Over the past year lots of us have go together to talk about how we can produce a compelling new story of change that can help move our ideas and ways of working from the margin to the mainstream where care and support is concerned.  This post draws your record of the work we did together.

First of all, we met in Manchester in May 2019 and talked about our vision for the future.  You can read a summary here and we included it in our publication ‘Talking about a brighter social care future’ which was published in November 2019.  Below are the ideas and thoughts generated on the day:

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Then in November 2019 we met in Birmingham and thought in more detail about the change we want to see in the world.  You can read a summary here

We thought about how the world would be different if our ideas took root:

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We considered what national and local government would be doing if it was aligned with our vision:

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And we considered what the chief obstacles are that stand in our way and the arguments that are made against our ideas:

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Then we thought about who we need to influence and what might win them over:

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We were also fortunate to have Dr. Pen Mendonça  on hand in Birmingham to produce her interpretation of our discussions:

SocCareF2019asSocCareF2019bs

Next we’re going to start looking in detail  at public ‘mindsets’ – at how people talk, think and feel about care and support.  In Manchester on February 4th we’ll work together to build some ‘hypothesis’ about public thinking which we’ll test in the research, before we begin to develop and test a new narrative.  We’ll be joined by Equally Ours who will kick of the day with a ‘framing 101’ session so that we’re all up to speed on the approach we’re taking.

This note and artwork by Dr Pen Mendonça offer a summary of thinking and ideas generated by #socialcarefuture network members in Birmingham on 28 November 2019.  It is presented here as a starting point and comments and suggestions and you are invited to help us to develop it, either using the comments box at the bottom of the page, via Twitter or Facebook or by contacting us at socialcarefuture@gmail.com

#socialcarefuture’s work on a new story is following the four stage research process outlined by the US-based organisation ‘Heartwired’: what is the change we seek and who do we need to persuade? What is the current landscape of discourse and thinking? What are the mindsets of our target audiences and how can we most successfully persuade them to support our values, vision and ideas?  Clarifying the change we are seeking and who or what needs to be persuaded by a new story to achieve it is the crucial first stage. This session was organised to explore those questions. The note below is based on the record of discussions taken down on flipcharts by colleagues during the session.

What is the big change we want to see? 

‘It starts with dreaming’

‘Social care’ as usually described, understood and done as a single one way service that ‘cares for’ older and disabled people, either in a person’s home or in some form of group arrangement. ‘Care’/being cared for itself is seen as being the product.   Ideas and discussion about social care are nearly all based on what has been called a “professional gift” approach, with low expectations of those older and disabled people needing support, which can be stigmatising.

Those coming together in the #socialcarefuture network practice and aim for a quite different model, whereby the ‘product’ is the person who needs support better positioned to lead a life they value, supported by and contributing to a shared web of community support. Rather than ‘caring for’ older and disabled people, the starting point is ‘caring about what people care about’ and working alongside people to make it happen. It is a model that is about the person establishing or re-establishing their identity and building upon their own strengths, including through the ‘glue’ of their relationships with the wider community. Any support is designed to transport a person towards achievement of their life goals (however seemingly modest), and not to constrain them. It is about establishing or restoring people’s potential and about supporting people to ‘be awesome in our own ways’. If working well, people with high support needs will be visible in their communities.

If this change is achieved, getting support won’t lead to stigma, just as going to see your GP doesn’t. Nor will it involve battle or cause fear. People will get support through a range of ways-in, with peer support available in hospitals, via the police and so on. Both those looking for or receiving care and support and those involved in providing or helping it happen will know, assert or live by their rights and obligations, with human rights being front and centre.

As a result, rather than a single “transactional” service, achieving these results involves activity to secure or build ecosystems of mutual formal and informal supports.   When working well, this web of relationships, living conditions and support acts as the ‘invisible scaffolding’ that provides us with what we need to lead our lives as we want to. Formal and informal support will be blended.

Like life, this approach to supporting people is messy rather than uniform.   But it doesn’t just happen. More financial investment is necessary, but it must come hand in hand with reforms to unlock imagination, creativity, problem-solving skills, resourcefulness and the power to make change that exists across all our communities.

What are the main obstacles in our way? 

