The future of adult social care and support

Featured article - 15 June 2020
By Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board

Ian Hudspeth

Many of the challenges facing social care that have been exposed by the Covid-19 emergency are not new to those of us in local government. Inadequate funding, an undervalued workforce, a provider sector battling with increasing pressures, an agenda for integration in which the needs of the NHS tends to dominate; these and many other issues have been at the heart of our campaigning work for some time. It is tragic that it has taken a pandemic to put these issues squarely in the public spotlight, but it has. And the tragedy will be exacerbated if we do not take this moment of national awareness, resolve and focus to finally secure the longer-term reforms to care and support that we all know are needed. So, what are the lessons we have learned to carry forward into the future?

In time, we hope that above all else, this pandemic will be remembered for revealing our natural instinct to care about each other. Whether it’s been our family, friends or neighbours, what we have wanted for those around us during this time is what we want for ourselves: to live the life we want to lead. Social care and support has shown itself to be an essential part of how we achieve that. Even in the most difficult and restrictive of circumstances, social care has been at the forefront of keeping people safe and well in different settings across the country. The huge range of activity across organisations to support people has also been notable for being an inherently local response, with councils playing an important leading and coordinating role. In this way, social care has also shown itself not as an inevitable end point on a journey toward a service or services, but as the way in which people are supported to continue their own personal journey in life. The extent to which social care is framed in this way in the weeks ahead will be an interesting indicator of the scale of the Government’s reform ambitions.

Thinking about longer-term reform

Maximising the potential of the growing focus on care and support requires action on several fronts. Now more than ever, we need to recognise that the funding model for social care, and the inadequate funding of that model, has held care – and therefore, people – back for too long. Of course, in the short-term, more funding will be needed. But as it is made available, we need to think how it can be used to help start a more concerted effort to move away from an entrenched and largely binary model of provision based around residential care or home care, to something more bespoke. The solutions are already out there and this crisis has helped reveal the value of micro-enterprises, the wide range of communities’ different assets, mutual aid, and innovative housing arrangements in supporting people, to name a few examples. These solutions feel infinitely more ‘human’ and are infinitely preferable to some of the more traditional services on offer. Such considerations need to be part of the thinking about longer-term reform, the time for which must surely have now come. Everyone needs to be heard in that debate, particularly people with lived experience of care and support, and it’s one we cannot allow to be defined within a narrow scope of protecting people from having to sell their home to pay for care. Of course, this is one important aspect of ‘fairness’ that sits at the heart of the debate about the future of care. But it is by no means the only one. Reform needs to consider the bigger picture and the role social care can and should play in helping to support individual and community resilience, wellbeing and independence. Done with, not done to.

The workforce will of course be fundamental to the delivery of the above. It is heartening to see social workers and care workers now being more regularly recognised by all parts of society. But as welcome as claps, a CARE badge and offers of free goods and services from retailers are, they are no substitute for proper pay and conditions and a pathway to progress within a professionalised career sector. Finally, we must recognise how the care workforce – at all levels – has worked extremely well with local health partners in responding to the pandemic. Relationships have flourished in many areas, providing a sound foundation for effective partnership working and cross-coordination for the future. This too needs to be harnessed as part of making the case for why the national NHS, and Government, should better recognise the vital contribution of local government and its partners – as equals – in developing local plans for improving health and wellbeing. With the right freedoms, flexibilities and, crucially, trust from the centre, local health and care partners will be better able to move forward as a more balanced partnership, developing more effective and responsive support for people that is co-produced and in line with what those same people say is important to them.

Through all of the above, we are seeking a change in how people are supported to live the lives they want to lead. This can’t be achieved by going back to where we came from before Covid-19; instead, we need to start our journey to where we always hoped we would move. This must be the legacy of Covid-19 for social care.

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