For those of us whose job it is to talk about social care, you may have noticed that something quite unusual has been happening recently; politicians have been talking about it too. It was one of the main points of discussion in the first TV leaders’ debate during the 2015 General Election, and the Care Act has also had a high-profile amongst the General Public now that phase one has been implemented.
At last, you might well say. However, this rise in the prominence by social care has been building for some time, and for good reason. We have a fast ageing population, growing demand on services and we know that it is vital that we have a vibrant and successful social care sector to protect our NHS.
Although it’s important that if we are going to meet these challenges and support people, we all need to raise our game. The changing demographics, and the changing aspirations of people, mean that our services need to be well-led, flexible and able to meet the needs of a diverse population. Delivering high-quality personalised care requires a skilled and committed workforce, who are recruited on the basis of the values they hold and who see their role as enabling people to live well, rather than just deliver a service.
Delivering 21st century social care
What can we do to deliver this 21st century social care system? Firstly, we need to focus on creating stronger leadership within the social care sector. It is no surprise that so far the Care Quality Commission (CQC) is finding a strong link between poor care and the existence of homes without registered care managers. Too many providers who have received critical inspection reports, have not invested sufficiently in producing good managers. We need to become better at identifying, nurturing and supporting leaders.
We need leaders who do the following:
- embody the value-base of their organisations;
- develop an open culture;
- are clear about delivering outcomes to people;
- are good at encouraging everyone to understand their role in delivering those outcomes.
The NHS has an abundance of investment in its leaders; social care needs to invest in its leaders too.
All of us, as leaders, must understand the need for integrated, seamless transitions between health, social care and housing sectors; and all of this in a variety of settings, including those services provided in people’s homes and in the community.
Lilian Faithfull Care Homes, based in Cheltenham, for instance, have invested in their own leadership programme to develop leaders at different levels of the organisation. This has helped the organisation to retain and progress skilled leaders in all four of its care homes.
The My Home Life initiative successfully delivers leadership support to managers. Independent evaluators found that the programme has reduced the isolation of care home managers, plus it has enabled problem-solving with peers; and it has also improved the recruitment of care staff.
Deliver good care
Secondly, we need to get the foundations of good care right. As a priority, we need to provide safe care. Safety is a major issue arising in some of the Care Quality Commission’s (CQC) reports. This is not good enough. We know much more now about what good safe practice looks like – the Social Care Institute for Excellence (SCIE) has a range of good practice guidance – and we need to renew our efforts to ensure that all providers are working to national standards on safety. So, for instance, rated as outstanding by CQC in April, Ashcroft, a care home for those with autism, is keeping people safe.
The Ashcroft CQC report found the following, ‘People were protected from the risk of abuse through appropriate processes, including staff training, policies and procedures…One member of staff said “We know everyone really well, including their usual behaviours. I would speak with the registered manager or call local authority safeguarding if I ever had a concern”.’ And if a small home in Somerset can provide safe care, why can’t every provider?
Prioritise service users
Thirdly, we need to place service users at the heart of decisions about their care. Service users really do know what is best for themselves, but unless we ask them what they want and also involve them in designing how care is delivered, we cannot ever hope to develop care that really works for them. Look Ahead, a provider of care and support to people with learning disabilities, regards all of its service users as ‘experts by experience’, working with them to design and deliver the services so that they provide personalisation and choice.
Hale Place Farmhouse in Kent, rated as outstanding in May, for example, was found to place people, ‘at the heart of the service. They were able to take part in a wide range of activities of their choosing. The arrangements for social activities were innovative, met people’s social needs and enhanced their sense of wellbeing.’ Reports like this are a joy to read.
Fourthly, we need to be open new ideas and innovation. In Care England’s Manifesto for social care, the talk is extensively about the importance of learning from the best. In many cases, this can simply be about looking outside the front door and embracing what is going on in the wider community; for instance, by asking local artists or dance groups to come in and work with care home residents.
And another thing. Innovation doesn’t need to be expensive. There are, for instance, a growing number of committed volunteering organisations that want to come into care settings and involve people in interesting and engaging activities. Take Cocktails in Care Homes, a project run by the charity, Magic. Its volunteers offer monthly evening parties at eight London care homes in Tower Hamlets, Islington, Southwark and Waltham Forest. These are highly-regarded and valued by residents.
Making it work
At a time when the sector faces massive challenges, none of this will be easy. It will take bravery and sustained commitment. But it’s also important to ensure that we can access the latest on what works; and we’re pleased to direct people to Care Improvement Works – a new online resource developed by SCIE, Skills for Care and the Think Local, Act Personal consortium, which signposts people to the latest good practice and guidance.
It’s been great seeing politicians talking about the importance of social care. Long may it continue; but what do we want them to be saying in the future? It’s for us to influence which direction that conversation goes.
Professor Martin Green is Chief Executive at Care England. firstname.lastname@example.org Twitter: @CareEnglandNews
Ewan King, Director is Business Development and Delivery at Social Care Institute for Excellence (SCIE). email@example.com Twitter: @EwanDKing
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