Alicia Wood, Dimensions
Martin Routledge challenged me to blog about social care as part of a quest to get a range of views from people in the social care field. Follow them on #socialcarefuture. I have so much to say about what is needed for a good social care so for the sake of brevity, I have condensed a wide range of thoughts down into my #socialcarefuture wish list…
1. Money can’t buy you love.
I’m going to get this one out of the way quickly, we need more money to pay for care and support. Local authorities do not have enough money to pay for the care and support needed in their communities and they need more. Providers are facing a broad onslaught of issues and regulatory changes that mean that care costs more. What we don’t need however is any more money being spent on care and support that doesn’t enhance people’s lives. We need social care that helps give people something to get up for every morning and recognises people as valuable human beings that happen to need a bit more help than most of us, not a drain on our economy.
No doubt that times are tough but I’ve also been through times when there has been a lot of money sloshing around and people were still not getting the care and support they wanted and needed. More money does not automatically equate to better services, we need a BIG rethink on what social care is and does that makes it something that we are all invested in for our own futures.
I want to see a care and support system that enables the people that use it to experience love, friendships and relationships, have meaning in their lives and be valued and contributing members of their communities. I don’t want to keep paying for what doesn’t work.
2. Put our brands and egos away and put our money into enabling disabled people and families to speak truth to power.
The social care narrative and debate often feels very paternalistic. That’s because it usually comes from professionals and organisations that represent professionals and organisations. A narrative peppered with beds, crises, the vulnerable, the disabled….blah blah blah. When if you listen to people that need social care, their families and those (often small and not well funded) organisations doing brilliant stuff you will hear the kind of narrative and debate that connects with people, and not just people involved in social care.
Please, please, please can those people and organisations that have power, money and the ear of those in power get behind these more authentic voices so that they can be heard and we have a chance of changing this sorry situation.
3. Communicate better about what social care is – no-one cares about ‘social care’.
I rarely use the term social care in my work or home life. It somehow feels so broad it is a bit meaningless to me. It is used to describe such a wide area of care, support and funding; social work, personal budgets, direct payments, community services, personal assistants, home care residential care, supported living…the list goes on.
If you ask the average person what social care is, most people don’t really know how broad it is and what it does. As an (unscientific) experiment, I just asked the person sitting next to me on the train what they thought social care was. Answer: social workers for children and carers that come to old people’s houses to look after them.
Yet we have conversations about ‘social care’ as if it is one thing. We talk about the needs of a wide group of people under one banner when the reality is that the needs of children and families is vastly different from disabled adults which are also very different from those of older people.
If we want to understand what we are really taking about ourselves, let alone the media, general public and politicians, we really need to start understanding and communicating much better about what social care really is.
It also doesn’t help that we have adopted industry jargon that is meaningless even to most people that use social care. It’s no wonder that most people don’t care about social care.
4. Personal budgets are not an evil way of privatising public services, nor are they the magic solution to making social care better.
Personal budgets and direct payments really work for some people and not for others. There I said it. I was one of the people that was evangelistic about them and I genuinely believed that they were THE solution for social care and continuing healthcare. I still think that they are great but I think that they are a small part of reforms that are needed. I want to see more focus on reforming commissioning so that people have a real say in local services and it is transparent, regulated and accountable. It is scandalous that so much crap is still being commissioned and we need local mechanisms to stop this, of which a part of is personal budgets.
If we stop commissioning the crap we may end up with a regulator that can regulate more effectively instead of constantly fire fighting.
5. Stop investing everything in ‘the next big thing/programme/pilot/vanguard and work on the basics to getting care and support right.
Don’t know about you but I can barely make myself read about THE NEXT BIG THING. It’s usually good stuff so don’t take this as a criticism friends and colleagues, but it is exhausting to see another reorganisation, integration, programme, initiative, set of standards etc. when there are so many basic things that need tending to.
Like how to make sure that disabled and older people are getting the support they need to live the lives they want and;
How to make sure that we pay those in care and support roles a wage they deserve for one of the most important jobs in our society and;
How we make sure that no one is getting substandard or dangerous care and support.
If there is going to be A NEXT BIG THING could it be that we stop tinkering with systems (that are flawed and will always be flawed) and just form relationships, talk to each other locally, have good conversations, listen to what the people who use social care and their families want and do what you can. If you can’t do what people want, tell them and ask for their help to find solutions as they will usually have some answers.
Lastly 6. People who need care and support also have a lot to give.
We need to stop framing people who use social care as simply vulnerable and needy as not only are we feeding perceptions that a whole group of people are a drain on our society but it simply isn’t true. Whether you are 105 years old and living in a care home or have profound learning disabilities and don’t use words to communicate, everyone has something to give. Who wasn’t inspired by the care homes that are working with nurseries? Or the examples of people with learning disabilities that help their older neighbours by picking up groceries and walking the dog, or volunteer in their local nursery or school to look after children.
My wish would be for housing, care and support providers to come out of their silos and shift their focus towards becoming community builders, community connectors and rights activists alongside the people they house or support to deal with some of our social problems such as rising mental ill health and loneliness. To enable the people they support to help their communities, get jobs, give and receive education and demonstrate that the value of human beings is much more than just economic productivity. We need older and disabled people to be central to our communities so that all our children grow up with people that are too often hidden from them, and our communities don’t miss out on what disabled and older people bring.
Alicia Wood is Head of Public Affairs for Dimensions and co-founder of Learning Disability England
#socialcarefuture has been developed to create a space, including a gathering in November, for a wide range of people and voices to debate and take action for a positive future.
We want to get past just thinking about stabilising the current system which isn’t fit for the future. We want to make a contribution to a much more positive vision, share what’s going on now that helps get us there, and find ways of supporting each other as we build the future.