Dominant definitions of social care are too narrow

Social care is being politically “framed” as about protecting property wealth or as free personal care for older people only. This begs the question: is what we want served well by the name ‘social care’? The media ‘don’t quite get social care even when trying’

Problem attitudes and baked-in low expectations

The general public does not see social care as having immediate relevance to them. Experience of the social care system has reduced expectations among people and their families about what is possible. People are worn down and prepared to accept mediocre support. Ageism and paternalism influence (and are influenced by) narrow ideas about social care. It is sometimes argued that our ideas don’t really work for people with significant impairments and health conditions such as late stage dementia. There is also a lack of trust in people and communities to take charge of their own care and support or to spend public money properly.

Rigidity and resistance to change

The imagination and creativity that can be found in the approach of members of the #socialcarefuture network is not routinely valued. Commissioning,  procurement methods and regulation are often rigid and suffocating. The regulator is not measuring the right things and lacks ambition. The system’s desire to control struggles with the messiness of community doing it for itself. The “sector” prefers re-organisation to overall system change and is risk-averse. It approaches scaling through standardisation in a way that can crush creativity e.g. social care workforce development and recruitment-drives are focused on a fixed idea of the ‘care worker’ quite at odds with the idea of a personal assistant. Even where there is progressive leadership in local councils, a disconnect can exist between leadership and commissioning practices.

Power and influence lies in the wrong hands

The sector sees itself as the experts. There is little ‘consumer voice’. A culture of ‘us and them’ persists between those ‘providing’ and those ‘receiving’ services. Few organisations understand how to work co-productively. There are powerful vested interests perpetuating existing approaches. Social care continues to be based on a ‘gift model’ ‘theirs to give’ (gatekeeper) rather than ‘ours to take’ (rights).

Who are our ‘persuasion targets’?

Participants identified the following as key ‘persuasion targets’:

  • Social care leaders and commissioners
  • Those who come into the social care workforce
  • The media and public who lack ‘a positive contemporary story of social care’
  • The public who don’t understand what has to change or their part in it
  • Politicians who get their ideas from the unambitious ‘sector’ or think tanks that are not well connected to the lives of people using social care – not from people or a more demanding public

Ideas for winning the change we seek.

Changing the story

A new story to reframe what social care is for and how it works, should centre on stories in which the role of care and support is embedded rather than stories which begin with social care, helping it to be understood as a means to other (commonly valued) ends e.g. Stay up Late’s focus on going to gigs. It should also major on these ‘better ways’ to help redefine what social care is understood to be and how it works well – for example, a recent news story of an older man going to school to have his lunch and talk to kids; of the pub opening up to offer free meals and company on Christmas day

Movement building

We should support the development of a local, regional and national network for change. Borrowing from the ‘Every Australian Counts’ campaign, for example we could promote a national coffee morning, encouraging people to come together and to talk about how they can together improve care and support in their area

Using law

 We should promote “legal literacy” among those using and those delivering care and support, including the Care Act, Equality Act and Human Rights Act. We should encourage legal enforcement in the field of social care by the Equality and Human Rights Commission

Rebuilding self advocacy

We should encourage and push for investment in family, peer and self advocate leadership

Wide-angle lens

Social care should be seen as sitting alongside housing, health, education, community development and regeneration in making good places to live rather than a standalone service, or adjunct to the NHS.

 

We would like to extend our special thanks and good wishes to Dr Pen Mendonça 

By Julie Stansfield

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As one of the convenors of a growing movement, I am proud, with In Control, to be hosting #socialcarefuture

Looking at the pre-election debate about social care I am struck by the absence of the voice of people and families who use it. I think that this absence pushes the debates – and probably the manifestos – in a narrow direction. The debates are about personal care and property wealth when they should be about good lives for all in strong supportive communities.

Over many years now In Control and our partners have found that when you bring people, families, professionals and managers together they find common ground and energy to build something so much better.

Last week we met a new “All Together Better” group. As we travelled down from Manchester to Somerset I wondered what the group would be like. I’ve learned you can never tell from application forms nor from first impressions. The process of those who embark on this journey is always different and unique. Nobody knows the troubles people carry with them and how the first session – where we go deep into ‘why things are the way they are’ will affect them.

What I do know is this course is the most worthwhile time I ever spend. I attended the very first course of Partners in Policymaking that took place in Oldham in 1996. 23 years later and with a range of associated programmes like “All Together Better”‘ I continue to bang this drum as loud as I can and make no apology for doing so.
In the majority of current great co production & “patient” leader groups, you will find Partners graduates. These are leaders that have negotiated with ministers, civil servants & senior managers for a better social care future.

