Changing social care: an inclusive approach

Background: Why is adult social care changing?

The changes in social care are just one aspect of a wider government drive towards reform across all public services. The reforms reflect three key beliefs:

• that everyone has a contribution to make
• that everyone has the right to control their own lives
• that people using public services should be able to influence and change them to ensure their needs are met.

For adult social care and support, the vision is most clearly outlined in Putting people first  (Her Majesty Government 2007) which sets out a detailed action plan for implementing personalisation at a local level. The document states that ‘In future, organisations will be expected to put citizens at the heart of a reformed system’. 'Putting people first' formally introduces the idea of a personalised adult social care system where people have maximum choice and control over the services they receive.

The Department of Health then issued a local authority circular in January 2008 (Department of Health 2008a) which was sent to all local authority chief executives and directors of adult social care. This introduced proposals for change along with news of a £520m social care reform grant to be introduced between 2008 and 2011.

it is essential that frontline staff, managers and other members of the workforce recognise the value of these changes, are actively engaged in designing and developing how [they happen], and have the skills to deliver [them]...councils will also need to talk directly to disabled people and their organisations. What is clear is that doing nothing is not an option

(Department of Health 2008a: 8).

These statements reflect a clear need for the type of changes explored in this guide and this vision extends far beyond adult social care. It is reflected in a range of policy, legislation and guidance, including:

• Independence, well-being and choice (Department of Health 2005a). A Green Paper, outlining the government’s vision for the future of adult social care
• Our health, our care, our say(Department of Health 2006). An adult social care White Paper, confirming the vision outlined in 'Independence', 'well-being and choice'
• Strong and prosperous communities (Department for Communities and Local Government 2006). A local government White Paper.
• Building on progress: public services (PDF)(Prime Minister's Strategy Unit 2007). A vision for public sector reform
• Independent living: a cross government strategy about independent living for disabled people(Office for Disability Issues 2008).A cross-government strategy to improve the experiences and life chances of disabled people
• LinkAge Plus (Department of Work and Pensions 2005). An initiative to provide older people with access to a range of more integrated, joined-up services
• Carers at the heart of 21st century families and communities: a caring system on your side, a life of your own (Her Majesty's Government 2008). A 10-year plan to deliver more integrated and personalised support services for carers
• Valuing people now: a new three-year strategy for people with learning disabilities (Her Majesty's Government 2009). Identifies the next steps in the ‘valuing people’ policy and its delivery
• Living well with dementia: a national dementia strategy (Department of Health 2009). A strategy to deliver improved support for people with dementia
• Working to Put People First (Department of Health 2009). the strategy for the adult social care workforce in England, to support the delivery of Putting People First.
• Care, support, independence. A forthcoming Green Paper

As well as reflecting a shared vision for public services, these various documents and strategies also highlight the ways in which these goals can be achieved. Making available direct payments and individual budgets are the most obvious of these, and provide a clear way for individuals to take control of their care and support. There is also frequent reference to the importance of prevention, joined-up services, and good quality advice and information. In addition, leadership, partnership working with residents to develop and deliver high-quality public services, and building stronger, more supportive communities are seen as key to achieving the required changes.

For a more detailed discussion of the origins of this vision for social care, see SCIE Report 20: Personalisation: a rough guide.