How far has social care come since 2003? 

The answer, in short, is probably not very far. 

Over those two decades, successive governments have promised to ‘fix social care’ and then failed to deliver. In 2005, in its document Independence, Well-being and Choice, the then Labour Government set out its vision of social care. It talked about independence and choice, about putting service users and their families at the centre, improving access, shifting the focus to a preventative model and empowering the workforce.  

Sound familiar? Hand on heart, could we really say that is what, as a society, we have done since that document came out? Numerous other documents have all followed, from governments of all political colour, all promising similar reform of social care. If we were to write the same vision today, the same desires would feature. 

Instead, here we are in 2023, some 1.6 million people can’t get the care they need and we have 165,000 staff vacancies. We have endured a heart-breaking pandemic the sector was  ill-equipped to withstand and a subsequent cost-of-living crisis. We now have social care provision on a knife edge, with all corners of the sector struggling and our ability to care for our most vulnerable compromised.  

The sector and its amazing workforce remain woefully underfunded, is not given the respect or regard it deserves and struggles to recruit. If we have a shred of hope, it is that the pandemic opened people’s eyes to the amazing work social care does and the vital role it plays, alongside the NHS, in the country’s healthcare. Maybe, just maybe, that has edged us closer to getting reform. Because, despite all the above, the sector does move forward, innovating and adapting to meet changing needs, harnessing new technology to free up staff and, above all, delivering great, life-enhancing care to many hundreds of thousands of grateful recipients on a day-to-day basis.  

The tragedy is that if we’d used these wasted two decades for reform, we could be delivering good and outstanding care to many hundreds of thousands more.  

I pray that we aren’t writing the same thing in 2043. 

Mike Padgham, Chair, Independent Care Group   @Mike_Padgham 

If I think back over the past decade, we have made great strides in the way we support people who use human services. We have seen some great pieces of legislation that have helped us focus on rights and see people as unique individuals rather than defined by their need.  

In my view the greatest Act in this period was the implementation of the Care Act 2014. For the first time an individual’s wellbeing was legislated to be at the centre of all that we do.  

The Act has created a huge opportunity and challenge to service providers to reshape their offer and listen more closely to the voices of the people we support and their families.  

It is with sadness and trepidation that I say that this rights-based legislation is not as solid as I would have hoped. We have seen recent attempts to weaken the Human Rights Act with reforms aimed at removing these hard fought for rights.  

Thirteen years of austerity is taking its toll on cash-strapped commissioners. Post pandemic we have a workforce that gave us so much and yet is still paid so little. There is a fragility to our gains made in the last 20 years meaning we must double down and collaborate in new way. Never has the quote, ‘If you always do what you’ve always done, you’ll always get what you’ve always got’, been more apt.  

Now is the time to be brave and bold and build a co-produced future that is robust to weather the next 20 years. 

Sarah Maguire, Chief Executive, Choice Support    @sarahmaguire30

Writing this reminds me of just how long I have been working in social care, as 2003 doesn’t seem that long ago in my social care career! That was the last year of my career in public sector services before joining the independent sector. 

Much of the time, it can feel like we’ve not come very far. Cyclical discussions about the need to address issues relating to funding, health and social care integration, workforce, accessibility, inclusivity and stronger communities all remain. Lobbying by many organisations to improve social care for those drawing on it or working in it can seem ineffective in any real outcomes and negative headlines highlight ‘unmet needs’, a ‘crisis’ in care and fragmentation of essential community support structures.  

On reflection though, we have seen change. We’ve seen the polarisation between public commissioners, third sector and independent providers diminish, with more common messaging and calls for action. We’ve seen thousands of adults living in institutions now living in their own homes, and stronger demands for choice and person-centred support. We’ve seen a shift to home-based care now being recognised as critical, ‘new’ models of live-in care, extra care and retirement living adapt and a huge reduction in the number of care homes along with dramatic changes in how they are used – all leading to people living at home for far longer. And we’ve seen the regulation of services adapt, as well as continued moves to integrate health and social care services: not just together; but with housing and community groups and, most importantly, with people drawing on care. 

All of these moves are by no means complete, far from perfect and with still much progress to be made. In the absence of solutions, and with increased expectations and ideas, people are taking control and, with movements like Social Care Future (www.socialcarefuture.org.uk), further positive change is being driven and new ways of working explored. 

Raina Summerson, Group Chief Executive, Agincare @Agincare