At the top of the hill

I have posted in the past about the feeling of running a small entrepreneurial venture, and how it can feel like pushing a giant boulder up a hill without much help, and how every time I think I’ve reached the summit a new peak appears. Well, for the first time, it feels like that feeling has changed. Suddenly it feels like I’m at the top of the hill, and I have a team of people to help me think about how to make the boulder roll. It is still a daunting task to get the thing to roll in the right direction, and there is still no guarantee it will start to gain momentum and size, let alone reach a good destination. But it does feel like possibilities are opening up that weren’t in my line of sight before. In fact, I now have the task of trying to scale up my ambitions – which is a really strange thing, after trying to keep my focus very much in the present and not falling backwards for so long!

So what has actually been going on? Well, in 2019 we secured a local small business grant to allow us to prepare to scale up. That gave us £50,000 to cover half the costs of getting some basic equipment and taking on an operations manager. We replaced some very dated laptops, and got some new desks and cupboards for our offices, only for the start of the pandemic to lead us to need to move to working from home.

That was particularly pressing, because the office we rented shared a stairway with three other units, which had just changed from very low risk, low traffic businesses (a geological survey company and a quantity surveyor) to a domicillary care company with over a hundred staff that were coming and going from the office in and out of elderly and vulnerable people’s homes. As an employer with staff who had various pandemic-related challenges (eg an employee with asthma who had to travel on public transport that included a lot of children on the school run; an employee in a multi-generational household; a vaccine-hesitant employee) and as a person with increased vulnerability myself due to preexisting medical conditions, we were quite proactive in that decision. I closed the office the week before the government officially locked down, and made the decision four months later to give up renting the office and go to a fully home-based working pattern until the pandemic risks resolved. Whilst that was a big adjustment, and I miss physically getting together with my team, having that social element and bouncing ideas off each other, in a lot of ways it has worked to our advantage. I’ve personally appreciated not having to travel as much, and reducing my carbon footprint, and it has allowed us to deliver projects all over the UK as everyone has become familiar with working remotely over Zoom.

We then secured a £220,000 Innovate Smart Grant to work with local authorities and complete our data set for BERRI. That allowed us to recruit a research team in the Anna Freud National Centre for Children and Families/UCL, where I also have my Senior Research Fellowships, to help us make sense of the data we collect and publish the validation, factor structure and early findings from BERRI. We have then set up partnership projects with eight local authorities (six in London and two in the north east). We added an Operations Manager and two Assistant Psychologist/Fieldworkers to our team to deliver the project. Working remotely meant we could also provide some light-touch input to placement providers across the UK, so we’ve continued to grow the number of organisations with BERRI subscriptions, and our ability to deliver training and consultancy online. We then secured a £96,000 Resilience grant to mitigate some pandemic related delays in the project, add some clinical staffing, commission an independent social and economic impact evaluation of our work, and use some sessional input from psychology graduates for a project in which we plan to build a wider “ecosystem” of resources around BERRI. Coupled with using the government Kickstart scheme (which subsidised businesses taking on young employees who were claiming Universal Credit) to take on three new members of staff, our team has grown rapidly. We now have input from two other qualified clinical psychologists, a small in-house data analytics team, a post to look at identifying and securing further grant opportunities, and a digital training administrator.

There have been other positive side-effects of the move to remote working. We’ve been able to recruit from a national pool of applicants and become more disability friendly – so our team now includes members from Kent, Cardiff, Somerset, Bradford, London, Buckinghamshire, Birmingham, Essex, Suffolk, Liverpool and the north east, rather than just local colleagues around Derbyshire. So I think we will probably work towards a hybrid model in which we have a small office space we use for meetings and training events, that local staff can choose to use when they want to spend more time with colleagues, which should be ready by the time the latest Omicron wave subsides. As well as continued court expert witness work, training and consultancy, and two new projects with additional local authorities, on the clinical side we are also setting up a second base in north Birmingham, where we plan to run a small neurodevelopmental assessment service. So we have recruited another AP to support that location, bringing our team up from me plus six employees in 2019 to me plus 19 today. We also have a network of placement students, researchers, contractors and sessional workers that mean we have over 40 colleagues in our wider network.

