach that can feel impersonal and mechanistic. 

4.Scaffolding 
Practitioners can start to step back as the people they help build enough confidence to take action alone. This ensures that change is sustained. Help may need to be ongoing for some people, but should create opportunities for people to take action themselves where possible. 

5.Role modelling and peer support 
Positive relationships expand our sense of what is possible and help us do things we wouldn’t attempt alone. Often the most powerful relationships are with people we consider similar to ourselves. 

6.Opportunity making 
Sometimes opportunities need to be created or barriers need to be removed to help people take action. This may require help from an external source. Examples include brokering relationships which lead to new voluntary or paid work, or other health creating or educational activities. 

7. Transparency 
Professionals (and their organisations) often have access to information about people that is not routinely shared with people themselves. Having open and shared data is an important part of building an adult-adult relationship and supporting people to make informed decisions.

47 comments:

  1. TR has ensured that the only power rests with those who decide whether to pay (or not) for services. Everyone & everything else just follows the money.

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  2. Sercos shitbag soames giving large on contracts kpis and still buying up carrillion contracts on the very cheap.there is no level the scum won't stoop. BBC news.

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    1. From Daily Telegraph:-

      Serco has shaved almost £20m off the price of 15 healthcare contracts it is taking over from failed contractor Carillion after revising the sale agreement in the wake of the company’s collapse.

      The contracts, which are spread across 50 NHS sites, will now be transferred to Serco for £29.7m, having been worth £47.7m in December when the deal was first signed.

      Serco said on Wednesday that it had signed a new purchase agreement with the special managers overseeing Carillion’s liquidation, with the lower price reflecting the fact that Serco now thinks the contracts will require “additional working capital investment”.

      As a result of Carillion's liquidation, Serco said it was forced to re-evaluate "potential liabilities, indemnities, warranties" associated with the contracts, making them less valuable.

      Just under 1,500 employees work on the contracts being acquired under the deal.

      Serco’s existing health operations already generate revenue of more than £350m, employ over 8,000 people, and provide services to organisations such as St Barts, England’s largest NHS Trust, and the Prince of Wales Hospital in Hong Kong.

      In December, Serco’s chief executive Rupert Soames said the contracts should add £90m of revenue and £8m of profits to the business in the coming years, as well as significant potential for future income.

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    2. Oi, watch out, my son, you'll have Gary Oldman to deal with if you keep on with that tone. Soamesy is Churchill's grandson. He's almost royalty.

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  3. Oh it's just such a joy to read all this, a relief. It still exists then, this way of working. It wasn't just a dream.

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  4. Great blog articles Jim. Thanks for sharing these!

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    1. I too think it's a great blog today, and an extremely important one.
      I'm of the opinion that there isn't much else out there then the wrong kind of help. It's because help has become a formula, it's not individually tailored, it's a corporate model, designed to achieve targets and outcomes more then suit the recipient of the help being offered.
      I find it very disturbing that most help extended by any organisation carries the possibility of sanction or punishment if the individual fails to respond to that help.
      In probation it may mean recall. At the job centre it may mean sanction and benefit loss. If you don't respond to the mental health remedy on offer you're often just signed off and left to get on with it.
      Failure to respond to the help on offer makes you difficult, unwilling to accept that help even, or just a nuisance.
      Everythings quantative, designed to reach the minimum standard which has become the target where you can sign off, claim an outcome, and get paid. The quality of the help on offer is sadly missing, but public services have become the Aldi of private enterprise, if you want quality you go to Harrods and pay for it.
      Even the charity sector are at fault here, they've become businesses and operate under corporate models of delivery, and if that model doesn't suit the people you target, hayho, as long as there's outcomes we still get paid.
      There's many good people in our society that want to help others, but they're hamstringed by corporate sentiment and compition.
      Don't give the homeless money, give it to us, we can put it to better use, (or at least the 5p that's left from every £ after processing and admin costs).
      If you're giving the homeless something to eat that you've cooked at home then remember about allergies you may find yourself in bother if someone becomes ill.
      Real help is qualitive, and quantative corporate models are just looking through the wrong end of the telescope.

