Introduction

This chapter offers two examples from practice. The first example, from Carmarthenshire, describes the community orientation of a substance misuse team in addressing issues arising from alcohol- related brain damage (ARBD). This has used imaginative approaches and community resources to transcend clinical and referral boundaries and provide a service that can demonstrate positive outcomes. The narrative includes the words of an individual service user who tells his own story of the benefits of such approaches.

The second example looks at the practice of a statutory adult team (known as a wellbeing team) in Torfaen. Here, they changed their approach to adult care a number of years ago, replacing a centralised service, use of eligibility criteria and standard assessment- based methods, with a neighbourhood- based service approach. The result has been an eradication of waiting lists, an increase in satisfaction reported by staff, users and carers and a reduction of commissioned services in favour of individualised preventative upstream solutions based on extensive knowledge of the community and networking.

Example 1: The Carmarthenshire Substance Misuse Team

Gary James is the team manager of the small Carmarthenshire Substance Misuse Team, with just five social workers covering the whole county from a base in Llanelli. With a background in design but a 20- year career in social work, he has always, he says, sought to find ways to be creative in his practice. The team he leads have been innovative and creative, to the extent that the story of their work with sufferers of alcohol- related brain damage (ARBD) provides a useful illustration, not of CSW, which is not their purpose or design, but of community orientation by a team committed to finding ways to be more effective than traditional prescribed routes seem to permit. Gary is described by one of his workers, Rebecca Phillips, ‘Becs’ as she is known, as someone “not interested in stats and things like that and always getting [into] rows for breaking rules”. However, without Gary's drive and vision and permission for staff to find new and different solutions to issues, it is unlikely that the ARBD project would have happened.