Speak up at the back there


Posted on February 9th, by geoff in CT blog. 3 comments

By guest blogger Debbie Sorkin,

National Director of Systems Leadership at the Leadership Centre

Adult social care must have done a terrible thing in a previous life. That would be one explanation for the particularly vitriolic coverage that the sector has had to live with over the past few weeks. Firstly, there was the contention that the overload in A&E admissions could be laid at the sector’s door, as if delayed discharge was purely a social care issue. Then, last week, the Daily Telegraph continued in the same vein, launching a campaign that was actually called “A day in the life of Britain’s bad care homes’.

I wonder whether part of the reason is also the continued willingness of adult social care providers to play an unsung, and unsinging, role in making integration work and taking the load off A&E: going into acute trusts to take the initiative and smooth the wheels, so that the people in their care can leave hospital as soon as they’re ready; working in partnership with Clinical Commissioning Groups to have on-site medical and pharmacy resources, funded by the CCG, so that they can catch potential problems early and prevent hospital admissions in the first place; playing a central role in new Intermediate Care models; and working in tandem with mental health services on services designed to ease bed blockages.

Admittedly, this doesn’t happen everywhere, or easily; local authorities and CCGs can be cash-strapped, and acute trusts can be hard to engage, if you can get their attention at all.

But equally, I know from care providers around the country – across the private and not-for-profit sectors; in rural and urban settings; and spanning all sizes of operation, from national organisations to those with one or two care homes – that there are excellent examples of adult social care taking a lead in developing, and implementing, integrated services. Why isn’t this more acknowledged, or even recognised? I wonder how much it’s down to the traditional culture of social care, which tends not to draw attention to itself – either because there’s a feeling that social care organisations shouldn’t take credit for simply doing their job, or because people feel scared by the prevailing coverage and are worried that if they speak up, something might go wrong? But none of these things seems to constrain the health sector.

So I’d like a call to arms, for social care providers to spread the word locally and nationally about the great work that they’re doing. Social care has to counter the lazy ‘all care homes are bad’ narrative. It’s wrong; it’s pernicious; it gives NHS Trusts an excuse for not engaging with social care; and it creates needless worry in the minds of people for whom residential care can and should be a positive choice. More noise, please.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.




3 responses to “Speak up at the back there”

  1. Bob Ferguson says:

    The national media, particularly the print version, is like a dog with a bone; once they latch on to an issue they keep worrying at it. Never was a cliché more deserved than: don’t let the truth get in the way of a good story. Perhaps the sector can feel some sympathy for Ed Miliband who will be under a barrage of negativity – most of it confected – from Tory titles all the way up to 7 May.

  2. I think the problem is a mixture of everything Debbie mentions, plus more. One way to break down the cultural resistance to integration between health and social care is to find a way to fund the pathway rather than the institution. That way they will be forced to integrate in order to meet the needs of those beig looked after. The Symphony project in Somerset is leading in this process and is seeing a positive response to pooling funds with a gradual realisation that this is a better use of funds where service users dip in an out of needing health and scial care at different times according totheir conditions.

    It would help enormously if politicians would desist from the temptation of giving the impression that the Better Care Fund is new money. It is not and if they were clearer about this then peoploe would be more willing to find more effiecient ways of utilising these sparse resources.

    It is also evident that the propensity to blame the social care sector is because so much of it is single care home owner based and they are wary about speaking up because it exposes them to being picked off. Their business are vulnerable to even the slightest change to commissioning practice such as loacl authority placement embargos based on the assumption of whole service deterioration of care when a safeguarding issue is raised.

    We need to see a collaborative and cohesive approach to care across and between the sectors so that the service user does not become the pawn in the process.

  3. Jonny Landau says:

    Hear hear! I’ve been specialising in the social care sector for nearly 10 years and I hear very little positive news. I’ve even started volunteering the sector so that I can see for myself some of the great work that goes on.
    I agree with Bob and I’d go further and say that generally the media are more attracted to negative stories to positive stories. There was program on radio 4 yesterday just on this topic – http://www.bbc.co.uk/programmes/b051r7j4.
    The challenge is to present narratives that are both compelling and positive. The call to arms is absolutely right. The good work is there – but the sector needs to do more to shout about it.


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