06
Feb 17

Social care: it's time to change the script

Posted: 6 February 2017

Late last year, Skills for Care and Professor Peter Beresford hosted a meeting of academics with a background in adult social care, practitioners, third sector organisations and people who access care and support services, to consider how a fundamental repositioning of social care and social work in the 21st Century might be achieved, as part of a wider health and care settlement for the future. Today, we briefly summarise the wide-ranging discussion which took place. Note, the views expressed are not necessarily those of Skills for Care.

Introduction and context

Since this discussion in November 2016 social care has had several ‘Today Programme moments’, rising rapidly up the political agenda. This is continuing in 2017 and we are see continual and growing calls for a sustainable long-term solution to how we deliver high quality care and support. The task facing the sector is to agree how to organise and mobilise its voice in support of that ambition. It was for this purpose that Skills for Care and Professor Peter Beresford agreed to facilitate a meeting of academics with a background in adult social care, practitioners, third sector organisations and server users to look at how we might achieve a fundamental repositioning of social care and social work in the 21st Century as part of a wider health and care settlement.

This document briefly summarise the wide-ranging discussion which took place in held by an invited group of social policy experts, practitioners, service users, academics and third sector organisations, which took place in Skills for Care’s London office on 15 November 2016. That discussion sought views on how the mass media and wider public’s largely negative view of the status and profile of adult social care had come to be the dominant narrative; and what would need to happen to challenge that by repositioning the sector’s achievements in a positive light. The nature of the conversation was necessarily high-level including the functions of social care and social work which have differences not always widely understood by the public and the alliances that would need to be formed to effect change.

Skills for Care and Professor Peter Beresford hosted a discussion on Tuesday 15 November 2016, to begin the process of developing a new and different narrative for social care: one that would challenge the old, largely negative stereotypes and celebrate the immensely positive contribution social care makes to society – not only in terms of job and wealth-creation but also the sector’s proven ability to adapt and grow as society changes.

The event was chaired by Professor Martin Knapp of LSE, who introduced four speakers:

  • Professor Peter Beresford - Professor of Citizen Participation, University of Essex
  • Dr Rhidian Hughes - Chief Executive, Voluntary Organisations Disability Group
  • Dr Josephine Kwhali - Senior Lecturer in Social Work, Coventry University
  • Colin Slasberg CQSW - Independent Consultant, Social Care

 

Each speaker presented powerfully, drawing on their own experiences, their view of the sector’s history and from further afield. All presenters looked at the barriers, opportunities and the necessity of creating a new, more positive conversation at a national level: a conversation that has to be inclusive and place the voices of those who need care and support at its heart; and one than draws on the experience of freedom movements, social movements and successful behaviour-changing campaigns everywhere.

After the presentations came table discussions designed to capture ideas, suggestions as to who the actors needed to be, the next steps to involve them and how to help shape the new narrative.

There followed a panel discussion in which speakers reflected on the discussion, an opportunity for delegates to state individual actions they would take from the day and some next steps (see end of document). After that, the panel reflected on the day.

The event represented the start of a process, not the end: all agreed the endeavor was worth doing and worth doing well.

 

Peter BeresfordSpeaker 1: Peter Beresford - Professor of Citizen Participation, University of Essex

For the last 30 years there has been a constant search for the ‘new’ in social care and yet it remains in long term crisis. We have had patch/community social work, normalisation, care management and privatisation from Mrs. Thatcher, direct payments from the disabled people’s movement, person centred planning and now personal budgets, the Netherlands Buurtzorg system and ‘the three conversations’ model. Most promise better for cheaper; all but a couple have so far failed on both counts. Meanwhile the crisis is getting worse.

What hasn’t changed is that social care remains needs and means-tested like the failed poor law before it and is grossly underfunded, despite massively increasing needs resulting from major demographic change.

Social care is presented as a deficit policy, creating financial burdens, when it can better be seen as a wealth creator, improving our personal, social and economic lives, alongside policies like health and education. It can create valuable support, saving personal costs and offer life enhancing employment and careers, part of an alternative to an unsustainable growth based economy, generating human social capital and wealth?’

Social care’s future needs to be considered in relation to two overarching questions:

  • How should we look after each other in a twenty first century society?
  • When did it become contentious to look after each other in society?