      'Getafix

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    2. http://www.edp24.co.uk/news/health/virgin-care-mental-health-1-5404233

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  5. “Speaking on ‘John Worboys: The Taxi Cab Rapist with Susanna Reid’, the Executive Director of the National Probation Service Sonia Crozier also offered the first on air apology to Worboys victims for the way they discovered he was being released.”

    https://www.mirror.co.uk/news/uk-news/head-parole-board-says-believes-12064767

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    1. The chief executive of the parole board for England and Wales has admitted it is “not sustainable” to continue to release prisoners without giving the public detailed reasoning in light of the John Worboys case.

      In his first interview on the subject, Martin Jones insisted “hundred of pages of evidence” were used when making the decision to release black cab rapist Worboys, but also admitted you could never be 100 percent certain someone wouldn’t reoffend.

      The parole board says he is now fit to be released, less than 10 years after he was convicted for drugging and sexually assaulting 12 of his victims.

      Asked what he could say about Worboys being released, Mr Jones told a new ITV documentary: “We look at hundreds of pages of evidence about the original offence the person was convicted of.

      "We will look at reports in relation to their behaviour in prison. What is their psychological assessment of that prisoner? And the people on the parole board are appointed by ministers to have the right expertise to make this judgment cause these are really vital decisions.

      “There are many hearings where you see prisoners and we have a set of detailed reasons explaining our reasoning, but we are prevented by law from telling people those reasons. I don’t think that’s sustainable, in particular for victims. I think that needs to change so that we can explain why we make the decisions that we do. The Parole Board has considered his case and now we’ve decided he no longer represents a risk to the public. Most of the time we get it right. 99.5% of the time people do not commit further offences after being released by the parole board. But of course you can never be sure.”

      Speaking on ‘John Worboys: The Taxi Cab Rapist with Susanna Reid’, the Executive Director of the National Probation Service Sonia Crozier also offered the first on air apology to Worboys victims for the way they discovered he was being released.

      Many of his victims heard via the media and were not warned or informed in advance of his imminent release.

      Sonia said: “I’m sorry those women, erm, some of those women heard of the news in a way I wouldn’t have chosen them to hear it. I think we have a victim liaison scheme that needs modernisation to work effectively.”

      Pushed again to apologise she added: “I believe it’s with absolute regret and I am sorry that some of them weren’t able to engage with this and we’ve got to fix the scheme and make it better.”

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    2. Thanks Sonia for apologising on our behalf - NOT!!

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    3. An apology implies blame. That poor VLO. An innocent pawn.

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    4. And a missed opportunity to present everything probation did right!

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    5. That the voluntary sector can offer forms of help and work in ways that statutory services cannot, is axiomatic and it also shows why it's misleading to compare the two services. When things go wrong, it's not the voluntary services that gets it in the neck. The remit of the statutory is broader and deeper as it has to balance needs and risks, it has to manage boundaries and various accountabilities. Take transparency as an example: having open adult-adult relationships and sharing data would in some situations be naïve and potentially dangerous.

      I don't know where the head of the parole board gets his reoffending figures from when he says 99.5% of those released don't reoffend.

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    6. I've just happened upon this article;

      https://www.aol.co.uk/news/2018/02/21/hospitals-jails-and-jobcentres-will-have-to-refer-those-at-risk/

      Any help with homelessness must be welcomed, but I'm wondering if it's locating the problem all in one place?
      Will simply referring someone for example by a CRC absolve them of any other obligations with regard to housing?
      Will a referral where accommodation is achieved be calculated as a payable outcome even though its really just a referral?

      'Getafix

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    7. This is the type of method CRC’s use;

      Soft targets (small payment):
      TTG plan
      Programme referral
      Programme start
      Housing referral
      Employment referral
      Education/vocation referral

      Medium target (medium payment):
      CV completed
      Basic numeracy and literacy assessed
      Housing advice provided
      Employment and disclosure advice provided

      Hard target (larger payment):
      Programme completion
      Housing gained
      Employment gained
      Qualification gained, eg health and safety, or basic numeracy and literacy.

