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Shaping the future for great care

The focus for our annual conference, Shaping the Future of Great Care, was determined many moons ago, but the pertinence of it could not be more on trend. As we enter the last week before the official leadership campaign begins for the next prime minister, we seem to be facing the prospect of a long summer of hustings where once again Brexit will dominate the agenda, and the energy and need to address domestic policy seems far from the candidate’s minds.

The urgent need for the politicians to address social care has, however, been made spectacularly clear in two recent Panorama programmes addressing the failings of the current system.

Two weeks ago Panorama showed footage from an undercover reporter at Whorlton Hall who exposed alleged abuse and systemic humiliation and degradation of people intended to be cared for and supported by the state. The untold damage to the individuals and their families is devastating. Beyond the immediate impact on those individuals, the wider damage to confidence in the care system and regulation will be long lived and for many life changing.

Then last week, we saw the first of two Panorama programmes. Entitled Care in Crisis, it focused on Somerset County Council and how it has been operating within an increasingly challenging financial environment.

Anyone watching this from the perspective of being ‘in the system’ would recognise the Somerset situation is playing out all across the country. However, whilst the programme showed the need for fundamental reform could not have been more stark – it equally showed the capacity for fundamental reform was never further away.

In order to change things, you need to have a vision; and in order for the vision to manifest itself, you need to have the right resources at the right time. I thought that one of the most telling comments of the progamme was made by Stephen Chandler, the Somerset Director of Adult Social Services, where he stated that people have become complacent about local government.

I am not sure I agree with him in relation to complacency. I suspect people outside of local government probably find it as mysterious a beast as they do social care; unfortunately I think the portrayal of Somerset will have done nothing to alleviate that. I know that we have of course only seen the tip of the iceberg in relation to what was filmed, and the film was most definitely telling a narrative.

However, the challenges of local government were laid bare. We saw local government senior staff stating that they were simply not able to comply with their legal duty to carry out assessments within 28 days, failing not just by a matter of days, but in fact by months. We saw carers on the brink, as they struggled to accommodate service closures, individuals perpetually in crisis, families frustrated and angry at the unwillingness of the system to accommodate their loved ones’ needs  and the sheer humanitarian crisis happening on the doorstep. These were of course the stories of the individuals who were not having their needs met, but the messages they portrayed were not unfamiliar.

Over the long weekend, I caught up on a number of books on my long list. The first had been sent to me by Elizabeth Orr. ‘Who can care for me now?’. It is a very personal tale, shared from Elizabeth’s perspective of having cared for her brother Norman. Her frank and poignant tale of determination to honour the dignity of her brother, bewilderment at the system she encounters and frustration and anger make for a sobering read. Almost no individuals or organisations appear to understand what Elizabeth is trying to achieve, which to me appeared to be a desire to have her brother treated with humanity, in a way that recognised the whole person – rather than what they experienced which was fragmented, disjointed approaches which seemed to have the system at the centre, rather than the person.

I also returned over the weekend to Atul Gawande’s book – Being Mortal. Whilst read many years ago, I decided to listen to it this time on audio book, and it still makes for powerful inspirational listening. The central take away for me from this book, which was had strong resonance with Elizabeth Orr’s personal tale, is how we have lost sight of what life is all about, and as a result, lost sight of what care in all it’s manifestations should be trying to achieve – and why.

Atul Gawande talks of how advances in medical science have become the dominant currency, valued way above a life where people still engage, still contribute, still maintain and build relationships and where there is a constant need to innovate and redevelop to meet changing needs.

It is galling to contrast this vision of where health and care should be with where we appear to have got to in the English care system, based on what we saw in fly on the wall discussions in Somerset. These discussions held around the assessment team showed the huge pressures on the social care system, resulting in less opportunity to consider  how to transform lives, or encourage greater independence or fulfil personal goals; it seemed the focus moved inevitably to the  discussions about survival, about harm minimisation and about duty.

It was uplifting, therefore, to finish the week with a rousing Britain’s Got Talent Final.

Where Colin Thackery, former Royal Artillery Soldier and resident at Royal Hospital Chelsea, was the outright winner. Here was a man, who has shown the country that it is right to still have ambitions, to still want to contribute, to still want to show their talent – and that this can all be achieved whilst living in a care setting. In this time of extraordinary difficulty it is good to know as we head into our conference on ‘Shaping the future of Great Care’, that care has a new hero, and an old hero to boot.

Please note there is a second episode of the Panorama programme on Somerset showing this week on the 5th June. It will feature NCF member Somerset Care.

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