This vast network across England (and beyond) is not organised by any one person or organisation, you will find Partners in very many organisations across England & Scotland. They all work & take action in different ways but they all share the beat of the same drum.

The significance of these courses is not purely in the course programme itself, that’s just the start of the journey – it’s the journey itself. It’s being given the magical mixture of grounded information along with inspiration. The knowledge aligned with hope takes each individual on their own journey but also unites them as a bonded group. It’s always interesting to see people come in their named role of worker, mother, father, professional, recipient, nurse and see that even by the end of the first session the roles drop and they see each other as people with gifts & talents to be used to lead change.

Last week was no different – families sat with council workers and providers and talked about what they had heard, how they felt and what change they would like to see locally. They currently have little idea of the growth of power that these conversations will achieve over the next 4 months.

Facilitating the groups is a massive responsibility, making people feel as safe and comfy as possible whilst the speakers rock and challenge them to think hard and inspire them to be the change they want to see in the world.

Partners become national pioneers, leaders of a better future, change makers, the range and variances are vast with just the one thing in common….inclusion of all people.
Gavin Croft famously said to a minister “I want a life not a service.”  This mantra has carried through generations of advocates for a better future. We are not there yet for the majority of people but the network grows and spreads to all people who want a better future.

I’ve seen people awake from bureaucratic slumber and become the most motivated leaders of change. I’ve seen people tired from the battle suddenly change direction and find a completely different way to get on with what’s important in their life. These amazing stories bring to life the quote of Margaret Mead “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has”

Julie Stansfield ~ CEO ~ In Control Partnerships

@juestanny

friends

Dear Friends

Please join us at the next Social Care Future Gathering at Friends Meeting House in Manchester on February 4th 2020.

This action-focused gathering is an opportunity to work together to help bring our emerging story of a brighter #socialcarefuture to life. It is the first of a series of gatherings that will take place every three months throughout 2020, to explore and develop our work on some big themes. The core focus of this first gathering is on our work to change the story of social care. As well as “reframing” we will have sessions and discussions about the initiatives that people have already started or that they are planning to build, plus some “open space” for people to bring and share their ideas and actions with others.

For more details and how to book, download the flyer here and easyread flyer here.  Please share with your colleagues and networks!

 

Tim Cooper, chief executive at United Response.

winning

Despite the reason behind this election, it’s still a ‘general’ election after all – one based on the full list of things which matter to voters up and down the land. If it wasn’t for the six-letter-word-beginning-with-B, social care reform would probably be higher up this list – and it certainly needs to be. So as the parties begin to launch their manifestos this week and election hype rises to a new level, we should expect to see social care reform playing a large part. But will we?

Even in these bizarre times, social care has stayed on the agenda… just. Quite an achievement given the limited capacity in parliament for any domestic policy since 2016. The problem is that care is an issue because it’s so bad, not because of the fantastic new models of inclusive community care and support which are emerging.

We in the social care sector have been guilty to some extent, focusing only on crisis and a lack of funding to fix it. The negative perceptions this creates undermine the real progress we have made in developing and delivering new community based approaches to our support.

For well over a decade a social care system funded in a way politicians think is acceptable to the British public has eluded policy-makers. It has beleaguered successive Prime Ministers, was (skilfully) dodged by the longest-serving Health Secretary in British political history, and famously cost the Government its parliamentary majority at the last election.

A former boss of mine used to remind staff: ‘Bring me solutions not problems’. On his first day in office, the current PM promised a new solution to ‘fix social care’ by the autumn – then swiftly kicked it into the long grass, reportedly after seeing the plan the Government had spent two years on. He told the Health Secretary to ‘do it again’.

The stakes are high and on one level it is understandable policy makers won’t stick their neck out, but if we need anything now it’s political courage and foresight.

Notwithstanding that most people don’t understand social care until they or a loved one need to use it, their perceptions are based on reports of a failing system, the billions it would cost to fix and where this money should come from – namely from themselves.

Politicians know that money has to come from somewhere. Raising tax is unpopular, insurance schemes subtracted from pay slips are a hard sell, Government taking a chunk of value from people’s houses loses elections. And then there’s the fact that over half the investment in social care supports disabled people who need care and support throughout their lives.

So the story of social care has become Kafkaesque: negative perceptions posing political danger leading to postponement and evasion, while the existing system gets worse and the process starts again.

