Written by Maggie Kufeldt

The ADASS report ‘Waiting for Care and Support’, setting out the results of the recent survey of Adult Social Services Departments was published on 13^th May 2022. The report describes what many of us working in Adult Social Care already know – the system is in crisis and that –

• more than half a million people are now waiting for an adult social care assessment, services or reviews
• levels of unmet, undermet or wrongly met needs are increasing
• growing numbers of people needing care and the increasing complexity of their needs are far outstripping the capacity to meet them
• more people left without essential care to maintain their health, and dignity and lead good lives in their communities.
• family carers are having to shoulder greater responsibility and are being asked to take paid or unpaid leave from work

Recent Health and Social Care Reforms introduced in Build Back Better and the White Paper People at the Heart of Care set out a vision and ambition for Adult Social Care that would bring about ‘once in a generation transformation’ to tackle the challenges faced and reduce demand by promoting early intervention, prevention and independence alongside excellent quality care.

The reforms are to be underpinned by the introduction of a ‘Cap on Care Costs’ – making charging for services fairer and the introduction of a new CQC Assurance Framework including the reintroduction of an inspection regime for Adult Social Care.

Most Directors of Adult Social Care are already leading significant transformation programmes, but the impact of the Pandemic and serious workforce and financial challenges mean often progress is slow and getting the right capability and capacity to support the changes is difficult. There are deadlines looming too – not least the submission of the Cost of Care exercises, provisional market sustainability plans and spending returns by October 14th, 2022.

Achieving sustainable transformation in the face of unprecedented demand, uncertainty about finances and a workforce scarcity is a tall order.

At 31Ten we’ve hosted several virtual Round Tables for Senior Leaders in Adult Social Care aimed a creating a network of support and a sharing of ideas. The round tables have been an excellent opportunity to share risks and challenges and more importantly think about what would work, what would help and how it would make a difference.

Our assessment is that there are 6 main areas that are key to making the difference…

Care Model – a clear co-created ambition for Adult Social Care relevant to your local area rooted in the strengths and assets of people who use services and built on their preference and choices. This means that people and their carers are always in charge of their own lives. Models needs to tackle demand management not by rationing care but by promoting independence, connecting people to the community, getting in early and having a proactive approach to recovery.

Care market including the right housing options – a strong, sustainable and vibrant care market that works in partnership with people and the local authority to deliver care and support that means people can achieve their goals and ambitions. Moving away from institutional, time and task care into more flexible approaches that people who use services influence and control. This needs to be backed by a strong supply of housing and housing adaptations enabling people to live at home.

Workforce – an integrated, partnership approach with local public and private organisations aimed at attracting and retaining the best people across a range of roles. Supporting people to see care as a career and promoting opportunities for development and progression. Quality training and development, as well as fair remuneration, need to underpin the approach to make it sustainable. Training and support should be extended to family and informal carers.

Technology – recognising that a range of technological and digital approaches will make the difference. For staff systems and equipment that allow them to be flexible, fleet of foot and to connect to service users and partner organisations. For service users’ access to self-help and assessments online, support to make the best of the tech they have in their homes to both social connection and care and support, access to the latest telecare solutions and a strong approach to digital inclusion.

Governance – ensuring proper programme and project arrangements are in place that are embedded in the transformation arrangements of the wider organisation and are accountable and transparent. Being CQC ready and ensuring that data and intelligence led approaches inform transformation. Having a strong approach to quality assurance leads to CQC inspection readiness.

Financial stability – achieving financial stability allows leaders to focus on quality and outcomes. The best form of financial stability comes not through cuts or rationing services but in getting the care model and the approach right. The need to get the cost of care, market sustainability plans and spending returns right to inform future funding allocations. Use of grants and ‘one’ off monies should be proactive, not reactive to support transformation.

It’s true the ‘heat’ is on for Adult Social Care, in short, what is called for now is strong leadership, a planned and proactive approach to transformation, sourcing the right capacity and capabilities to make change a reality, clarity of governance and accountability and the ability to make the new funding available work for people and for Local Government.

Interested in hearing more? 31ten are hosting a free masterclass on the topic of the Fair Cost of Care and Market Sustainability for local government professionals on Tuesday 7th June 2022 between 8.30 and 9.45am. To sign up, just click here.