By Ewan King
For all the problems it faces, the social care sector has always shown that it can innovate. From personal budgets, which were pioneered in social care, through to shared lives schemes around the country, it’s a sector which can produce innovations.
The same cannot be said about its ability to grow these innovations – to bring them to scale, to use the jargon. Instead, innovative models have tended so stay small scale – at the margins rather than being core business. Forever trapped, it would seem, in a pilot phase.
It’s a longstanding issue. In 2010 the CQC wrote that ‘many councils are still at an early stage in transforming social care and developments are patchy, varying between different groups of people’. Even further back, in 2005, the adult social care Green Paper of the time acknowledged that whilst there were pockets of innovative practice, more effort was needed to ‘ensure that existing good practice is spread right across the system.’
Jeremy Hunt has also acknowledged this lack of progress in his recent speech on social care. He said that Government was duty bound to ‘encourage new models of care provision to expand at scale’. This was, for me, the best part of his speech.
Luckily, there are no shortage of excellent models of care, which with support could be encouraged to grow.
Local Area Coordination (LAC), a person-centred approach focused on prevention and co-production to help individuals lead better lives, has demonstrated that it can transform lives whilst reducing costs, most recently delivering ‘statistically significant improvements in health status, health confidence and personal wellbeing’ on the Isle of Wight. In Somerset, a group of locally based staff, working as Village Agents, have helped to reduce social isolation and support people to live independently by helping to connect people to one another and to community services.
People who need accommodation as well as support in their community have often borne the brunt of low quality care. For people who need this kind of support, Shared Lives – a service that provides family-based support for older people and people with disabilities – continues to deliver high quality support, with 87% of all shared lives services in England rated good and 4% outstanding.
There is huge scope too, to invest in ways which support disabled people to live where they choose and receive the kind support they want. One example is award winning Bradbury Place, developed by the charity Enham Trust through co-production with residents and families, which provides 8 one and two bedroom wheelchair accessible apartments, catering for live-in care, couples and single occupancy.
For those just out of hospital who need support, new models of care like British Red Cross’s First Call, a 12-week volunteer led home support service, have shown that they can help people regain their confidence and community connections whilst saving the state money.
These examples point a way to the future, but we are yet to see the seismic shift necessary to take these models to scale. In our recent paper with Shared Lives, PPL and Nesta, we argue for a concerted and far reaching strategy to bring about the necessary change. We call for the Government to introduce an innovation scaling fund to test new approaches to scaling across local areas and support capacity building and coaching for social entrepreneurs and change-makers, including disabled entrepreneurs.
Locally, we call for a greater commitment from systems leaders to shift resources away from traditional models of services which deliver low quality care towards more innovative, community-orientated, high quality ways of delivering care. More money to support this transformation will be necessary, but as places which are delivering innovations at scale like Wigan, Bradford and Nottinghamshire have shown – it is by no means impossible to make progress.
This year should mark the turning point for social care, where the disappointments about progress expressed in past Government policies become a thing of the past. In his speech on social care Jeremy Hunt quoted Ronald Reagan. I will quote another American President, Barack Obama who said:
“If you’re walking down the right path and you’re willing to keep walking, eventually you’ll make progress”
Ewan King is Director of Business Development and Delivery at the Social Care Institute for Excellence