Manifestos coming out this week must change this narrative to break the cycle and attempt to reframe reform as the positive opportunity it really is – painting a picture of the great work already being done at the centre of local communities across the country and how this could become the norm.

Manifestos should show how valuable social care is, not only in financial terms but in terms of the difference it makes to communities. People might then understand reform and the benefits it would provide. If the narrative is changed and this vision is sold to the electorate, they might consider fair ways to fund it, removing the political danger so that politicians have the confidence to put real choices to the people.

But it’s not just politicians who have a responsibility to change perceptions. Providers like ourselves at United Response and others in the sector have a duty to demonstrate what good care and support looks like too. Organisations have gone on about the ‘Care Crisis’ and billions needed to fix it for too long. This has undermined progress and emphasises the ‘bad’ over the ‘good’.

That’s why we’ve been working with Social Care Future and supporting their brighter vision for social care. This approach centres upon the importance of speaking of social care in terms of hope and possibility. As a sector we want to offer a positive vision of the future as well as spelling out how our work might serve as potential solutions to take us there.

There is one narrative of social care not mentioned so far and, believe it or not, it’s positive. All the parties broadly agree that a successful care system must be jointly delivered and fully integrated with community health services and other local public provision. Disabled people, children, elderly people, families – people across local communities brought together to access a range of health and care services that everyone needs.

Perhaps another ask for manifestos this week is an agreement for parties to work together in the next Parliament to sell this shared vision. Perhaps then we might add a new slogan: ‘Let’s get social care done’.

Paul Burstow – Chair, Social Care Institute for Excellence

Our default narrative about social care is too often one of crisis, fragility, staff shortages and underfunding with vulnerability and neglect thrown in for good measure. Its time change that.

For most people social care is out of sight out of mind.  It is little understood, unlike the NHS there is no spontaneous emotional connection.  A typical sample of the headlines that social care attracts tend to be about the sector talking about itself, even to itself.

This dominant narrative of a broken system has been consistently communicated over a decade or more.  Compared to the NHS, social care is and always has been the poor relation.  We have tested the narrative of crisis to destruction and the result?  Sticking plasters rather than solutions.

During the General Election we will likely see the weaponising of social care with parties competing over how much more they will spend.  But will any of the parties offer up a better future for social care?

For me social care is the means not the end.  The end is how we promote wellbeing, simply put: the things that matter to a person in their everyday life.  There is no place for one size fits all.  It is not just the provision of the most intimate of personal care, it is much more.  It is about having the opportunity whatever your age, your disability, your circumstances to have a life you chose. As Social Care Future put it:

“Imagine a world where we all get to live in the place we call home with the people and things that we love, doing what matters to us in communities where we look out for one another”

I was delighted recently to chair, at SCIE, the launch event for “Talking about a brighter social care future” This report, incorporating research by Lancaster University academics, analyses the story being told by “the sector” and the print media and heard by the public. It’s a story unlikely to underpin the change we need to see. The report uses “framing” theory and practice and examples of national and international movements working to shift public thinking on big issues – such as the successful equal marriage campaigns – to help consider the new story for social care, and how to tell it.

Up and down the country there are great examples of this story.  A story of hope, of living, of mutual support.  SCIE, Social Care Futures and TLAP have these stories to tell.  The Innovation Network, convened by SCIE and partners, is proof that there is a desire for this narrative, to be shapers of our future rather than victims of a dystopian future.

Against the odds excellent care is being delivered in many parts of the country. Wellbeing Teams a relatively recent arrival in social care provision, involves self-managing teams of wellbeing workers performing many of the tasks relating to staff support, reviews and quality assurance checks normally performed by the registered manager. Recently rated outstanding by CQC, it found that wellbeing teams ‘put the people they supported and the people who knew them best, at the heart of organising and planning care, so that the best outcomes for people were achieved. Where wellbeing workers felt alternative support or approaches would better help a person these were discussed with the person and people who knew the person well to identify how positive outcomes could be better achieved.’

So as Directors of Adult Social Care gather in Bournemouth for their annual conference as the stewards of social care what will their message be? Where is the vision, the aspiration, the hope to inspire a movement for a different future for social care?

Of course, a long-term funding settlement is required, so too is clarity about how we pay for this.  Workforce too requires a long-term settlement.  But, pouring more money into the current model of care and expecting a different result is extreme folly.

Any new investment in social care must make real the aims of the Care Act, promoting wellbeing, supporting informal carers and preventing and postponing the need for formal care.  Above all giving voice and control to people to have the life that matters to them.