      Eg, offender referred for housing, education and employment. Targets met, payment received, even if never turned up. Or referred but found to not require services, payment triggered. Or get home and job himself, payment triggered. Or turns up to referrals triggering further medium payment, and completed triggering further payment. Win win for CRC’s and TTG services.

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    8. Reading between the lines you’ll see it’s lucrative to refer every offender to housing and employment services. Whether they need or receive housing and employment does not really matter as the pay target is already triggered.

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    9. This is what Through The Gate TTG basically does.

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    10. Prisons and NHS Trusts are among the public sector organisations that will soon have a legal duty to refer people at risk of becoming homeless to a housing authority.

      Heather Wheeler, the Minister for Homelessness, announced on Thursday that, for the first time, several public bodies will be required to assist the Government's efforts in reducing the number of people sleeping rough by intervening early.

      The legally binding obligation will also extend to probation services and Jobcentres.

      The new guidelines come ahead of the Homelessness Reduction Act, expected to be passed into law this April, which places legal duties on English councils to prevent homelessness.

      They will be required to ensure the advice and information provided is tailored to specific at-risk groups, including care leavers, people leaving prison, ex-members of the armed forces and survivors of domestic abuse.

      Heather Wheeler said: "Everyone should have a home to call their own and we have put in place strong protections to guard families and individuals against the threat of homelessness.

      "Our reforms - putting prevention at the heart of everything we do - are designed for lasting change and to back this up we're investing almost £1 billion over the next four years to break the homelessness cycle once and for all."


      The Government has pledged £72.7 million of funding to help councils deliver these changes when they come into force this April.

      The increased preventative work brought about by the Homelessness Reduction Act is expected to result in substantial savings for councils in the long term.

      Certain measures within the Act - such as personalised housing plans and bespoke prevention services - have already been trialled on Southwark Council in central London, who receive the third largest number of homelessness applications in England.

      As a result, Southwark has eliminated its use of Bed and Breakfast accommodation for homeless families.

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    11. In reality;

      The NPS will provide a leaflet with details of benefit entitlement, local night shelters, private landlords and hostels, and refer to local authorities housing.

      The CRC’s will do the same and get a payment for doing so.

      It’s what we already do. Lots of advice but nobody extra actually gets housed.

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  6. Let me share my experience of a CRC with you

    1. Power sharing
    None, just dictated (patronsised)to with zero input into inappropriate crap

    2.Enabling conversations
    No real conversation of any meaningfulness at all

    3.Tailoring
    personalised? are you having a laugh. they couldnt give a shit what my goals are or even if I had any NEXT

    4.Scaffolding
    Yes i did gain confidence. confidence to build a huge wall to protect myself from these dangerous jokers and parasites

    5.Role modelling and peer support
    nothing is possible

    6.Opportunity making
    they are there specifically to put barriers in your way. sometimes goading you to cock up or make a mistake so they can pounce

    7. Transparency
    yes they sure will and do piss your private data everywhere. not before they have littered your file with mistakes and cock ups. with zero respect for data protection, breaking rules whenever they feel like it.

    yeah some good guidance i would say, Its a shame your average CRC PO would look at that and then wipe their ass with it

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    1. Your experience sounds bad, but you might find you get further if you stopped generalising and making comments about "your average PO". Otherwise you just come off as someone with a gripe, probably because they've been told something they don't like, who's come to post here for a little giggle but who actually just gets ignored.

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    2. Most people on probation will have gone through numerous PO's both in and out of prison and so will have a pretty good idea about the quality of the average PO. And unfortunately most people's experience of those working in probation these days is far from positive with the best of them being uninspiring and the worst who should probably be locked up themselves. People will have been able to draw their own conclusions about the standard of PO's from their interactions with those numerous PO's. Therefore to claim that anyone who has been a "client" of probation is "generalising" about PO's when they comment is both ridiculous and patronising in the extreme. We comment based on our personal experience and if your personal experience plus that of numerous others we know also on probation is all basically the same, that's not generalising but being accurate about what we have experienced. You may not like what we have to say but you certainly have no right to dismiss people's genuine experiences of probation.

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    3. Thousands of people work in probation. Hundreds of thousands of people are on probation at any one time. No matter how many "numerous others" you've spoken to, it's still only a tiny percentage of the whole. So to extrapolate this into making claims about "your average PO" or "99% of POs" are gross overstatements - and only based on opinion, not fact.

