This article forms part of the LGA think piece series 'Towards a sustainable adult social care and support system'.
Without doubt, last year’s snap election pushed adult social care up to the top of the political agenda. The Conservative Party manifesto launch set out the Prime Minister’s commitment to reform social care and place this essential service on a stable footing through measures that were part of a wider drive to address inter-generational fairness concerns. This reignited previous debates, particularly from the 2010 election, over the best way to fund social care. The upshot is a Government green paper on care and support reform for older people that we expect before Parliament’s summer recess.
In my 25 years of public service, I can’t remember a general election that was ever being fought on social care, a tribute to the work that the LGA with ADASS has done over the past five years in highlighting the significant resourcing challenges facing adult social care alongside a recognition that society is changing and we need to have a model which is future proof.
However, and perhaps even more significantly for adult social care over recent times has been the double-edged sword of the connection that has been established in the eyes of politicians and the public that the winter pressures in the NHS are attributable to the funding crisis facing social care. Whether or not that is true, it certainly has got traction as additional monies through the improved Better Care Fund now become increasingly linked to achieving system flow in the NHS.
Stretching or some could say undeliverable targets for delayed transfers of care, underpinned by a new Care Quality Commission inspection framework for poor performing areas has led to significant amounts of leadership time being placed by directors of adult social services and their teams up and down the country through A&E Delivery Boards, health and wellbeing boards and sustainability and transformation partnerships to address this challenge. In Cornwall, over the last month, adult social care senior directors have been involved in twice daily meetings to help to move the health system from OPEL 4 to OPEL 2 despite the adult social care delayed transfers of care figures being at their lowest level from averaging over 70 down to less than 20.
But alongside this, there is a growing confidence in reclaiming the role of community based social work as in many areas including Cornwall, the adoption of the Three Conversations model is changing the way people are supported. This new approach requires social workers to have a much deeper understanding of the range of opportunities available in the community and to work with individuals and their families to find solutions that really work for them. With less focus on individualised models of care management, social workers are collaborating more with each other, with partners and with other colleagues in the local authority.
This wider perspective is essential. With increasing demand pressures for health and care, we need to work differently.
Adult social care has a key role to play in enabling families and communities to play their part in supporting vulnerable adults.
Through deeper conversations with families and individuals social workers are getting a much richer picture of the interventions that really make a difference connecting people with each other and securing in the case of Cornwall a 10 percent reduction in new packages of care.
Social workers should also be shaping how our communities change and grow. In Cornwall through this changing approach, social workers are working with Community Link Officers to set local priorities for investment.
With councils up and down the country focussing on growth and creating homes and jobs, having social workers able to play their part in shaping the offer is key to meeting future demand.
In Truro, this is resulting in discussions involving Falmouth University and Planning to look at new models of inter-generational living in the city centre with students living alongside older people working together to use new digital technologies to improve lives.
Social care is an essential part of the local government family. It is about enabling all individuals to live a good life as valued members of society. For many people that it supports, this will need to be achieved through working closely with NHS colleagues but it’s more than that. In the past the debate was epitomised by debates about a medical model of disability versus a social model. Now I think it is more important than ever to remind ourselves that only 10 per cent of health gain comes from health and care services. A social care service that connects the way in which we deliver social care to those wider factors that keep people well such as work, housing, social interaction and friendships, a good environment is more needed than ever.
Kate Kennally
Chief Executive, Cornwall Council