The Vision Project

SOCIAL CARE:
A POSITIVE
OPTION
BY AMANDA DEEKS
Amanda was Chief Executive of South Gloucestershire Council, a role she
held for 14 years until she retired in 2019.
An item on the radio about social care:
Cue sad piano music, presenter’s gloomy
voice and a story of service failure,
loneliness and isolation...
Cut to real life:
• My neighbours’ twin teenage sons with severe
learning difficulties. I’ve watched them grow
through school, college and into supported
living in a home shared with friends. They
have busy days, a great social life and holidays
abroad. They are happy, healthy young men
living without being dependent on my now
ageing neighbours.
• A recently visited elderly friend who was being
supported to die at home. Not much money in
the family, but a warm, clean and welcoming
home as always. Family able to drop by and
a constant stream of friends and neighbours.
All made possible by a fantastic district nurse
working with two great home care workers,
supported by the GP and palliative care
services. My last memory of him was lots of
love and laughter.
• A friend whose grandson who was born
prematurely and has severe physical and
learning difficulties. He lives at the heart
of a loving home, adapted for his needs,
surrounded by his boisterous siblings. He
attends an amazing school with the help of
specialist transport and support. A happy and
loving little boy.
• A close relative’s mother has a degenerative
illness and her husband of 64 years was
struggling to cope. She is now happily settled
in a local care home a short bus ride from
her husband. He can visit every day and they
spend the afternoon together, still holding
hands.
Lovely stories of social care at its best. So, what’s
the problem? When I asked these families, the
issue always comes back to funding and the often
complex, confusing and sometime adversarial
process of securing the services needed.
Amazing advances in healthcare mean that
many more people can now survive for longer
with increasingly complex conditions. Our current
system does not adequately recognise these
changes in demographics, nor does it recognise
the changing social context.
Institutional care is no longer an acceptable
model. Quality care must recognise the needs of
the individual and that the burden of care and cost
should no longer fall on the family.
The majority would agree with this, but there has
been no recognition of the costs involved. So, what
are the implications of an underfunded social care
system? There are a number of factors which are in
themselves problems, but together can sometimes
lead to disaster.
Costs have been driven out of the care system to
a point where pay rates are no longer competitive
and some care home and home care providers
sometimes struggle to maintain staffing levels.
Society rightly expects quality services, but a drive
to the bottom can only result in service failure and
failures in quality. Often employers rely on agency
staff, this can be a positive, filling short term gaps
and sometimes bringing in experienced staff.
Agency work can also offer the freedom to the
individual worker, which may mean the difference
between keeping good colleagues in the sector
or losing their skills and expertise. However, if
overused and badly managed, use of too many
agency staff can lead to situations which may
be sub-optimal and occasionally unsafe for the
customer.
DEVELOPING HEALTH & INDEPENDENCE
45