Readers will be well advised to read a very interesting and provocative article in The Spectator on the need for reform in the social care system, concluding the system needs much more than just fresh cash.
The article, by James Mumford, who led a review of social care for the Centre for Social Justice, argues that funding is not the only answer for social care. Especially since, as implied in the last general election campaign, many seem unwilling to countenance a change in funding in order to fund those in need.
As Mumford points out, though, as we have consistently said on this blog, that lack of funding is not the only issue with our care system: “It is not a funding issue when a resident isn’t given a glass of water. It is not a funding issue when people in charge fail to deliver. And it is also not a funding issue that we, so often, look the other way or quite simply stay away.”
Mumford points out that when people are moved into a care environment, they are typically cut off from their possessions and their social connections, and are seldom given the opportunities to develop new ones. As a result, their mental well-being deteriorates along with their physical health. Mumford references a recent social experiment broadcast on television where children entered a care home and caused an increase in the physical health of residents, evoking a similar scheme in the US.
Mumford also echoes Advantage’s calls for us to think bigger and in a more imaginative way, citing the proposal from a New York doctor for smaller but more homely facilities for the elderly. Above all, he stresses the need to end the “marginalisation” of the elderly. There are no shortage of ideas to help with this. One idea mentioned in our Future of Care report called for housing schemes to be designed around the young and the elderly.
Increasingly, the mood seems to be that funding is not the only answer for care. Instead, we need radical and progressive thinking that recognises the need for a change of culture and mindset.
Although the media will no doubt focus on the negatives, a new CQC report on the state of care in mental health services has actually uncovered a lot of good news.
A study of mental health services conducted between 2014 and 2017 has found that 68% of core services provided by the NHS are good and 6% outstanding, while the ratio is 72% and 4% respectively for independent services. Among those services for which special praise were delivered were community services for those with learning disabilities or autism. Even providers labelled as requiring improvement have made “real progress”.
Unfortunately, the report also highlights a “substantial minority” of services where improvement is needed, and cited a number of familiar areas of concern, including staffing shortages, locked rehabilitation wards, poor quality clinical information systems, and the variation in the use of physical restraint and restrictive practices.
The latter is certainly a hot topic in the sector today, and the reason behind Skills for Care’s recent push on positive behaviour support. Clearly, services needed to embed the latest guidance in their training programmes more deeply to achieve change.
The full report and data is available on the CQC website.
The results of an Advantage survey for a new report on the Future of Care show that many in the care sector are pessimistic about the future of the sector and the quality of care.
The survey asked respondents to rate their optimism about the future of the sector out of 10, with 10 being very optimistic, and 0 being very pessimistic. The average rating was just 3. Of those that delivered very low ratings, the main reason stated was a fear of demand outstripping supply and funding. Only 13% of respondents gave a rating of 6 or above.
A majority also felt the quality of care would suffer in the foreseeable future. Of those that answered ‘Other’, the general feeling was of stagnation.
Why did our survey respondents feel so negatively? What can we do to help our social care system prosper? Download our new report on the Future of Care to find out.
Skills for Care are ramping up the publicity on their Leadership Programme, which is open to applications.
Skills for Care have a raft of leadership programmes (with a discount for members) that many seem unaware of. Although it can be hard to take time out of an organisation, it’s always important to ‘sharpen the saw’.
If you’re a leader in a care organisation and you feel like you’re constantly under pressure, then this is an opportunity to work ‘on’ the business rather than ‘in’ the business.
You can apply to the leadership programmes here.
The Social Institute for Excellence has published a new highlights paper on how intermediate care can deliver better outcomes for people in care.
The report has found that effective intermediate care reduces pressure on hospitals and on social care settings. For example, it has found that 72% of people who received intermediate care did not move into a more dependent care setting, and 70% who received intermediate care after a hospital stay returned home.
Intermediate care is designed to treat people to prevent the need to go into hospital or care. It is delivered prior to, or after a hospital stay, and aims to promote independence. Although it is not a new idea, it has received fresh attention with the drive to reduce pressure on the NHS and social care system.
However, it seems that there are a number of challenges to implementing intermediate care more widely, with the report citing effective leadership, integration, and unrealistic expectations. Of course, these seem to be challenges across the whole spectrum of health and social care.
What do you think about intermediate care? Do you think it is deserves more attention?