Charting a post-COVID-19 future for social care

Featured article - 14 May 2020
By Kathryn Smith, Chief Executive, Social Care Institute for Excellence

The other morning, I woke up to the terrible news that care workers are significantly more likely to die from COVID-19 than the general working-age population. One hundred and thirty-one had tragically lost their lives; and that was only up to 20 April. It was another bad news story about social care; just one of the many in recent weeks.

• Office for National Statistics analysis
• SCIE: COVID-19 support for social care
• Other opinion articles in this series

This is a sector which was sadly unprepared for the virus. We lacked good facilities, equipment, technology and sufficient numbers of care workers. Nor should this have come as a surprise for reasons that have been well rehearsed by my colleagues at The King's Fund; the sector is underfunded. It has been for many years.

• King's Fund: What’s your problem, social care?

This does not mean, however, that the sector has given up thinking about what a better future looks like. In fact, quite the opposite. There is a huge amount of fresh thinking taking place on the future of care and support. This is why I am so pleased to have joined SCIE – which is currently leading a project called the Social Care Innovation Network that explores how we create the conditions for innovative models of care to grow. This builds on other work we are doing to support the Government to recover from COVID-19.

• Social Care Innovation Network

Government is providing a variety of guidance, including on GOV.UK and is signposting, through the Social Care Institute for Excellence, resources for care homes, including tailored advice for managing the COVID-19 pandemic in different social care settings and with groups with specific needs, for example adults with learning disabilities and autism.

Our Plan to Rebuild, the UK Government’s Covid-19 Recovery Strategy

• Recovery Strategy

In my previous role at Alzheimer’s Society, I was always impressed with the huge amount of energy and commitment of staff towards finding better ways to support people with dementia. I am also happy to be a vocal supporter of Social Care Future, which is a grassroots movement trying to find better ways to deliver care.

Don’t we all want to 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.

Social Care Future

• Social Care Future

But COVID-19 is here and, as I write, the numbers of people dying in care homes has seen continuous rises. But on the day of writing this, the media reported a welcome fall. Providers that I know well do complain to me daily about the continued shortage of protective equipment and the lack of consistency with testing. I have been shocked by what I have seen.

• Care home deaths 'starting to decline'

The other side of the story

This is not to say that we haven’t seen good practice emerge, and very often inspiring contributions from people who work in care, and volunteers. To quote Alex Fox, Chief Executive of Shared Lives Plus and SCIE trustee: “We have more creativity than we knew: people and organisations finding a million ways to offer their help, knowledge or skills to others, often for free”.

• Alex Fox: Social Care cannot until the crisis is over to rebuild

I agree with Alex. For every news story about a tragic death, there is another about a care home connecting its residents up to family via Zoom, or of a social worker working creatively online to plan an active and engaging week for someone. I have no doubt that the sector will bounce back.

But is ‘bounce back’ the right phrase? Are we really trying to go back to what we had before COVID-19 sparked up? Is that even possible? Or do we instead want to chart a different future? I think it is time to ask much more searching questions about where we go next with social care.

Here are some questions which have been on my mind:

• How do we capture and galvanise the undoubted social solidarity which has risen up in many communities? Could it be possible for us to maintain a permanent army of volunteers to support people?
• How do we create a new contract between the citizen and the state – as we have started to see in places like Wigan - which binds people to a relationship of mutual rights and responsibilities?
• How do we create a sector which has put in place better universal systems for protecting it against future outbreaks, such as better information sharing and access to equipment, whilst maintaining the uniqueness and independence of small providers?
• How in the emerging world of Teams and Zoom, where so much more is now done online, do we finally harness the true potential of technology to aid better, more person-centred care?
• What is the role of the care home in the future? Do they need to be smaller, or have a different staffing structure? Or do we need to re-think how we build homes in the future which are better equipped to support people to live much longer at home?
• What should the workforce of the future look like? It will need to be better paid, and more widely respected. But what will it need to do differently?

Last week I attended a virtual funeral for my auntie, who sadly succumbed to COVID-19 while in a care home. It was a deeply moving affair. Like so many relatives across the country affected by this crisis, I have reflected deeply on the crisis and what we should have done to reduce its deadly impact.

At the same time, I asked myself this: what are we now trying to achieve for social care in the future? Are we simply trying to put the sector back together, like it was before? Or are we going to think bigger – about how we build a sector fit for future generation. Personally, I think it’s time to think big about social care.

• Kathryn tweets @kathryn1smith