It was interesting to find myself agreeing with Jeremy Hunt. His article in the Guardian on 13th July struck a chord, coming on the back of Sir Simon Stevens (CEO, NHS England) saying social care needs to be fixed within a year and another article by Ros Altmann suggesting nationalisation of care.
That social care needs to be fixed and fixed fast is not news. What many people in the sector and elsewhere are grappling with, is whether to go for a ‘good enough’ fix to tide us over, or a once and for all resolution of the problem that has been in the ‘too difficult’ pile since the Dilnot Report in 2011.
I believe that with the public, media, and politicians’ attention now on social care, there is a real opportunity to make the case for a once and for all settlement of the debates around social care.
The Association of Directors of Adults Social Services (ADASS)’s most recent report – Shaping a Better Future – sets out nine statements they want to shape the future of social care.
Among these is a call to rethink how the social care market operates. Crucially, statement five – ‘Housing is central to care and our lives’ – notes that every decision about care is also a decision about housing.
Therefore, reform must be shaped around a ‘Home First’ approach. Overall, ADASS calls for a stronger emphasis on existing types of housing-based care and support services and is less focused on longer-term large scale care homes.
It is reassuring that housing is recognised so strongly. Perhaps the link between Health and Social Care, created by putting the two together at a government department level, can enable housing to get a foot in the door to reform and to make the strongest case for housing’s contribution to a long-term solution to the conundrum of care.
To succeed in creating a truly Home First focused care system, we need some very clear asks of government:
1. On social care funding:
We should be asking for:
- A system that is fully funded and free at the point of need with a mixed economy of funding that includes tax/National Insurance increases.
A model of care insurance that is government-backed and not left to the market (with its track record of miss-selling scandals).
A model that facilitates time banking. This means people who contribute to their community by caring for neighbours, can accrue care credits to support their care in the future. This has been tried in Japan.
- An end to eligibility thresholds and a whole system focus of preventative support that recognises and supports workforce and family carers – with the latter being especially supported to give the best care they can to their loved ones.
- Housing to be included in integrated care and health pathways i.e. supported housing, extra care housing, sheltered housing, and independent living, etc. This housing-led provision is a key component of preventative services.
- Pooled budgets that support continuity of care and incentives in the system that focus on preventing the need for care, rather than escalating it.
- 5. A capital and revenue framework that creates the safe, digitally enabled support and care provision for the future
2. On the care workforce
We should be asking for:
1. A funding settlement that leads to proper pay for care workers.
2. A national register of care practitioners.
3. A training pathway that integrates housing support, social care, and health – with a core curriculum that covers all three areas and then if they want to, enables people to specialise.
4. A Royal Institute or National Care Council which takes responsibility for professional standards. This would provide an academic underpinning to develop care models and practice, raising the professional standing of care. It would also recognise that care is complex work, requiring skills in working with increasingly complex care issues, as well as an aptitude for empathy, compassion, and personal resilience.
5. The ‘what I’d want’ test! For each and every one of us to recognise that we may need care at some point in our lives, or that we will have to care for someone close to us and to ask – is this the care system that I’d want to have to rely on?
Now is the time to launch an effective campaign and make a clear ask of government – sort out the care system once and for all!
To discuss this article, contact Liz Zacharias : email@example.com or on Twitter @LizZacharias_CT
Photo Credit – Geralt (Pixabay)