Social care after Co-vid-19

By Anna Severwright

Reset, Recover, Restart, Refresh, Renew or maybe you want to Run away! So many R words are being used for ‘life after Co-vid’. The reality is we are probably going to be living with Co-vid for a long while. Co-vid has shone a light on many issues and challenges in our society. But also shone some rays of hope.

Recently I have been asked to speak a few times about social care after Co-vid – so here is a blog summarising some of my thoughts:

We need brave, radical reform. Obviously, we need more and fairer funding. But we must make sure we are not just funding more of the same. Where going into a care home is the last resort, but there are often no realistic alternatives. Where families and disabled people talk about ‘the battle’ with the system and people with learning disabilities are too often still in institutions.

I want to start from a place that we ALL have the right to a good, ordinary life, regardless of age, health or learning disability, as described in this co-produced vision from Social Care Future:

“We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us.”

We all have gifts and potential and by being us make our communities better places to be, in our own ways. But some of us will need some form of social care to help make this vision a reality in our lives.

Co-vid has again highlighted the inequalities in our society, especially around our health. We all knew they were there, but for too long it has felt they were tolerated as the ‘status quo’. This must change. People from BAME backgrounds, living in poverty or who have a learning disability all have worse health outcomes. The causes are diverse, complicated and systemic, but social care and it’s foundation of social justice must play a role in challenging these causes and help to start to narrow the health and wellbeing gaps that have been widening.

Society needs to start to value social care and view it as an asset. Social care has been much more prominent during co-vid, unfortunately a lot of that due to the large numbers of tragic lives lost in care homes. Too often social care has been seen as a thing for others- the old or disabled, not something good for all of us in society. The language of ‘the vulnerable’ that has become common parlance during the pandemic, serves to further increase this dehumanising divide between those who need care and those who don’t, those seen as capable and useful to society and those not.  But by having a strong social care sector it produces many jobs (crucial at a time of high unemployment), allows us as people to fully contribute to society, makes communities stronger, richer places to live, reduces isolation and improves people’s wellbeing. We need to make social care something that everyone wants to invest in and attractive for their older age.

Health and social care need to work better together in a joined-up way. This doesn’t mean they have to merge into one huge organisation and lose the skills and values specific to social care. But that the organisations, and crucially people within it, should be working together around my life. They should have a shared goal, of allowing me to live the way I want to, as well as possible. The culture of ‘that’s a different team’ or a different budget needs to end as it just causes delay and frustration. The fact that I can’t ask my PA to pick up a prescription as that’s a ‘health need’ is ridiculous and if I didn’t get my medication damaging to my health and wellbeing, but that’s just one example. This needs to include a person’s whole life- education, housing, benefits…. People don’t divide their lives into sections and yet that is how the system insists on interacting with people.

A positive to come from Co-vid has been community spirit, often in the form of the springing up of mutual aid groups or neighbourly WhatsApp groups. Communities showed that they were capable and effective in mounting a quick response. This reminds us that strong communities are vital to our wellbeing, often providing informal services, friendship or support that prevent or delay the need for more formal social care. However, the relationships between these more sporadic and flexible approaches and large organisations is often tricky, due to differing culture and language. It is essential that local authorities and other organisations encourage and support communities to thrive, but not try to control or fix them.

Another essential area for me is that people should have genuine choice and control over their lives, including their care and support. Family carers, often at breaking point, feel they have no option but to send their loved one into a care home as no viable alternative is offered. Younger adults, including myself, have limited care hours, so sometimes have to choose between having a shower or going to the supermarket. We can do better. In some areas, there are pockets of innovation and change, but too often these can’t fit the wider system so don’t survive or get adopted elsewhere. Things like direct payments, that were meant to offer genuine choice and freedom, get swallowed up into complex systems and restricted, making them not fit for purpose. The system needs to start working with us as partners, building positive relationships, built on trust and allowing flexibility, not on the current power model of scrutiny, threats and inflexible rules.

Ultimately for genuine reform to be successful, communities and citizens must be involved in the shaping and delivering of it. For too long power has been top down and hierarchical, but social care is about life and relationships and for these to flourish there needs to be a shift. Co-vid has massively changed the way we do things and we must grasp this opportunity to be big and bold in our aspirations for social care and for the lives we all want to live.

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