That’s a huge shift, and the rapid growth looks set to continue. We’ve secured two more small grants to develop a digital training platform and a demonstration app version of BERRI, and we’ve just submitted a large grant application to build on our with with local authorities. The independent social and economic impact evaluation has generated some amazing stories of how BERRI has changed the way that services are able to deliver psychological support to young people in care, and their lives have been positively impacted as a result. Whether it is a young person who was stuck in an inpatient secure bed with a negative prognosis who is now living in the community with aspirations of employment, a carer who is able to be more empathic to a child’s trauma history rather than seeing them as naughty, or a professional who feels more able to do their job effectively, it is amazing and rewarding to hear that my little project to develop an outcome measure for children in care is helping to create these increasing ripples of positive impact. It has also shown a remarkable level of economic impact, with a £100 return to the economy for every £1 invested in our service! My goal to change children’s social care and to find a better way to identify and support children’s psychological needs is no longer just a wild fantasy, but might be something we can actually achieve.

The other positive side-effect for me personally, is that I’m finally paying myself the salary I would be on in the NHS. After having started the company by investing my redundancy pay, a decade of subsidising the project through my court expert witness work, and some months where I drew down money from my own mortgage to pay staff, that is no small milestone! It means we are secure enough financially to firm up the social purpose embedded in the business into a formal social enterprise structure, where the majority of profits are pledged to delivering the social impact goals (which isn’t a hard task, given the vast majority of our turnover has always been spent on research and delivery of clinical psychology services).

So, what are the next steps? We have lots of new developments in the pipeline. The BERRI system itself is constantly being improved in various ways, so the next steps are adding third party reporting (eg if a social worker wants to get a questionnaire filled in by a foster carer, or a psychologist wants to get the school to complete a BERRI about a child they are assessing), putting percentile ranks into the reports for greater granularity, and improving our reporting of data to organisation by adding a dashboard with new data visualisations. We are exploring the potential of a Personal Edition of BERRI for concerned parents to fill in to know how best to support their child. And we are building an “ecosystem” of information sheets and videos to advise parents and carers about common issues.

We have several current research studies:

  1. Meryl, our PhD student, is collecting the community norms for BERRI. So if you are a parent of an adolescent in the UK, or know anyone that is, please use this link: https://uclpsych.eu.qualtrics.com/jfe/form/SV_9um9UfYGd2HX9gW (ethics granted by UCL). We really want as many participants as possible, and you don’t need to be concerned about your child or have any involvement with social care – we just want to hear from as many parents as possible (and if your child has no difficulties it should only take 5-10 minutes to compete). If you don’t have kids yourself, please share the link with others, and post the link to our research facebook page on your social media: https://www.facebook.com/BERRIResearch/
  2. If you live outside of the UK or your child is not aged 11-18 to qualify via the UCL research link, and you want a link to the questionnaire to rate a child or young person aged 5-21, just email earlyaccess@BERRI.org.uk, as I can offer free early access to the system to anyone willing to give us some feedback about your experience.
  3. We want a few people to complete a BERRI about their child (of any age) and then to complete a short interview about their experience. So if you are willing to do this, please email David, the MSc student who is doing the interviews, at david.carney2021@my.ntu.ac.uk and he’ll set up a call. (Ethics granted by NTU).
  4. We also want some foster carers to tell us about how different life experiences impact upon children in their care. So if you are a foster carer and have half an hour to participate, Lizzie would love to speak to you about her MSc research. Email lizzie.hill2018@my.ntu.ac.uk to set up a call. (Ethics granted by NTU).

We are also going to look at how we incorporate the young person’s voice into BERRI, and recognise signs of progress, strengths and post-traumatic growth.

I’m going to apply for some larger grants to look at scaling up our impact, and we are busy expanding the clinical side of our services to deliver more assessments and consultancy. BERRI has been used to review the use of residential care in some authorities, and to idenfity when children are able to return to family based care (either a foster placement, or to a member of their birth family) and what support is required to make this successful. This has generated significant cost savings for some authorities, so we have been commissioned to provide a similar review for a new authority. We are also supporting the growth of in-house residential provision in a couple of authorities, and expanding our clinical services to support fostering and edge of care consultancy in others.

So the future seems full of opportunity to make impact and – provided I can keep up with demand and keep all the plates spinning – maybe that boulder I’ve been pushing up the hill will start to roll. I just need to work out where we want it to get to!