Beyond COVID-19. New thinking on the future of adult social care

03 September 2020

Three shifts are needed to address the devastating impact that COVID-19 has had on an already struggling social care system. That’s the conclusion in a new report today by the Social Care Institute for Excellence (SCIE). The report, out today, also calls for a for a long-term plan for social care.

Early on in the crisis, SCIE explored the impact of COVID-19 on the sector, both negative and positive, drawing out lessons and implications for social care reform. They also examined – and talked to the sector about, what’s needed to improve social care in the future, once we have emerged from the worst of the pandemic. The report draws on a series of essays and podcasts from sector leaders and a roundtable attended by Helen Whately MP, Minister of State for Social Care; along with learning from SCIE’s wider work with the sector.

In the report, SCIE sets out three priorities for reform - which they call the ‘three shifts’ - and make specific recommendations that they believe need to be implemented in order to build the kind of sector everyone wants after the crisis. They call this programme: Beyond COVID: new thinking on the future of adult social care.

COVID-19: Negatives and positives

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. As a crisis, 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.

Three shifts needed and a long-term plan, according to SCIE

Faced by an enormous set of challenges, but also opportunities for reform, SCIE started a programme of engagement with the sector and analysis of key issues from its work on COVID-19 and innovation, with the aim of determining what kind of future is needed for social care when we are successful in moving beyond the COVID-19 crisis. SCIE conclude that we need to see three shifts:

  • Shift 1: From hand-to-mouth to long-term and sustainable funding . We simply can’t go on like this, and call on the Government for a fair and long-term funding settlement for social care
  • Shift 2: To shift investment and focus away from remedial and acute services towards prevention. To assist with this shift, introduce innovation funds which for the sector to scale up the most effective preventative models of care, housing and technology
  • Shift 3: From workforce low pay, low recognition and poor conditions, towards higher pay, better conditions, progression and development - and parity of esteem with the NHS.

SCIE is also calling for a long-term plan for social care, mirroring what we have seen with the publication of the NHS Long Term Plan. They are calling on the Government and other sector bodies to consider these proposals, as they develop their thinking on the long-term plan and other strategies to boost the sector.

SCIE’s Chief Executive, Kathryn Smith, says:

Since I became a care worker at 16, I have never known a worse period for social care. Every day, as more reports came in about deaths that could have been prevented, lack of testing kit and personal protective equipment, or local authorities and providers facing financial ruin, I’ve felt a sense of despair. However, I am also reminded every day of the enormous resilience, versatility, passion and empathy of the care workforce, and within wider communities. And I ask myself, can we come out of this undoubted crisis stronger? I think we can.

SCIE’s Chair, Paul Burstow, says:

In this report we call for a long-term plan for social care that will deliver on this vision. We also identify three shifts we think need to happen to build system which is financially sustainable and fair to access, preventative in focus and supported by a well-paid and supported workforce. We also set out a number of specific recommendations for Government and other organisations which we hope are considered as part of future plans. I hope that Government and sector leaders find this report a source of inspiration and ideas for turning that vision for social care into a reality, one that gets us Beyond COVID-19. As ever, SCIE stands ready to support the sector with its journey to a better place.

Contributing to the thinking, Professor Donna Hall CBE, most recently leading Wigan Council (now New Local Government Network), says:

If we had declared a national emergency two weeks before lockdown, local resilience forums would have been able to put in place communications that reached out and listened to their valuable residents – even the best systems with integrated place-based hubs struggled with communications in the first few weeks.

The sector has also seen an acceleration in innovation during the crisis, including in the use digital technology, as noted by contributor Sir Andrew Dilnot of Nuffield College, Oxford University:

My hunch is we will continue to see moves towards looking after people in their own homes. But, if that is to work, we will move people into homes which work better; new homes purpose built, or adapted for it…New and exciting ways of looking after people in their own homes. More reliance on technology, monitoring people’s conditions.

And SCIE heard about the potential of community-based, preventive model of care:

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.

Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board and Leader, Oxfordshire County Council.

About the report

The 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 SCIE’s own work in support of sector improvement.

In particular, the report has been developed from SCIE’s work for the Department of Health and Social Care (DHSC) to support the implementation of the COVID-19 Adult Social Care Action Plan and the DHSC funded Social Care Innovation Network, which SCIE leads with the Think Local Act Personal partnership and Shared Lives Plus.

Notes to editors

SCIE improves the lives of people of all ages by co-producing, sharing, and supporting the use of the best available knowledge and evidence about what works in practice.

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