The COVID-19 pandemic has shaken social care to the core.
We have seen a workforce overstretched, the tragic deaths of too many people in care homes, and commissioners struggling to find the money to meet the scale of the challenge.
This begs the question once again: how do we create a better and more sustainable care system?
Thankfully, the Government seems to be committed to social care reform, to be kicked off this year. The Secretary of State for Health and Social Care, Matt Hancock, has said, ‘Social care reforms are long overdue, and absolutely must happen.’ It also remains committed to cross party talks, to build cross party consensus on a future vision for the sector. But is this even possible?
Sadly, we have been here before, 12 times if we count the number of White and Green papers over 25 years. There has been progress during this period; in personalised care, in terms of inspections of care, and in terms of innovation. Yet it’s not nearly been enough. We still lack a grand and affordable vision for change.
Back in March, peers in the House of Lords were asked to become involved in cross-party talks on social care. Many at the time, perhaps worn down by the stop-and-start nature of past attempts at reform, were cynical about their chances of succeeding. But will they turn out to be right? Is it possible that we could make progress this time?
Any ‘blame-game’ over care homes can’t be helpful. Arguments of this nature, which cut deep given what the sector has been through this year, are unlikely to provide a useful backdrop for future talks.
Crisis on this scale, however, can actually bring people together rather than scatter them. Could it be that this crisis, which is unprecedented in its scale and devastation wrought, will unite everyone for the national good? I am certain that the public, at least, will not easily forgive any politicians who put party politics above what is clearly a national crisis. We also know that where there is a will, there seems to be the money to spend.
There is also a relatively recent precedent – the Care Act 2014 – which although did not start with cross-party talks, certainly ended up with cross-party backing. If it was possible then, why should it not be possible now?
And if cross-party talks do go ahead, what should they talk about?
We need to discuss how we arrive at a common vision. This would provide the scaffolding for a more a more detailed strategy and approach to funding. This is one that views social care as a force for good, giving people a life and not just a service. How about we start with the definition produced by Social Care Future: ‘Social care is about supporting people to live in the place we call home with the people and things that they love, in communities where we look out for one another, doing the things that matter to us.’
Part of this vision must be the recognition that ‘place’ – the local neighbourhoods people identify with and call home – should be central to how we plan and deliver services. The goal must be to shift more of the resources, commissioning and decision making, down to the level of place, ensuring that the community and the voluntary sector have a strong voice in how services are delivered.
The issue of funding can’t be avoided however. We have already had several painstakingly detailed reviews of funding, including the Dilnot Review which identified sustainable and fairer ways to fund social care. We don’t need more reviews; we need decisions.
Part of the plan should also recognise that we need to do much more to grow approaches to care that really work. There are many good examples of innovative approaches to care and support that are person-centred and community based, but they remain small-scale and exist in pockets. We need a national fund to help these great models of care to grow, like Key Ring, which helps to connect local, isolated people to support; or Community Catalysts, which helps small homecare agencies provide personalised care.
We also need a plan for prevention. Without a stronger approach to prevention – helping more people maintain their independence for longer – we will continue to see demand rise, and services becoming unaffordable for those who need them. This means using data much more cleverly to understand, predict and respond to demand.
If the COVID-19 crisis has taught us one thing, it is that there is a huge willingness in communities to come together to solve problems. Already we are seeing the benefits of this more collectivist spirit. But if politicians can’t show leadership and work together nationally, we’re likely to struggle to arrive at a blueprint for a sustainable social care.
Ewan King is Deputy Chief Executive at Social Care Institute for Excellence. Email: email@example.com Twitter: @ewandking
Read SCIE’s Beyond COVID-19 articles here.