A vision for transformed care

Creating the five year forward view for social care

Adult social care has repeatedly demonstrated its capacity for transformation: pioneering de-institutionalisation, personal budgets and more recently, asset-based approaches. It is under unique pressure from falling budgets and rising demand.

Incremental change is not an option: now is the time to re-build adult social care from the bottom up, re-shaping service interventions not only around a more individual understanding of people’s needs, but also around the creativity and capacity of individuals and families and leadership within communities that is too often overlooked.

Total transformation must change systems and processes, but first it must change hearts and minds. We need language that we all understand – that enables managers to explore ways to improve services whilst balancing budgets, but also helps people to think about how their communities can flourish. It will be difficult – trust me – but we need to find goals that we can all agree are worth working towards.

Clenton Farquharson, person who uses services and Director, Community Navigator Services

Promising models

Our approach is based on the premise that models which are currently promising but peripheral in each of these five areas must become the centre of this new system.

We have identified models in each which can help local conversations consider different ways to combine scarce state resources with the capacity of individuals, families and communities. These models often also enable frontline workers to shape more fulfilling roles and draw more effectively on the voluntary, community and social enterprise sector.

Building a ‘good life’

Our vision is for every area to have the difficult, honest and creative local conversations which release ‘stuck’ systems and create space for moving forward together.

These conversations start not with questions about services and budgets, but with

What does a good life look like in this area and what are we all willing to do to achieve it?

This question can then lead on to considering the five key ways in which adult social care and its partners try to help older and disabled people build a good life, and the most promising local and national models for transformational change in each:

  1. Helping all people and families to stay well, stay connected to others and stay strong.
  2. Supporting people and families who need help to carry on living at home.
  3. Enabling people to do enjoyable and meaningful things during the day, or look for work.
  4. Developing new models of care for adults and older people who need support and also somewhere suitable to live.
  5. Equipping people to regain independence following hospital or other forms of health care.

Every local area needs to build its own vision, but there are also many features which the most promising models have in common and which are transferable to any area. Some models are already well-evidenced and nationally available, like Shared Lives and Age UK’s Living Well service, and these are examined in more detail below. With others we will need to weigh up the risks of investment based on emerging evidence against the certain failure of no change. We would like to hear from you about models which we have not considered but which have evidence of both good outcomes and lower costs.

Re-imagining social care and support

If we can work with a number of local areas to re-imagine social care and develop costed models which feel like a better and more sustainable system, we have the opportunity to build a national case for investment. This could be the missing piece in the Five Year Forward View for the NHS and a significant step towards integration which works for people, families and communities.

Alex Fox, Director, Shared Lives Plus

Clenton Farquharson, person who uses care and support and Director, Community Navigator Services