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Yesterday’s announcement

Yesterday’s announcement (7th September 2021) by Boris Johnson, Rishi Sunak & Sajid Javid demonstrates the lack of recognition of the social care crisis we have been experiencing for so many years. The announcement was to share the proposal for a 1.25% increase on National Insurance Contributions as a levy towards Health and Social Care.

With the social care workforce significantly depleted- workers are leaving care to take higher paid jobs in other sectors, offering more financial security and career stability. Loss of freedom of movement following Brexit has meant loss of many migrant workers who were propping up the social care workforce. A survey of the Directors of Adult Social Services last year found that only 4% were confident that they had the budget to meet their statutory duties. This is extremely concerning, but not at all surprising given the many years of austerity measures.

More to do with the NHS than Social Care?

Initial announcements about the new levy suggested that the funding for social care would ensure fairer rates of pay to providers and support for building and improving the workforce. Within 24 hours, the message had changed significantly to messages about NHS recovery from Covid-19 pandemic and #buildbackbetter. At one point in his announcement, Prime Minster Boris Johnson clearly stated that this reform was about reducing waiting lists for NHS. He used the phrase “Biggest catch-up in the history of the NHS” and talked about the levy going towards more emphasis on NHS treatment delays and improving salaries for NHS key workers which had been affected by the Covid-19 pandemic.

Later in the announcement, Sajid Javid commented that funds from the new levy will initially move into the NHS. He went on to say that this was the beginning of wider reforms- referencing the forthcoming integration white paper to deliver health and care as one.

According to the announcement, £36bn will be put into the NHS over the next 3 years. As a rough calculation, if averaged out across the 106 CCGs in the UK, this would be less than £350,000,000 per CCG over a 3 year period. Once broken down into an annual amount per CCG, it suddenly doesn’t sound a lot.  Not an awful lot of money would be left for social care once the issues relating to shortage of nurses, pay rises for NHS key workers & waiting lists have been addressed.

Is Social Care the poor cousin of the NHS?

The people actually paying for social care currently are those who require social care support- often those on low incomes, with additional household and family pressures to manage. It simply isn’t good enough.

It’s a very generic message which (when you dig a little under the surface) has far more to do with putting a sticking plaster over the NHS and very little to do with social care at all. A little extra funding is not going to make any real impact to the very broken social care system long-term, and it sounds as though social care won’t even see any of the funding initially anyway! We need a radical system change. Could ICS’s (Integrated Care Systems) offer an opportunity to develop a more efficient and cost-effective system with a single point of assessment, planning & resource allocation so that people can Self-Direct their own care & support arrangements? Could it offer the opportunity to strengthen communities and bring power, decision-making and financial resources to local areas where it really makes sense?

A clearer message is needed – what is this funding actually for, how will it be rolled out and what difference will it make? It’s worth pointing out that the decision hasn’t actually been made yet at the time of writing- we are yet to hear the outcome of the proposals.

Share your thoughts with us!

It’s quite common to hear about ‘person-centred approaches, ‘choice and control’, and ‘self-directed support’ in Adult Learning Disability and Autism services; but we don’t often hear about innovations and personalised approaches in the delivery of older people’s care and support arrangements.

Imagineer has been delivering training in person-centred approaches including support brokerage for many years; and recently we were approached by a forward-thinking provider organisation in Devon- Love2care

This organisation provides home care support services mainly to older people across the Torbay area of Devon. They are rated as ‘outstanding’ by CQC and have a really unique, creative and personalised approach to the way they deliver their services.

Traditionally there are 3 main types of service model adopted for the care and support of older people:

The founder of Love2care Devon- Maddy Bird was keen to train her staff team in the principles of self-directed support and to develop their skills as Support Brokers so that they could really open up the way they supported their clients both at home beyond the traditional models of support, and also when there were any transitions into a hospital environment or a change in their care and support needs. Love2care commissioned Imagineer to deliver the full accredited Support Broker training to an initial group of staff at the organisation. Due to Covid-19 restrictions, the training was moved to online delivery, via the Zoom platform.