 

Rhidian HughesSpeaker 2: Dr Rhidian Hughes - Chief Executive, Voluntary Organisations Disability Group

Rhidian spoke of the disparities about public discourse on disability - including by the media – where on the one hand those with disabilities were in his view being described as scroungers, yet initiatives such as the Invictus Games presented disabled ex-Forces people as heroes. Rhidian talked about the potential learning from the NDIS (Australia’s National Insurance Disability Scheme) to understand how to successfully reposition social care and how a positive shift in public consciousness might be achieved. Rhidian added that important lessons could be learned in the UK using similar techniques to ensure voices and messages are heard - not least through social media. Rhidian posed the following questions:

  • How can we use the learning from NDIS (Australia) as a way forward?
  • How do we better get people who are users of social care to lead a campaign?

Rhidian was clear that for a movement to work, there needed to be a single narrative acting as a wellspring; MPs should be asked to champion a new narrative; social care providers would need to let go control of the message – an uncomfortable idea for many - in order for a wider movement to happen; and added that social media was an essential ingredient eg #everybritcounts

 

Speaker 3: Dr Josephine Kwhali - Senior Lecturer in Social Work, Coventry University

Josephine opened her presentation by remarking on the relative passivity of the social work profession now, compared to nearly 50 years ago. In 1968, the then highly influential Seebohm Report inspired the birth of the modern social work era, in which there was energy, idealism and commitment to reshape the profession and focus on families and communities for the wider benefit of society. Josephine suggested that social work has perhaps too easily lost its ‘radical edge’ and merely accepted the current narrative whereby people are responsible for their own adverse circumstances. Josephine also spoke of her fundamental belief that most people are of good will but that the profession needs to be far more assertive in its beliefs and values. Josephine added that 2018 will be the 50th Anniversary of the very influential Seebohm Report and this would provide a possible hook for a concerted campaign and celebration social work’s achievements and also embracing social care. Josephine asked:

  • What has become of the social work profession?

Josephine was clear that to strengthen the conversation, a coalition of the willing must be brought together: it must stand with those who are voiceless or vulnerable. The Seebohm Report contained a vision of social care rooted in communities driving betterment for all. In 2018 it will be 50 years since Seebohm – this should be used as a springboard to help the sector celebrate the start of modern social work and how much progress has been achieved since then.

 

Colin-SlasSpeaker 4: Colin Slasberg CQSW - Independent Consultant

Colin based his presentation on what he sees as a fundamental wrong. For many years there has been institutionalised conflict in the way ‘need’ is perceived by local authorities. He argued that the national approach to managing the tension between needs and resources results in a circular approach to ‘need’, with councils only declaring a ‘need’ if they have the resource to meet it:’ This is politically expedient as it means ‘eligible’ needs are always met, no matter the level of funding. However, it is deeply damaging to practice and the practitioner/service user relationship. Colin said we need to free up practitioners to work in partnership with service users to articulate authentic need. This would also reveal the true cost of meeting social care needs, which will enable political leaders to take responsibility for the level of need met and not met.  Colin asked:

  • How can we challenge sector and political leaders to understand this?

Colin finished by pointing out that only by telling leaders what they need to hear rather than what they want to hear can the system justifiably claim to be on the side of service users.

Table discussions

Tables then discussed what they had heard and were asked to report back the ideas and suggestions they had come up with. There was some challenge on how to ensure any progression of this work addresses issues of inequality and particularly racism and disablism. We need to positively engage communities in making a difference, ensuring that activists in race and disability movements lead the thinking.

It was agreed that the first step is a report from the day to mark the event, capture the discussion and share more widely. This paper is that report.

Next was that a group drawn from those attending should create a script as a starting point for more detailed discussion about what this would be. It would draw on the discussions at the workshop, the good things people saw in the Care Act and on any previous work people would point us to.  It would draw in lessons from work on how public issues move from evidence to policy and from the work discussed in Australia. The focus for action could be the 2018 anniversary of Seebohm. 

