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Health and wellbeing

Towards resilience: making community matter in social care

Ahead of our event exploring the role of community in providing social care, Caroline Speirs, head of the Think Local Act Personal partnership, shares her thoughts on how our shared experience of the pandemic can help to transform social care so it works better for everyone.

A well-known proverb says ‘it takes a village to raise a child’. This has always struck a chord with me in relation to my view of social care. Since our inception ten years ago, Think Local Act Personal (TLAP) partnership has been all about promoting personalisation, with the basic but fundamental idea that support should fit around people rather than the other way around.

We have always understood that social care is much more than the provision of formal care services, important as these are. Our approach is best exemplified in the phrase ‘people want a life, not a service’. The role played by communities in caring for and about each other is a crucial element in a personalised, resilient and sustainable approach to social care.

Despite huge efforts by all parts of the workforce, the pandemic has only highlighted the shortfalls in the care sector”

Seven years ago, parliament passed the Care Act 2014 which was intended to overhaul social care in England by formalising the role that local authorities should play in our care system. However, despite some progress since then, the aspirations of the Care Act have fallen short of its ambition. Buffeted by a decade of austerity, local authorities have struggled to retreat from life-and-limb maintenance and move towards supporting people’s independence and wellbeing. Despite the huge efforts made by all parts of the workforce – and I include in that the vast number of unpaid family carers out there – the pandemic has only highlighted and reinforced these shortfalls in the care sector.

During the first phase of the pandemic, with the support of TLAP partners and our allies, we undertook a rapid evidence review on the impact of people accessing care and support during the crisis. We published our findings in our report, A Telling Experience, which highlights common problems faced by people who draw on care and support.

Communities need to be made – they require individuals coming together with the support of local and national government”

The report uncovered difficulties with communication, a lack of co-production through citizen involvement, a fragmented care market, and a narrow focus at central government level on social care skewed towards care homes. There was also a strong sense that social care is largely subordinate to the NHS. And, as been widely discussed, the impact upon groups that are the core concern of adult social care – namely older and disabled people (including people with mental health needs, learning disabilities and autism) and non-white people and communities – has been profoundly unequal.

But our review also succeeded in capturing examples of what does work – such as when councils and other organisations committed to holistic and innovative approaches responded with agility and flexibility. At its best, there was willingness to share power with people and providers, to act on trust, and take some risk for a common cause. The response to the pandemic also highlighted the role of community, where we have seen local people come together to look out for one another with the rapid flourishing of mutual aid groups and exponential rise in volunteering.

It is now time to take stock and see what lessons we can learn and build on. We are aligned with and support Social Care Future, a growing social movement that is articulating a bolder and more optimistic future for social care based on this vision:

We all want to live in the place we call home with people and things that we love, in communities where we look out for one another, doing things that matter to us.

An ‘asset-based’ approach, which seeks to pool all resources (state, community, as well as the individual’s own) will help to achieve this. The pandemic has illustrated the transformation that can be achieved when state, communities and individuals work together, and we want to build on this. This also means ramping up co-production; that is, sharing power and decision-making with citizens and communities. Co-production can help the sector to develop and spread models of care and support that are rooted in people’s lives, rather than a narrow menu of services that has changed little over the last 30-plus years.

However, it is important to recognise that not all communities are in a place to be able to transform their care landscape. Poverty, discrimination and social exclusion must be grappled with in social care, as in all areas of public policy. Community is not just defined by place; there are communities of interest and identity as well. ‘Community’ is not a universal construct, nor is it a simple panacea. In a real sense, community and communities need to be made – they require the agency of individuals coming together with the support of the state, both local and national, together with the contribution of intermediary organisations such as the voluntary, community and social enterprise sectors.

During the pandemic we have seen great examples of where the statutory sector has responded positively to support the voluntary efforts of local people. As we move forward, we need to rethink the roles and relationships between the state and citizens. In the context of social care there are important questions over what councils and other parts of the formal care sector need to do (and not do) to enable communities in all their myriad forms to look out and care for each other so that we can become that village that works together to raise a child.

We’ll be discussing these important questions further at our upcoming webinar hosted in partnership with Local Trust on 23 March.