Maddy talks below about their experiences of doing the training and the impact it is making on their work as an organisation:

Love2care has people at the very heart of the service, and when we talk about ‘people’ we don’t just mean the person we are caring for.  We mean them –  absolutely, but their loved ones also – the carers who provide paid and unpaid support. We also value our team and employees, as people. We focus on getting to know what matters most on an individual basis – not just feeling like we are completing a set of tasks for someone; but that we are facilitators and part of a support system, as advocates, listening ears, and objective eyes.

I often say to people that Love2care is a person-centred organisation, because although we may be juggling a lot of changes or difficult situations; we are disciplined in our practice, ensuring that others don’t feel that strain. We are careful to ensure that people feel listened to, heard and valued. We then support each person to look at ways to address what it is that they want to achieve.

Our service is very much focused on building & maintaining positive relationships, and having clear boundaries.  We work hard to avoid getting caught up in bureaucracy. We truly try to work with the people we support, so that they can live the life they want to. For me, the word ‘facilitators’ is very apparent within the organisation.

My work background prior to Love2care was in a corporate organisation, and my role was ‘brokerage manager’ – working under a ‘prime provider’ framework with my local authority. I loved being able to help secure care and support for people, but what I quickly realised was just how ‘un person-centred’ the processes were. I felt that (for me) care has been a vocation, and a journey, and yet throughout my career I was starting to come further and further away from the person. I was brokering care and support for people whose names I didn’t know, as it was done via an excel spreadsheet. For me, this just wasn’t ok. 

I felt that I needed to do more.

I then established Love2care, and through my work, I have just always had a passion for changing that experience. I have been able to do that via Love2care in some areas, but I then had a vision that my team around me would have the competence and the desire to support people more, enhance their lives, and also have meaningful conversations. 

I think within our service we regularly felt like we had more to give, but less autonomy through local authority contracts. We equally wanted to support our local community – so there were definitely feelings of restriction and limitations in our role. I developed an idea using support brokerage, and using our CQC registration, which explored a new model of care offering the potential to free up social care time and resources; and work in a much more personalised way with people to self-direct their own support.  

We really enjoyed our training. There were a couple of things for me, firstly being able to invest in my team to develop them personally and professionally; giving them a skill set and knowledge base that not all front-line social care staff have the opportunity to normally receive. The training is giving them the confidence and competence to be able to have more in-depth conversations, and autonomy to look beyond a task list for people.

Secondly, what I also took away really positively was that our care and supporting planning was really person-centred already. Recognising that as a home care provider, we had the resources and we were utilising them; but through completing the training we were able to go deeper. I now have more resilience and flexibility within the service, to offer people we may not necessarily need to provide with direct support, but to offer them a brokerage service that means they are feeling heard, and that they can self-direct their own support.

My staff team have the autonomy and confidence to go beyond the norm. They understand how to look at different resources, so people remain independent for longer. Even just our conversations as a team have changed – I feel that we have given people more choice and control – allowing them to make the decisions they want for their lives.

Our local commissioners are really enthusiastic about us thinking differently. We are looking at developing Individual Service Funds (ISFs) within our local teams; however, due to the restrictions of Covid (and now heading into winter pressures), I think there is some delay – even though in one sense and in an odd way, I also feel that because of Covid – we are years ahead.

We will keep doing our thing, and hope that people see that a new model of care could really make a difference.

Surely we have to try?

Are you interested in finding out more?

Imagineer offers accredited support broker training, mentoring and other training/resources relating to self-directed support and strengths-based approaches regularly throughout the year.

Visit our explore our website for further information which can be found under the drop-down menu heading ‘What we do’’ for further details, and subscribe to our mailing list to be kept up to date with future training dates. 

To find out more about the work of Love2care- Devon, visit their website: https://love2care.uk/about-us/

About us

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

 

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC.

Maddy Bird has worked within Adult Social Care for 10 years, in various roles from Community Carer, Care Coordinator, Brokerage Manager in a prime provider commissioning model, and is now founder and leader of an Outstanding Rated organisation, Love2Care Devon – established in 2017.

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