@PaulBurstow

 

By Peter Hay

 

So let’s cut to a summary of the evidence that there are stand-out social workers and excellent social work within systems that are under so much stress.

  • ‘Compassionate, committed and creative’ – a description of Gareth Benjamin , Mental Health Social Worker of the Year 2017
  • “Innovative and different – thinking outside the box …experiential and evidence based” – the view of Prof Hugh McLaughlin about Essex County Council’s Virtual Dementia Tour, award winners in 2017.
  • Or the words of The Chief Social Worker for Adults, Lyn Romeo, about Jennifer Staude, Adult Social Worker of the Year, 2018 ‘ (Jen) has won the confidence of the other professionals and most importantly service users! Brilliant’

The Social Worker of the Year Awards exist to raise the profile of social workers as they support people to live great lives and to change the systems that influence lived experience. Over nearly a decade, the awards have consistently developed our approach, striving to do more to support our purpose. Here are six lessons that we have learnt along the way that might help with thinking about social care futures:

 

  1. Great practice needs to be nurtured: there are employers who foster a culture of recognition through practice development that facilitates the leadership shown by great practitioners. (A particular shout out for the sponsors of the awards and those who have repeatedly sponsored and supported our work!)

 

  1. We need a narrative about good from people with direct experience of social work that changed them. The awards continue to develop the direct involvement of people with lived experience. My personal reflection is that there is untapped power in the stories that people tell about social workers which set an expectation of courtesy, understanding and building up self-control. When hospital social worker, Vidhya Bju became the Overall Social Worker of the Year in 2017, the testimony of friends and relatives of people she had worked with rang out; “if ever I needed a social worker, I would want it to be Vidhya’.

 

  1. Social work needs great story tellers from more than just social care background. In 2018 BBC News Reporter Ashley John-Baptiste shared his story of how his social worker made Cambridge University possible for him. James Corden made a surprise interview from his US studio that you can find on social media illustrating the power of such support. We’re indebted to our amazing patron Lorraine Pascale, and many of us (ok, me!) share the gratitude that her social worker introduced her to cakes! Lorraine’s support, alongside her tweets and blogs link the awards and the sort of social work to the public in very different ways.

 

  1. Social work is at its best when it stays grounded in social justice and human potential. The awards centre on the international definition of social work and over recent years have put more stress on the balance between great work with people and the requirement of social work to promote social change. The awards to Social Workers Without Borders, Norfolk’s People From Abroad Team or to Carolyne Willow of Article 38 amongst others illustrate that these values are alive and well.

 

  1. Social work’s edginess and image mean we have to work hard at creating new spaces for political support. The Awards have enjoyed consistent support from our political patrons, Tim Loughton MP and Emma Lewell-Buck MP who have built up Ministerial support and involvement over recent years which we hope to sustain. Their tours and talks at our winner’s reception in Parliament do much to open up an understanding of the context around social work and public policy. Many of our sponsors have strong local political leadership who ‘get social work’ and are delighted to support it.

 

6. We can do more and the Awards want to continue to develop. We are being led more and more by people with experience and by social workers. We want to develop an offer to learn from the amazing practice of social work that we recognise and we continue to strive to shape public understanding. We are undertaking some survey work with the University of Birmingham to help us further understand our impact.

We have just shortlisted entries for the 2019 awards so look out in November for the stories about the 2019 winners. There is little doubt that their work will show the development of social work values rooted in ‘social justice, human services and human potential’. (To borrow a phrase from one of judges, Clenton Farquharson MBE).

The life changing role played by a great social worker was brilliantly captured by a person receiving social work from Sian Miljkovic, the Student Social Worker of The Year 2018:

‘When you knocked on my door, you literally turned my life around. Finally, there was a woman who understood and knew exactly what to do to help. My eyes have been opened and I feel free.’

So great, life changing social work is out there: it’s innovative, brave and builds the confidence and freedoms of those who experience it. Sometimes the last people to see the power of social work can be social workers themselves and the Awards continues to work to raise the level of support for a culture of reward and recognition. As we continue to debate reforming adult social care, perhaps we need at times to remember the refrain from the Imitation Game that there are people doing things that can’t be imagined and make the aim of further reform to create the conditions where we can imagine social work being this good (and better) everywhere.

Peter Hay, Chair, Social Worker of the Year

@peter_hay