      I'm not dismissing your experience. I (probably, given the odds) don't know you, so I have no reason to do so. I'm merely pointing out that making rude, deliberately inflammatory comments here is unlikely to get you taken seriously. If it helps you feel better, then go ahead, knock yourself out. But don't expect me to not call you out on your trolling of this blog.

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    4. As a probation officer I think I’m well placed to say many probation officers are not very good. Reasons can very from poor character, discriminatory views, not suited to the job, poor training and support, bad line-management, stress, toxic work cultures and practices, and lack of resources. This is no secret, it is not new, and many offenders are right to take this view. One of the signs of a not very good probation officer is one that refuses to acknowledge the experiences and concerns of those under supervision, just as were seeing here.

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    5. Sigh. Go through my posts at 16:03 and 17:51 and tell me exactly where I've "refused to acknowledge the experiences and concerns of those under supervision". I'll wait.

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    6. Annon@1727

      Most people?
      You continually cry about people making assumptions, but "most people" who are you talking about?
      You speak for no one but yourself.
      I speak for me. And I think you have issues with yourself that you put on other people.
      Advance the world, say something constructive, or please just shut up.
      I'm an ex con.
      I'll listen if you've got something to say, but spare you're own dignity, stop crying.

      'Getafix

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    7. Probation Officer22 February 2018 at 19:09

      If that is their view about "your average PO", then that is their view. Id agree about the “average PO”, the good ones old and new are in the minority. There was a time the “average PO” was very good but I do not believe this is the case any longer. To the frustrated client, vent your concerns, get it out, but it will not amount to anything accept wasting time that you could spend doing something else, reading a book even.

      “Let it go, let it go
      Can't hold it back anymore
      Let it go, let it go
      Turn away and slam the door
      I don't care what they're going to say
      Let the storm rage on
      The cold never bothered me anyway”

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    8. Well I think the 'average CRC PO' is pretty crap and yes it can be for a number of reasons. To much pressure and a toxic culture seems to be pretty much the deal. I think actually some of the CRC POs (not all of course) wouldn't have the life skills to be able to appreciate what the 1-7 actually mean or the interpersonal skills to deliver them. Some would but then with zero support structures and zero on offer how can they back it up anyway? and btw 16:03, being judgemental and being a good judge are different things. He/She didn't get ignored did they? so your little playground tantrum had the opposite effect

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    9. “I think actually some of the CRC POs (not all of course) wouldn't have the life skills to be able to appreciate what the 1-7 actually mean or the interpersonal skills to deliver them.“

      Most PO’s nowadays are females under 25 with life skills totalling of completing a Criminology degree at university. Stop expecting so much and move on. Probation is a failed experiment.
      http://www.independent.co.uk/news/uk/crime/probation-privatisation-failure-transforming-rehabilitation-enforcement-poor-crcs-monitoring-nps-a8201536.html

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    10. Speaking as a late-30s male PO, I could do with a little less misogyny around here.

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    11. @20:34 Empty vessels make the most noise. S/he didn't get ignored, but I doubt their views have been taken very seriously by anyone, or got them anywhere.

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    12. Anonymous23 February 2018 at 08:17

      ''@20:34 Empty vessels make the most noise. S/he didn't get ignored, but I doubt their views have been taken very seriously by anyone, or got them anywhere.''

      Oh dear oh dear, talk about butt hurt loser. Seems to me a debate got going and you got upset others agreed with him/her. You attitude problem speaks volumes and shows your complete lack of understanding for whats required for the job. Your redundancy is there for all to see and will sure as eggs be in the post alot sooner than you thunk

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    13. Resorting to an ad hominem attack is, frankly, pathetic.

      Delete
  7. There are three universal lies:
    1. The bank are processing the payment and it will be with you soon.
    2. Of course I'll still love you in the morning.
    3. I'm from HR and I'm here to help you.
    And therein sits a suggestion, what happens if you replace HR with Probation Officer. Harsh I know but begs a question or two at least. (Contrasted with knowledge that many many pass through your offices relatively unscathed and indeed helped :))

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    1. Probation Officer22 February 2018 at 20:33

      Anon 20:11 You’ve hit the nail on the head.

