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Are we expecting too much ?

22 Aug 2018

By Edel Harris – Chief Executive, Cornerstone

There is no getting away from it – things in social care are challenging and it seems they are getting worse . With the emphasis on austerity and the resulting public service funding crisis, the social care sector in the UK has become an industry that in many cases has lost the focus on the person requiring care and support. Time and tasks have become the order of the day with often stressed, low paid workers following a schedule that has more in common with a manufacturing production line. The financial power sits with the commissioners of the service who are under enormous pressure to work within very restricted budgets (and often don’t feel very powerful) Unfortunately this now effectively means the trading of a commodity to the lowest bidder is commonplace and pricing that commodity to support good support or include a decent rate of pay for the person delivering the care, has become increasingly rare.

This is not going to work – especially for the future. In carrying out some market research with the people we support and their families and holding focus groups with people in the age range 25yrs-45yrs who had never had any involvement or connection with social care or social work services more generally, it was fascinating that the aspirations and expectations of those already in the system were so much lower than those who were approaching the market research as consumers with no point of reference.

It doesn’t have to be like this. Our research and more importantly our conversations with the people we support, tell us that individuals who require care and support have very reasonable expectations – they want to be supported by a small team of people who know them well and share their interests and by people with professional skills relevant to their disability or condition; they want caring and empathetic people in their lives who use their imagination and creative skills to design services with and around each unique person; and families in particular need practical help and advice to navigate the system.

What can we do? We are interested in the roles and responsibilities of support providers in this context. Despite the constraints of commissioning practices and funding cuts, we as providers have responsibilities to use our commitment to people and our experience and creativity to help build a better social care future.

We want to be part of a progressive support provider community sharing ideas and approaches and coproducing the future with people using support. To that end I want to offer a very brief glimpse of the journey we are on.

One of the main objectives of our new model is to continue to put the person at the centre of our activity and assist them to live the life they choose. Our ship wasn’t broken. Despite all the pressures, like many other organisations we believe we were continuing to provide good quality care and support. However the ship was creaking and we recognised that if we wanted to continue to meet our charitable purpose – to enable the people we support to live a valued life – a life they choose – we needed to have a serious rethink about how we did things.   We were delivering on our contracts and doing that well but there were serious limits to us being able to do all the additional things that allow the people we support to live a valued life. There was never enough time, there was no additional budget, and there were so many policies, procedures, rules and regulations which meant we were spending far too much time on paperwork and bureaucracy – valuable time that could be spent with the people we support.

Cornerstone was not established solely to be a provider of contracts on behalf of local government.   These important contracts became the vehicle upon which we could deliver our charitable purpose. However in recent years, our contracted care often provided just the minimum with less and less opportunity to genuinely place the person at the centre and provide a truly person-centred service. The human relationship between the person requiring care and support and the care-giver is critically important. It is one of the most intimate of transactions and should be delivered by people who are trusted to do a great job. This is one of the things we hope our new model will address.

What does that mean in practice? Genuinely valuing the social care profession is something we feel really passionately about. To this end we have introduced a flat operating structure of up-skilled, professional carers working in neighbourhood self-managing teams operating within a culture of empowerment and trust. Conversations about paying our colleagues the living wage have become irrelevant.

The current system serves no one well. It doesn’t have to be like this

It’s hard to put a transactional value on care and yet we all instinctively know when a human relationship, whether with a family member or a paid professional, is literally worth its weight in gold. I don’t think that is asking too much – do you? We want to be part of a better #socialcarefuture and are excited to contribute to a growing social movement to share and learn with other support providers, people with lived experience and others.

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