29 August 2018

KeyRing responds to LGA Green Paper

The Local Government Association (LGA) has produced a ‘Green Paper’ about how it sees Social Care should be in the future. It’s done this because of the Government’s recent decision to delay its own Social Care Green Paper, which it sees as disappointing and frustrating. 


The paper says:

We all strive for a happy and fulfilling life. We should all have the support we need to live one. Many of us can live the life we want without much, if any, help. Others may need a great deal, receiving it from a range of sources including family, friends, neighbours, community and voluntary groups, and statutory services. What matters most is that everyone can exercise their right to opportunity, independence and control.

Too often adult social care is seen as an adjunct of the NHS, existing simply to relieve pressure on hard pressed acute services. While it is true that social care and the NHS are inextricably linked, it should be seen an essential service in its own right and the people who work hard to deliver the service should be seen as just as valuable as staff in the NHS.

You can read the LGA’s Green Paper here.

The paper is well written and people have been asked to respond to it.  KeyRing has sent its response, including:

In what ways, if any, is adult social care and support important?

KeyRing has seen, for many years, too many people getting the wrong sort of support – they are either over-supported in a deficit/paternalistic way to the point of creating, perpetuating or escalating dependency or left with no support until they hit eminently avoidable crises. This very real manifestation of the social model of disability is morally wrong, it also is a huge waste of money.  Adult social care and support is seen to address this, when services are developed through a truly outcome-based approach, with genuine co-production between service users, families, providers and purchasers.

It is still too rare; it is rarer still in Health, so adult social care's biggest role is to show how it can be done and illustrate the huge benefits, including financial ones, that can be gained by so doing.

What evidence or examples can you provide, if any, that demonstrate the funding challenges in adult social care and support in recent years in local areas?

We have witnessed examples of where people whom we used to support before services have been withdrawn due to cuts have:

  1. lost their connections and sought friends in the wrong places, and ended up costing the CJS a ton of money
  2. ended up in unsuitable housing, lost a string of jobs and ended up on more benefits with deteriorating MH
  3. drifted in crises or psychosis because they are not interacting with people who have got to know them and are able to spot early signs and know how to interject
  4. Where we have been able to spot early signs of an impending crisis, it has taken six referrals to a stretch Mental Health team for it to be picked up, by which time a lot of ground has been lost and more time and resources are needed to support recovery

This shows how light-touch prevention approaches ultimately gives people better lives and the country better outcomes.

Beyond the issue of funding what, if any, are the other key issues which must be resolved to improve the adult social care and support system?

The NHS is deficit-based in its approach; it has more money than social care and 'protected status' in the eyes of the Public (and, therefore, politicians). This gives it more power and makes this deficit-based culture dominant.  It also makes Health's view of social care and voluntary and community sector provision patronising at best.

The position in local authorities and social care is better; I feel we still have to acknowledge  that local authority commissioning creates a monopsony, with the purchaser pressured by duty of care and public funding pressures, which means that true partnership working, with risk taking innovation, is often not the reality that emerges from good intentions.