      “I'm a Probation Officer and I'm here to help you”.

      This statement was once true, but has long been replaced with;

      “I'm an Offender Manager and I'm here to enforce your compliance and manage your risk”.

      This statement is true and those that state it with pride (the majority nowadays) are not individuals I’d want to be ‘supervised’ by. Still, many indeed pass through our offices relatively unscathed and helped (contrasted with knowledge that many are not helped, breached, recalled, and are blocked at release stage).

      “The line it is drawn
      The curse it is cast
      The slow one now
      Will later be fast
      As the present now
      Will later be past
      The order is
      Rapidly fadin'.
      And the first one now
      Will later be last
      For the times they are a-changin'.”

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    2. "Don't follow leaders"
      The best work has been generated ground-up, the worst driven relentlessly by the vain and ambitious

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  8. Wryly amused that Probation Staff are, by and large, unified in chanting "this is shit" at the architects of TR, and then unified in their own defence when any of their clients whispers "this is shit"
    That aside, it is extraordinary how positive and animated the debate is as soon as the topic becomes how to do The Work well, rather than how appalling the current state of Probation is. Seems there is a groundswell of progressive, intelligent, values-based, evidence-based agreement on the part of academics, practitioners, community organisations, clients, oh just about everybody bar the Big Private Sector "providers" and their sponsors. If you chucked out the HMPPS top brass and the CRC owners, and put everyone in a room, they would have this fixed in a nano-second. Probation, CRC and NPS are SO in the wrong hands.

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    1. From what I’m reading there’s probation staff here agreeing with the clients “this is shit”.

      The problem is not the HMPPS top brass, it’s the NPS and CRC Probation directors and managers that dance to its tune without question, and while doing so bully and coerce probation staff to comply.

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    2. Managers in the CRCs bully staff with threats of discipline all the time we are a broken organisation.

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    3. I'm happy to agree with the clients who whisper "this is shit". My objection is against those who make it a personal attack all probation staff (ok, 99%, how reasonable of them) based on their own experiences. I also object to the way they loudly protest that their views are being dismissed, when actually if they took a slightly different approach they might actually get somewhere.

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    4. ''if they took a slightly different approach they might actually get somewhere''
      Oh yeah, whos listening exactly?
      where is the feedback process that guarantees change? no I didnt think so.
      Oh so YOU'RE the arbiter of change are you?
      The guy who gets jeoulous in a nanosecond becasue someone with a right to free speech speaks up.

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    5. How far has denigrating an entire profession based on narrow, personal experience got you? Not very far, I'd guess, if you get your kicks trolling the On Probation blog. Use your free speech by all means, but don't expect me not to use mine to call out arrant bullshit.

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  9. From what I’m reading there’s probation staff here agreeing with the clients “this is shit”.

    The problem is not the HMPPS top brass, it’s the NPS and CRC Probation directors and managers that dance to its tune without question, and while doing so bully and coerce probation staff to comply.

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    1. No wonder the staff bully the clients. #learnedbehaviour

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  10. Probation was corrupted as soon as it was placed in the grubby hands of politicians, then passed across to the command & control crew at NOMS,now HMPPS. The learned behaviour has been accumulating over the last 20+ years. Its been interesting to see how quickly the sharks sensed the blood of a wounded organisation & rapidly moved in, sadistically toying with it & s l o w l y tearing out its heart. Spurr & co in particular have enjoyed the sport of the last 7 years or so, with green lights on all fronts offered by the mendacious Tories. Now the 'sexy' so-called high risk work of the NPS is firmly in their grasp, while the 'tedious' bread-&-butter work has been farmed out. No sense of respect for staff or those subject to court orders, no sense of breadth or depth, just a perverse desire for power & control - & personal advancement. None of the arrogant selfish fuckers would ever consider that being a PO or PSO was a valid lifetime career choice... they'd always be the first to look for the next opportunity to scramble & cut someone's throat for their own advantage. So, agreed, 23:05: learned behaviour.

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  11. hmm, this is became a problem because peoples view are different

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