People at the Heart of Care – time to make the rhetoric a reality

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People at the Heart of Care – time to make the rhetoric a reality

Written by Maggie Kufeldt

The adult social care reform white paper – People at the Heart of Care was published in December 2021. For experienced Directors of Adult Social Services like myself, it would be easy to view this as ‘just’ a continuation of the strategies lots of us have been employing for years to try and achieve good outcomes for and with the people we are here to serve. And to treat the content with a little bit of cynicism.

However, the paper actually stopped me in my tracks and provided me with a real point of reflection about the state of Adult Social Care. We’ve come a long way when it comes to putting people ‘at the heart’ of what we do, the action we all need to take to ‘fix’ adult social care and move to systems of care and support that can consistently deliver the three main objectives the paper sets out.

  1. People having choice, control and support to live independent lives
  2. Access to outstanding quality and tailored care and support
  3. Adult Social Care being Fair and Accessible

It’s true adult social care is in a parlous state – ‘demand’ is high, social care providers are under pressure and there are big gaps in workforce capability and capacity. Although personalisation is well understood and happening it hasn’t yet achieved the scale, standard and consistency that would truly transform the lives of all the people and carers who need social care support. The impact of the Pandemic has led to slow progress in the transformation of some areas and put distance between social care services and the people who use them. In short, there’s a lot of work to do and doing what we’ve always done won’t solve the problems.

The first thing that struck me about the paper was the change in tone and language and the recognition that it’s the embedding of personalised care and user-led systems and services that will make a real difference. Of course, we’ve all known this for a long time and there’s amazing evidence that feeling in control of your own life really does improve outcomes and enhance quality of life, but I’ve not seen this reflected so explicitly in a government document before. Evidence that the voices of people who use services and those who have campaigned to have their voices heard is working, I hope.

The phrase ‘at the heart of care’ resonates with me because it’s the people who ‘draw’ (the term the paper uses!) on services and their carers that are the experts and have the skills, knowledge and experience about what works not just for their own lives but in the wider systems, processes and service offers.  They are the ones who pump life into strategies and transformation plans, know the pitfalls of the things we do and have ideas for transformation and improvement.

The Paper recognises that the care and support workforce are our biggest asset (the Pandemic proved this) and there are about 1.5 million people in England employed as part of the social care workforce. We need to support this workforce with new models of commissioning, care and support. Together with their employers, we need to ensure they are equipped to provide person-centred support and the training and education that enables them to do a great job for the people they work with. And ultimately, achieve the kind of job satisfaction that comes from knowing you’ve really made a difference.



Photographs in the White Paper have moved on too, from those that depict people being frail, passive recipients of care to ones that show people participating, contributing and just straightforwardly enjoying their lives – it’s those images and the ones I have from my own personal experience of people achieving great outcomes that will be foremost in my mind as I support Local Government and my DASS colleagues to make sense and move forward in their transformation journeys.

The paper sets out the key policies that will transform social care over the coming three years – these include investment in the workforce and a focus on values, as well as skills and qualifications. The widespread use of technology and digitization, the important role carers play, having a home where you can live safely and having good access to support and information.

In addressing these strategies, we will have to find new and more relevant ways of doing things – not relying on traditional models of commissioning or care but being truly transformational and delivering 21st century support and services rooted in the places that are important to people.

If you’re interested in joining a roundtable discussion on the implications and impact of the coming reforms in social care, then we’d love to hear from you. 31ten will be hosting virtual roundtables on Thurs 24th March and 7th April. To register your interest in attending, click here.



Image credits: Department for Health & Social Care – People at the heart of care