We need to talk about doing social care differently
Of course the money matters. But the debate about social care should be about meaning and purpose as well as who pays
A new year and a new minister will pick up the social care reform baton. But how far will they get before they pass it on or drop it?
This year offers little prospect of short-term relief for the social care sector. I hope I am wrong, but the absence of any new funding in the November budget makes further cash unlikely. That means all eyes will be on the green paper and the 2018 budget to pave the way for a sustainable funding settlement.
While 2017 saw greater public awareness of social care, there remains little understanding of the sector. Most people don’t know that social care is means tested or where it ends and the NHS begins.
Before any funding reform can succeed, the veil of ignorance must be lifted.
But funding for what? In 2018, the debate about social care must be more than a question of funding and who pays. Of course the money matters, the current offering from our state-subsidised system is limited, offers little innovation, compromises quality and is focused on task at the expense of relationships and connection.
In 2018, we need to talk about doing care differently. A new report by Independent Age is clear that there isn’t a one-size-fits-all solution. But, whatever the solutions, it should be less about what services are on offer and more about people having meaning and purpose in their lives. This shift of focus does not need new laws; the Care Act 2014 enshrined a new organising principle for adult social care: the promotion of individual wellbeing.
Let me introduce you to Andrew*, who is 66 and recently retired. Since his wife died two years ago, he has lost contact with his friends and started to drink excessively.
Andrew was seeing his GP about his back pain. The GP asked him to see a link worker at the practice who used a social prescription to refer him to John, a local area coordinator. The GP also referred Andrew to a volunteer-led older men’s peer support network to help him reduce his alcohol use.
Andrew discussed his goals with John and how he could work with others to achieve them. This led to him being introduced to Scott, a person with a disability who shares Andrew’s passion for the local football team and wants someone to go to matches with. Andrew started going out more and drinking less.
On a cold winter’s day, Andrew slipped on some ice and broke his hip. He had a successful operation but worried he would struggle to get going again.
Before being discharged from hospital, Andrew met a social care discharge coordinator to discuss his mobility, social and care needs on returning home. This reassured him that he would be able to get around his flat safely. He also met John to revisit his goals and how he was working with others to find support, which included getting daily help from a micro enterprise providing homecare, supported by Community Catalysts. Scott was also in touch, and met him on the day he got home, continuing to visit weekly.
After six weeks, Andrew felt much recovered but still hadn’t been able to do much walking and was worried about becoming isolated from friends at the football club. Encouraged by John, he registered for a buddy walking group, who met him at his front door twice a week and walked him to a local cafe, which helped him build up his strength and was a chance to meet new people.
At the heart of this story is an important truth that should inform the future of social care. Connectedness, purpose and reciprocity have been vital to Andrew’s recovery.
One thing we must do as a society is encourage people to plan for their later lives. We can all bolster our resilience and stay in control and connected. That means ageing and the language around it can become more aspirational and empowering. And we must tackle ageism; although banned by acts of parliament, it remains rife in public discourse.
We need to take a long view and government should create financial incentives for us all to be more literate and engaged about how we age. The Treasury orthodoxy that care is a deadweight cost must be challenged. Social care is an engine of economic growth; its value to our economy is significant and growing. It’s part of a policy debate about family life, economic growth and the sort of society we want to live in.
Let’s hope that 2018 will see social care in the headlines for the right reasons; recognised for the vital contribution a functioning system can make to the quality of life for millions of citizens and to the prospects of a post-Brexit UK plc.
Andrew is a composite of service users interviewed by researchers