It will take more than money to create an excellent social care system for the elderly in the UK. Thinking at root level about how we define good care and good lives would be a good place to start when building a system in which we could take pride. Why not begin with humanity and kindness?
Our national debate about adult social care in England arises from two prophecies of doom. Firstly, we know that people are getting older, and those with complex needs are living longer. Our public authorities are consequently stretched and care has become synonymous with the penury of local authorities. Our second prophecy is much more personal, and concerns our own financial risk. For those with modest housing assets we associate social care with the prospect of losing everything, should the great lottery of life result in a long period of residential care. No wonder social care has become our public policy Jeremiah, a foretelling of great lamentation and calamity.
Money, whether personal or institutional, is an undeniable fundamental problem in social care. (In which area of public policy is this not the case?) So it is not that our national debate is based on false premises, as both population pressure and the potential for catastrophic personal care costs are very real and require attention. However, solving the “money” problem will not, in isolation, create the care system we need.
It was in this context that last year, Jericho Chambers and Grant Thornton began to create a community interested in a new debate. Without ignoring the meta is- sues in policy, politics and funding, we have begun to describe a way that social care can change itself, from the ground up. We are calling the body of work we have developed “A Caring Society” which in its naming deliberately shifts emphasis away from social care as services provided by institutions.
We began our work with the knowledge that great things are happening in social care up and down the country.
Often on a small-scale basis, a movement of “asset-based” practitioners and organisations are beginning to redefine good care and good lives. By thinking about the strengths of family, friendship and community that surround us all, people in need are being liberated from the straitjacket of service solutions into real help in their lives that enables enjoyment and fulfillment. But these developments are of- ten too small scale to make the difference they need to, and continually hit the barriers of the time and task strictures so prevalent in our organisations and institutions.
Yet we can change this dynamic. The answers are local, and require system leaders, people with lived experience and communities to come together with a new agenda based on three linked questions:
1. What do we mean by care?
We will never change our system if we think care is measured by money, time and task. If we think of care as broad- er than services we pay for, we can start to tap into the abundance of humanity and kindness in our communities
2. What should the local state do?
A new meaning for care creates a new role for the local state. Councils are currently commissioners and little else but should be activists and connectors for the system, using data better, intervening in care markets, investing where needed and championing quality of outcomes.
3. How can we accelerate innovation?
A more vibrant local state would allow innovation to flourish, scaling up what works, bringing new technologies into the system and giving people the products and services they would demand from any other area of our economy
“We know there is change in the wind”
Our programme of roundtables has addressed these questions with help from a stellar list of provocateurs such as Hillary Cottam, Julia Unwin, Georgia Gould, Donna Hall, Alex Fox and Brendan Martin. But building a Caring Society is a work in progress, with incomplete answers. In July we will hold our first Caring Society conference, which will mark the transition from discourse to one of action.
We know there is change in the wind. There are many leaders in social care with vision and purpose in our system. Our hope is that the Caring Society formula can accelerate the progress these leaders are already making by providing a framework for collaboration and action.
Optimism in social care can’t be found in the corridors of power or in our media. But our communities are rich in as- sets and solutions. We’ve just been looking in the wrong place.
Alex Khaldi is Partner and Head of Social Care at Grant Thornton. He is a deal shaper, consultant and delivery expert in local government and health- care and has written extensively on the challenges facing adult social care and is a regular speaker at conferences and events. His expertise includes: adult social care transformation and cost saving, out of hospital healthcare, urgent care systems, business case development and benefits realisation, local government commercial management and revenue raising, and behavioural change and demand management. Based on the organising thought “how can we build a Caring Society?” Jericho Chambers has been working with Grant Thornton to shape a framework that helps enable a paradigm shift to transform adult social care.