In the heat of an election, it can often be forgotten how important the role of evidence is to the making and implementation of good policy. This is especially true of adult social care where we have often lacked good quality evidence. The role of IMPACT is to ensure that good evidence is used to shape policy and practice in adult social care with the goal of ensuring that people receive high quality care and support.
This short briefing highlights some important evidence about what works in adult social care. It asks the political parties to consider this evidence in shaping their thinking on pitches to the electorate. We hope it will be picked up by whichever Government comes to power after the election, as a guide to some priority areas for policy, training and investment.
Download the full briefing here, or read our recommendations below.
IMPACT is the UK centre working to improve adult social care across the UK – by making a practical difference to services and people’s lives. We know what works by using extensive evidence and working with people who draw on care and support and their families, front-line staff, providers, social care leaders and others.
Adult social care is currently facing a series of really difficult financial, service and workforce demands and issues, and with a General Election approaching there has never been a more important time to focus on these. However, social care is not just a set of ‘services’, it has the potential to support people to live a good life.
We hope this brief will be of interest to people in all four UK nations, but we recognise that the General Election will not directly affect social care policy in Wales, Northern Ireland and Scotland, where devolved administrations have powers for health and social care policy.
At this critical time, there are five key areas for action to improve adult social care, create a system that better meets people’s needs and help us all lead the lives we choose. We are calling on all political parties to:
Enhance voice, choice and control
What’s the problem?
People who draw on care and support need to have a much greater voice and have more choice and control over the care and support they receive (including what services they receive and how, when and where support is provided). Evidence suggests that progress has stalled, and in some cases, even reversed in recent years.
Very few people in the UK know about, or are able to access, ways of getting care and support that would help them have more choice and control. These include Individual Service Funds or co-operative models. There is evidence that IMPACT has produced showing that minority ethnic communities face significant barriers in accessing support to enable them to exercise choice and control.
What needs to happen?
Wherever people are – in their own homes, in hospitals, or residential settings – people need to make their own decisions, big and small, about their lives. The next government needs to work with people who draw on care and support and their families to co-produce ways of designing and planning their own care. Alongside this there needs to be accessible information to develop high-quality personalised care.
Ensure people stay healthy, connected and well at home
What’s the problem?
People have a right to lead good and independent lives at home.
Everyone knows that we need more preventative action, but it can be really difficult to achieve this in practice, in a system designed with crisis-focused, episodic approaches, in which stretched services have to prioritise meeting the most urgent needs. Policy in each of the four nations highlights the importance of prevention but it still feels a long way from the mainstream reality.
What needs to happen?
·An ambitious innovation programme needs to be established to support small scale exemplars of innovation in early intervention and prevention to reach scale across the country.
Create the workforce we need – now and in the future
What’s the problem?
The social care workforce is currently understaffed, it can be poorly paid and many workers experience poor working conditions. Recruitment of caring and values-driven people into the sector is one of the greatest challenges we face.
There are many problems we need to overcome. Firstly, social care is too often seen in negative/crisis-laden terms (so we need to re-frame the importance of care and relationships) which puts people off joining the workforce.
Secondly, we may sometimes have recruited into social care in quite traditional ways, which means we are not attracting new people to the workforce or keeping the right people. Finally, when people have joined the sector, we often don’t support them well enough or pay them well enough.
What needs to happen?
There needs to be a national shift in the narrative about adult social care. Values-based recruitment can only be successful if the people being recruited are valued, and the work that they do is valued. The system is failing – not the staff. Fair pay, genuine recognition for their work, and opportunities to develop and progress would encourage a lot more people to work and stay working in social care.
Build on the strengths of people and communities
What’s the problem?
Public services have sometimes been based on what people can’t do, rather than on the skills, strengths and relationships people draw on to live their lives. Progress has been made towards building better services including person-centred planning, family group conferencing or outcome-focussed approaches and there is more work to be done. In policy and academic circles, approaches which build on the strengths of people and their communities are often referred to as asset-based approaches, and feedback from people with lived experience suggests we should adopt more accessible language when referring to these approaches.
What needs to happen?
A national programme should be created that supports local authorities and statutory partners to develop a network of community-based hubs which adopt a community development approach. These should include activity-based funding to support voluntary and community organisations and which have empathetic and well-connected link workers or coordinators.
Make integration a reality – starting with the person
What’s the problem?
Integration between health and social care has been much promoted as an answer to many of the challenges we face in both sectors including the fragmented nature of services, and the lack of joined-up support provided to people. Progress has often been limited. Previous attempts to integrate have become unstuck because they have overly focused on structural and organisational changes as the solution, rather than starting with the person being supported and their specific and often complex needs and aspirations.
There continue to be people who are stuck in hospital who do not need to be there, and it is essential that, once and for all, this problem is addressed.
What needs to happen?
The next government should make sure that plans and guidance given to ‘integrated care systems’ treat social care as an equal partner in setting priorities and implementing them, ensuring there is no competition for staff and resources.
A statutory obligation should be imposed on local NHS organisations and local authorities to support people out of long-stay hospitals to live good lives in their local community.