Has the current model of adult social care reached its sell-by date?

Intervention by Martin Routledge at the ADASS Spring Conference 2019

We are debating the question “Has the current model of adult social care reached its sell by date”?

I’d be very surprised if anyone here thinks that our current model is anything like the end of history.

So the key questions are what do we want the future to look like and how do we make faster progress towards it – when the incredibly committed, skilled and hard-working people in the room are needing to focus so much energy on keeping the show on the road.

This is in the context of the biggest financial shock to the system in our lifetimes and when public and political priority remains low – so there’s little underpinning for major change?

Many here will remember, in his inaugural speech as ADASS president. Harold Bodmer called for a social movement that could build an alliance to engage with the public around a positive future for social care and generate political commitment to fund and support that future. We agree that this is crucial and #socialcarefuture is now working to build this. We are a movement of people using social care and other public services, families, professionals, commissioners, support providers, community groups and individual citizens.

We are growing the movement, connecting people who often act separately, linking people with many different contributions with the common aim of driving major positive change. Short term this is about closing the Care Act Rhetoric-Reality gap but medium term it’s about going much further. There are three linked elements of our approach:

  1. Coproduce a guiding vision for a radically different social care, then a new story or narrative about this. From this build a new approach to communication and campaigning to grow public and political support. This will be evidence based using reframing approaches to move towards hopeful, positive story of what can be – something that can shift the media and public position
  2. Glimpses of the future. Using our wide networks to identify pieces of the jigsaw of our desired future already in place around the country – and then catalyse, support and connect initiatives based on these and led by coalitions of the willing, that can show and pave the way for others
  3. Challenge and change the present. Though action at all levels and with a range of alliances – Help grow the power of people using social care to have their voices heard, their rights respected and their choices delivered.

We are getting going. 300 people came together in Manchester in November alongside the NCASC conference and launched the movement. We have published many glimpses of the future and worked to build connections and alliances. Initiatives catalysed or energised by #socialcarefuture are developing – some involving people here today. In June we are bringing people leading these initiatives and others willing to drive the movement forward to come together and further develop our strategy.

What is the role for ADASS in this? We are reaching out to you – formal system leaders – to explore common interests and goals – areas where we may move forward together. Having just undertaken a “Next Generation review” hopefully we will find plenty of common ground.

There are no shortage of think tanks and ideas people coming up with visions for the future. But of themselves they don’t make big change happen. At local level people face complex combinations of drivers and inhibitors – resources, positions and roles of key partners (especially health) varying political configurations and practice cultures.

Having said this – it feels like we are moving closer to what Bob Hudson calls the picture on the jigsaw box – models of what Think Local Act Personal call asset based areas are being developed and glimpses of the future starting to appear – with elements of the asset based area starting to come into being in more and more places.

So – how do we move faster towards this future given the range of constraints facing us? What should various players do and how might activities combine? We want to explore this with you and hope to do so with some of you in the summer.

But I need to say – if we are to go beyond marginal changes to what social care is and does and modest changes to investment we wont be able to do this unless we build and transmit a very different vision. To be blunt, crisis comms might get you a few £million to keep the current system on its feet, but it won’t underpin radical change. The Kings Fund report this week noted 25% public satisfaction with social care and made a link with the negative media narrative about social care, using research we commissioned (with support from members of the Voluntary Organisations Disability Group) from Lancaster University – this looked at every piece in the main print media over a year – 2.5m words in 5.5k articles. We have an opportunity to change this narrative because the media story is the one that our sector is currently telling them – one that research and framing theory shows us is likely to achieve the opposite of the one we intend – putting people off from engaging with social care or believing it can’t be different.

Building on this work, over the past year we have been preparing the ground for a major change in the story about social care and how it gets told. Using lessons from campaigns that have helped people change their minds about really big issues – a recent example would be equal marriage.

With support from the School for Social Care Research we’ve scoped the next stage of this work. We aim to co-create with lots of people using or involved with social care a new positive vision – and together disseminate a new, productive and hopeful story of change to build public support for the values, principles and ideas underpinning a better social care future. Products will include tested new “frames” and approaches to engage with the media, public and politicians in a way much more likely to stimulate support for and investment in social care

We’d be pleased to share our plan for this with those seriously interested in supporting it. More broadly we would be keen to look for that common ground – shall we do it?



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