The draft would then be used to widen out the discussion with others and for further development, and it would be good if members of the groups and organisations attending the workshop helped to facilitate this. The group would need to think about how to educate and involve young people in its development, potentially educational policy-makers and the experience of young carers, any future campaign drawing on the energy of the young and building community understanding of how social care and caring benefits the whole community.

If possible (i.e. resources permitting), this could all be linked to establishing a Seebohm commission, with a call for evidence and to report in 2018 on what happened to implementing Seebohm and where do we need to go from here. 

The colleagues present also spoke of the need to acknowledge the contribution of black and minority ethnic group communities, educators, social workers and social care staff and users. There was a time when the ‘script’ for social work and social care included a commitment to issues of equality and anti-discrimination but that contribution has not always been heard or acted upon.

A wide range of groups were identified as potential members of a coalition or alliance of the willing. These included public sector bodies, trades unions including NUS, providers, key members of the media, politicians across the spectrum, community organisations and the bodies that represent people who access care and support services (as well as they themselves). Also mentioned were the Guides and Scouts movements as having great potential to engage.

Resources for involving others in a wider discussion about the draft script (e.g. paying expenses for service users to attend events) would have to be considered.  The wider discussion would help to develop alliances and establish a mix of top-down and bottom-up initiatives and connections to broaden the social movement.  As the new script was developing it would be good to have discussions with others more expert in how to directly communicate with the public to make the sure the messages are communicated in a way that people will connect with.

There was a consensus that the sector itself needed better communications with public, between disciplines and greater information and advice for people using care and support services – before the need them.

Important to use personal biographies and life stories to help explain the sector in ways the general public can understand. Real stories will help improve public perceptions of the sector by focusing on the many positives to be found. There was widespread acknowledgement that the media’s role is naturally to report on the bad news, not the good (unfortunately).

 

Individual pledges

Professor Martin Knapp asked all the participants what they intended to do to help create a new narrative after this meeting. Individual responses included:

  • Talk with my manager about what we can do
  • Speak to friends and neighbours – for example, tell them what I do - I help people
  • Announce at forthcoming national conference there is a report, movement, join us
  • Ensure this is talked about within Public Health England sponsored Learning Disabilities Public Health Observatory – and that materials being developed reflect our conversations
  • Let groups with parallel concerns know of our meeting and aspirations – work towards coming together under one umbrella / one voice
  • Talk to people currently outside of social care about my personal experience of how suddenly you may need it
  • Start a Hashtag  #ProudofSocialCare
  • Publish this work in the international Disability & Society journal
  • Write to Guides Association about engaging with social care – others said Scouts too
  • Engage with 11,000 LSE students via fresher’s week
  • Speak about this every time every place everywhere, never let social care be  undermined
  • Offer of a virtual Australia NDIS meeting to help the group discover what has been achieved elsewhere
  • The Guardian to champion 50th Anniversary celebrations
  • Go back to my organisation and extend the dialogue
  • Revisit data on what people know or don’t know about Social care and reignite writing about this

 

Panel feedback

Panelists agreed that parallel conversations regarding this topic needed to be joined up as early as possible – to make sure the work is aligned. Work needed to be done to define the narrative; so that any messages would need to resonate with the public using the language of every day; and messages should support the proposition that improving status of social care and pride for recipients and providers was central to this. Panelists agreed on the importance of learning from other sector groups and exploring who can be brought into the discussion and how can this be resourced. It is vital to make inclusion in the process real. They liked the idea of an Anniversary Commission could be set up for the Seebohm Report.

 

Next steps

Skills for Care will support the steering group to draw similar conversations together.

Our original steering group should discuss how to define the tasks we need to do next, including learning the lessons from elsewhere. On this point, Rhidian kindly offered to get in touch with NDIS to see if a conversation with them is possible.

More widely, partners agreed that in order to help ‘fundamentally reset’ public understanding about social care (in its widest sense) the following outcomes were needed:

  • Alliances need to be formed across the sector but in addition, new voices need to be recruited from across civil society and non-governmental organisations
  • Other, similar conversations needed to be joined together to avoid duplication
  • Work was necessary to define a new script; what was in scope; who ‘owned it’ ie should there be a master version from which a number of complementary campaigns could draw
  • The voices of service users needed to be central; a social movement was most likely to engage the public and help inform a national conversation.

 

Ends.