Could this winter’s election finally bring social care in from the cold?

As we turn the central heating up and autumn turns to winter, the country finds itself in the unusual position of preparing for a General Election. It will be the first time in almost a century that the UK has gone to the polls in winter to elect all our MPs.

 With the manifestos of the main parties all now published we at least have a clearer idea of each of their policy proposals. Perhaps we can now turn down the rhetoric and the soundbites and focus instead on some of the detail; and try to understand what their ideas will mean for the future of our country.

 Brexit has of course dominated the campaign, however a small number of other domestic issues have jostled for attention. The NHS has had perhaps the most cut through. Note I say the NHS, not health policy - and definitely not social care policy. Labour has successfully secured the NHS top spot after Brexit, with considerable attention on funding, as well as the perceived privatisation threat from a future US trade deal.

 Sadly, there has not been enough discussion about how we create a health and social care system which is truly fit for purpose; on how we truly integrate the two and ensure they work together for the benefit of people who are ill, elderly or disabled. In the first of the TV debates, I was dismayed to hear social care only given the briefest of mentions.

 With politicians of all parties falling over themselves to promise additional cash for the health service, I see little serious attempt to grasp the nettle of social care. Whenever politicians do seem to propose a solution they invariably end up in a political crisis, often of their own making. Many leaders are terrified of social care policy proposals backfiring on them and leading to headlines about “dementia taxes” or “inheritance taxes”. This acts against a thoughtful consideration of the problem in my view.

 So my first request of politicians during this General Election campaign would be to just take the issue of social care more seriously. For a start, can we please have at least an attempt to take the agenda beyond just a bidding war over funding?

 A serious analysis of the issue must explore credible ways to truly integrate our health and social care systems. At present an inadequately resourced and failing social care system is pushing too many people in the direction of health services, especially hugely expensive hospital care. If the social care system was working properly it could act as a much-needed pressure relief valve for the NHS. But until we dismantle and reimagine the massively over complicated and separate systems of health and social care this won’t happen.

 Only when the care of individuals is the responsibility of one system, with one budget, will we begin to address this problem. In the meantime only the accountants seem to benefit, whose job it is to work out which bit of the system must pay for what. If ‘prevention is better than cure’ works well for patients - it also has the potential to work for the system as well.

 We also need to see the reversal of a number of trends which have inexorably led us to our current predicament over a number of decades. The first is the systematic closure and running down of day care services many of which served the needs of vulnerable adults very well. Local authorities have closed these services which often provided places for people to socialise and engage in meaningful activities. We need to rediscover the value of these services, and to reimagine them as places where service users can learn new skills and take part in training and education. For a great example of this in action see the work of Valorum Care Group’s partner company 1st Enable based in Ellesmere Port. Its hugely successful Skills Centre is positively redefining what day services can be.

 The last few decades have also seen a decline in the number of residential homes for older people. Instead, the emphasis has been on either keeping people at home or when this isn’t possible putting them in higher dependency, higher cost, nursing homes.

 Unfortunately, as this has been accompanied by a reduction in the level of personal care provided at home, we’ve seen an increase in those needing to skip a step and go straight to the nursing home level.

 With a lack of home-based care, people struggle to cope so living at home becomes unviable. Either they end up in hospital or in a much more expensive nursing home. The decline of the residential home is therefore an issue I would like to see politicians address.

 Then there is the question of who provides social care: the private and voluntary sector or the state through local authorities? The outsourcing to non-state providers since the early 1990s has undoubtedly, in my mind, improved the quality of provision in many respects.

 But these providers have consistently been expected to do “more with less” from the outset. In my view, the problem is not the outsourcing of provision, but the expectation that it can operate at resource levels significantly lower than the local authority model.

 We expect outsourcing to be more resource efficient, that’s largely the point, but the balance has tipped too far the other way. With all three main parties at least committing to higher wages for social care workers this will have to be addressed by whoever wins the election.

 Recruitment and retention is the other issue which has to be addressed at the policy level by whoever finds themselves in Downing Street on December 13th. Companies like Valorum Care Group are doing a great deal at the coal face, with a particular emphasis on making sure staff feel valued and motivated at work. As I’ve said before it’s not just about pay. And while other measures, such as a ban on zero hours contracts, might be superficially popular they can often have unintended consequences. For example, many of the staff we employ value the flexibility which not being on a fixed hours contract gives them. An outright ban would deny them that flexibility.

 Policy measures are needed which raise the status and value we place on the profession. I’d like to see the government explore ways to shift perceptions around social care work. Perhaps we can envisage a day where it is on a par with more valued public sector professions such as doctors, nurses and other “blue light” services. I want to see young people choosing social care as a profession while they are still at school. To do this they need to see the career pathway potential of social care - for example into a job in nursing.

 So as you head out into the cold to cast your vote this December, spare a thought for the social care sector. The challenges facing social care are among the greatest facing our society - and yet it often struggles to get a look in. Let’s hope this election is its chance to finally come in from the cold.