“Genuine reform is needed now”: Prof Donna Hall and Anna Severwright on fixing our broken social care

New Local and #SocialCareFuture are co-hosting an event exploring ‘How Can Community Power Create a Brighter Social Care Future?‘ on the 16th November. Ahead of the event, Katy Oglethorpe spoke to New Local Chair Donna Hall and Anna Severwright of #SocialCareFuture about the need to change the social care system.

There’s been more money promised to social care recently – should we be celebrating?

Anna: For me the announcement on the Health and Care levy misses the point. It’s so focused on how we’re going to fund social care, but not what we’re trying to fund. We know many people who draw on social care are not living the life they want to lead. That announcement didn’t give me much confidence that will change. Genuine social care reform is needed now.

Donna: Despite promises there is a plan, I don’t think there is one. There is no strategy or vision. We are trying to patch up a broken system rather than reimagine a new one, which is what’s needed.

Funding is unnecessarily complex – there will be a tax on earnings but also a social care precept as part of council tax. And there will be a three-year wait for the money to go from the NHS to social care. That’s completely wrong. Social care is months away from collapse in a lot of places.

Some of the policy work that people like Social Care Future are doing is just incredible. People like Anna should have been locked in the room with policy makers until they came up with a strategy. 

Anna, if you were locked in a room and left to come up with a social care strategy, any idea of what that might be?

Anna: I would want to create a system that gives more power and genuine choice to people and their families. That includes asking fundamental questions like are care homes the right places for people? With earlier support, the right kind of support in communities, we could keep people well for longer and keep connections to the things – and people – that gives lives purpose and meaning.

I’d love a social care system that wasn’t designed just to be a gate keeper that kept people out, but was designed to support people, and support them to use their own networks, while still giving formal support to those who need it.

Donna: Absolutely right. We need to move beyond seeing social care as a job of getting people out of bed and washed. We need to treat people as equals rather than as a burden. And we need to stop seeing social care as a means of getting people out of hospital. For the NHS discharge is an aim in itself – they pay little attention to what people are going to do afterwards.

Social care has long been seen as women’s work, which women would do it for free. Even Beveridge admitted he’d forgotten about it when he first wrote his report. He tried to correct later but never got funding in place. It’s always been a side act, the poor relation to the NHS.

How have your personal experiences of social care shaped your passion for its reform?

Anna: It’s not a secret that my first 10 years drawing on social care were often a struggle and a fight for the support I needed. In my advocacy work, I don’t think just about my care but about the many people who are really facing horrible situations. I find social care hard to navigate, and I have a degree and used to work in the health service! I should understand the system, but I had to battle, I felt powerless and often fearful. Imagine how much harder it is for others.

Donna:  I remember when my mum was discharged from hospital with a wish to die at home. Twenty-two different people came to see her afterwards -all in the wrong order. Nobody knew her as a person or wanted to. They didn’t ask about her skills or ours, even though my sister was a midwife at the same hospital. I felt I was project managing her care: that’s the complexity of system.

What is the human impact of councils finding social care harder to pay for?

Donna: Every time there are cuts from government the threshold for support becomes higher and even harder to access. Some councils have even adopted a DWP-style approach to accessing services – you’re locked out and have to prove your need to get in. The message is: go away, get worse and then come back.

Anna: You’re left in a situation where you’re scared to get any better in case you lose support. It’s actually creating – not reducing – dependency. There’s no incentive to find solutions yourself.

Where do social care staff fit into the vision for a new system?

Anna: I massively care that people who support me are well paid and have a good life. Because it impacts on me but also because it’s fundamentally right that their work should be valued.

I struggle with the language around social care recruitment: the need to build a ‘professionalised workforce’, the calls to ‘care for the vulnerable’, or ‘be a hero’. Working in social care is rewarding but it’s not just ‘looking after’, it’s enabling people to make choices; to live their lives. People have so much to offer and if you’re given time – not just 15 minutes get someone out of bed and microwave a meal – that makes for a more satisfying job and a better experience for the person drawing on support.

Donna: The people I know who work in social care are just the most amazing people. They know what changes need to be made. That’s why it’s bizarre that social care and frontline staff haven’t been brought together to build a strategy – they are the people with intimate knowledge. One of the best pieces of policy making now is ‘The Promise’ in Scotland, where around 5000 care-experienced young people and frontline staff are part of an independent review team to create children’s services based on first-hand experience. That’s what’s needed for social care.

Register now for our event on November 16th – How Can Community Power Create a Brighter Social Care Future?

Join our mailing list