There is a crisis in care, but there are glimmers of hope

Featured article - 08 July 2019
By Paul Burstow, Chair of SCIE

Paul Burstow, Chair of SCIE

Crisis in Care: Who Cares, the recent two part Panorama programme, lays bare the truth about the state of social care in England. Following four families receiving care over 10 months in Somerset, the programme tells a story that is all too common in town halls and families up and down the country.

It shows social workers and carers working hard to balance impossible demands against diminishing resources. Anyone who says sorting out the short, medium and long term funding of social care is easy, is living in another reality.

But there is another Somerset story to tell. As a report from Think Local, Act Personal says, a national partnership committed to personalised care, Somerset is working hard to promote innovative approaches to care.

Implementing its ‘Community Connect’ strategy, which was developed with their staff and community partners, Somerset is establishing a different approach to social care which is less about undertaking formal assessments and rationing packages of care, and more about working alongside people to connect them to support within the community.

Two initiatives exemplify this philosophy. The first is the development, with a social enterprise called Community Catalysts, of a network of micro-enterprises – small providers with often only one or two care workers – to provide person-centred home care across the County. The county boasts 253 new community micro-enterprises with 700 more expressing an interest, which an external evaluation shows is improving the quality of care and reducing costs.

I recently saw for myself the difference these micro enterprises are having – delivering personalised support in places that traditional home care just could not reach.

The second is Somerset Village Agents, a community based initiative that is supporting people, often living alone in rural areas, to connect to community groups, volunteers and services including Community Catalysts' micro providers. An independent evaluation of the scheme showed that it has delivered significant cashable savings whilst 93% felt they had better outcomes as a result.

Is everything perfect in social care in Somerset, in social care anywhere? Far from it, as the Panorama documentary shows! However, Somerset is trying to implement a very different way of meeting need and managing demand. Like many Councils who are innovating in this way it is still early days, but there are lessons to be learned.

In recognition of these efforts, Somerset is a member of SCIE’s, TLAP’s and Shared Lives Plus’s Social Care Innovation Network, a group of 17 local authorities, innovative provers and citizens who are working together to find ways to scale innovation.

In gatherings of the network so far, some important themes are emerging: The need for a different approach to leadership, which is more about convening and enabling partnerships, than issuing directives; embedding co-production throughout; undertaking commissioning in a way that encourages small innovative providers to grow; and using everyday and specialist technology to help prevent and postpone need for more intensive support. The goal of the network is to spread the lessons and develop products and tools to help the sector make the change.

In powerful article about Crisis in Care, Lucy Mangan, in the Guardian, writes “What is striking throughout is how little people [receiving care] are asking for. They just want enough to keep their loved ones at home, to continue caring for them without wrecking their own health and strength in the process”. But what struck me was just how much our broken care system relies on love to keep it afloat.

System reform or funding reform can be presented as a binary choice: That all that is required is an asset-based care revolution and then everything will be fine - or that all that is required is more money and more certainty about future funding. Both are wrong; neither is sufficient on its own.

Panorama was a powerful clarion call to action. We need to take the best innovations to scale and we need long overdue funding reform too.

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