Executive summary: New thinking on the future of adult social care

COVID-19 has had a devastating impact on social care; by June 2020 there had been more than 30,500 excess deaths among care home residents, and social care staff have been more than twice as likely to die from COVID-19 as other adults. Deep-rooted inequalities in society have also been amplified by the crisis, as have the sector’s fragile finances and the low pay and conditions experienced by many care workers.

However, it has led to some positives. Within communities, we have seen a willingness to become part of mutual aid and support networks; the steadfast professionalism and commitment of the social care workforce throughout the crisis; and the capacity for many organisations to innovate, moving their entire operations online or developing totally new services in the face of enormous challenges.

Faced by an enormous set of challenges, but also opportunities for reform, SCIE started a programme of engagement with the sector and analysis with the aim of determining what kind of future we needed for social care when we are successful in moving beyond the COVID-19 crisis.

The specific aims of this programme were to:

• explore the impact of COVID-19 on the sector, both negative and positive, and draw out lessons and implications for social care reform
• examine what we needed to improve social care in the future, once we emerged from the worst of the pandemic
• produce recommendations that explore what kind of sector we want after the crisis, and what the priorities are for reform. We called this programme, Beyond COVID: new thinking on the future of adult social care.

This position paper from SCIE sets out the findings of this programme, and is based on an analysis of a series of essays we commissioned from sector leaders, a roundtable which the Minister of State Helen Whately MP attended and an analysis of SCIE’s own work in support of sector improvement. In particular, it has been developed from our work for DHSC to support the implementation of the COVID-19 Adult Social Care Action Plan and the DHSC-funded Social Care Innovation Network, which SCIE led with the Think Local Act Personal partnership and Shared Lives Plus.

This is an important time for social care. The Government has recently restated its commitment to produce a long-term plan for social care in the autumn: ‘to give every older person the dignity and security they deserve’. A new Social Care Sector COVID-19 Support Taskforce, chaired by David Pearson CBE, has also been set up to ensure that the Adult Social Care Action Plan is implemented and that the sector will be supported through the next year.

This paper attempts to set out a bold plan for reform: one that we hope both the Government and the Taskforce consider and find useful. The plan needs to be bold because the challenges we now face are considerable and deep-rooted. To overcome these, half measures won’t be enough.

We also need to deliver a different vision for care - a positively framed, and co-produced vision, along the lines of that produced by Social Care Future, which SCIE endorses:

We all live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us.

The NHS has benefited from having a long-term plan for health. We believe it is now vital that we have a long-term plan for adult social care, clearly setting out a vision and plan for social care. This should be co-produced with the sector and with people who use services and carers.

To inform this plan, this paper sets out three strategic shifts which are needed to overcome the immense challenges we face, along with 21 recommendations which will help facilitate rapid progress towards these goals. We call on the Government, along with other national bodies with responsibilities for social care, to consider these proposals as they develop their thinking on the long-term plan and the Taskforce’s recommendations.

Read our recommendations: three strategic shifts and our 21 recommendations