Framing the problem with social care

By Neil Crowther

The vision and narrative developed by #socialcarefuture, which we published in April, was developed with people that draw on social care to live their lives and it was tested and refined through consultation with the general public.  It shifts public thinking about social care towards the way we want people to experience social care, and through doing so it commands more support from the public to invest in and transform social care.  

It offers a ‘North Star’ for social care and the beginnings of a route map to get there.  That’s vitally important because, as Thomas Coombes has said ““If we do not make the case for the world we want to see, who will?”

But it doesn’t say what’s wrong with social care today.  And that’s a weakness for two reasons.  First of all, as I have found, it can make it seem detached from people’s everyday lived reality and as a result, though people may be attracted to it, it can seem implausible or too far away from the immediate challenges people face.  Second, because – to flip Thomas’s point – if we do not define the current problems in the way we want and need them to be understood, who will?’  Framing the problem is a really important element of shifting thinking, because otherwise people default to their own assumptions or to what others are telling them and in turn the solutions we propose to them don’t make sense.  For example, in its work for the Joseph Rowntree Foundation on changing public thinking about poverty, the Frameworks Institute found that people saw poverty only as the absence of basic material things, like food, shelter, clothing and warmth. All other things are understood as ‘wants’ or luxuries.  They conclude that this way of thinking “can help to garner support for a limited form of welfare support that meets basic needs, and action to address the costs of housing. However, it undermines support for a more robust welfare state and leads the public to focus on tightening up the benefits system.”  Or as As Julia Unwin has said ‘If you talk about housing in terms of desperation and  need, then you can’t be surprised if it becomes an emergency service.’  Similarly, if we allow the ‘crisis’ in social care to be about ‘failing to look after the most vulnerable’, whether or not people have to sell their homes to pay for care or about the threat of ‘provider collapse’, we will lose our grip in shaping the human-sized and shaped solutions we want to see.

So how can we fill that gap?

Firstly, by sticking to the headline vision ‘we all want to live in the place we call home, with the people and things we live, in communities where we look out for another, doing what matters to us.’  Good framing practice consistently advises us to lead with ‘shared values’ and with an articulation of what it is we want to achieve, not with the problem.  If we don’t do this we can cue up unsupportive values, especially paternalism, confirm people’s sense that this is about ‘other people’ and not relevant to them, and because few people have any experience or understanding of social care, fail to raise their expectations of what could be.  The function of this vision is not to depict social care as is, but to reveal the distance we have yet to travel, while setting the coordinates to get there.

Once we’ve done this, we can then frame the problem or problems in a way that reinforces this vision of what should and could be and points people back towards our vision and the solutions we advocate.  This is something the recent Whose social care is it anyway? Inquiry report begins to do, with its sub-heading ‘from permanent lockdown to an equal life’

The use of ‘permanent lockdown’ works at a number of levels.  It has universal resonance, and brings to life our headline vision, because these are the things that all of us, to different degrees, have experience the loss of: of being with the people and things we love, or feeling connected, or doing the things that matter to us and which make us who we are.  Hence, the problem with social care is that it fails to support people to live the life they want to lead – it restricts and restrains.  But it also crucially frames the problem as external – as having been imposed on people and hence something that can be resolved, through investing in and organising social care differently, which in turn will free people.  It’s a framing that can work across a range of specific issues, whether the inadequacy of packages of care or the impact of care charges (as many of the people speaking in this excellent File on 4 programme on care charges do so eloquently), the imposition by councils of strict rules over how we can use direct payments, or the failure of successive government’s to invest in building a sustainable future for social care for example. Note that it is also always important to bring into clear view the ‘heroes and villains’ of the story. That is, be as clear as possible about who is responsible for creating and solving the problems.   

Of course, we should never only talk about problems. By saying ‘from permanent lockdown to an equal life’ we provide the sense of release and the possibility of the better future towards which we want to move. Our vision, and the steps advocated by the Whose social care is it anyway? Inquirers are hence our ‘roadmap to freedom’. It’s crucial to marry an articulation of problems with a believable plan for change, without which fatalism can set in.  The inquiry group will be doing that over the coming months, and as they do, thinking about how to frame the solutions they advocate will be crucial too.

Ultimately our research and guidance has produced a framework for communicating differently – and for those that share our values and goals – more effectively to win public support, not a script. It is there to guide how you communicate and to help people to think differently about social care, not to dictate or police it. By following some basic rules, you genuinely can open up new possibilities, challenge assumptions and reshape expectations.

Nevetheless, the #socialcarefuture we advocate is one in which everyone has a stake and role, and so it only follows that everyone must have a voice and be heard. Try to follow the rules, but remember that the best communication is always a conversation where we respectfully listen, not a who can shout their message the loudest.

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