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By Debbie le Quesne

How social care takes the lead in prevention

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If anyone should ever doubt the value of social care, I suggest they read an online article in Care Talk by Debbie Sorkin, whom I met recently at a Care Alliance meeting in London.

Her theme is simple – prevention is better than cure. Always better.

It is, as she points out, the cornerstone of recent health and social care policy. This is all about keeping people healthy and independent in their own homes – a “defining principle of the 2014 Care Act.”

She makes the point that “It means encouraging people to take more control of their own health and wellbeing: a move that is being supported, if slowly and patchily, through the introduction of Personal Health Budgets.”

But it’s also about supporting people, whether in their own homes or in residential care.

A great concept, this initiative is a pillar of NHS England’s Five Year Forward View – but, as Sorkin says “it should be clear that it’s also been the settled practice of social care for many years.”

But there is a problem. If we want preventative care (and we do). if we want to keep the elderly and frail out of A&E departments, if we want them healthy in body and mind . . . it costs money.

While I applaud Sorkin’s positive approach, she does point to a major cloud of foreboding.

She says: “ . . . Keeping people well, or nipping problems in the bud – is getting harder to do, particularly in relation to older people, where the social care system is struggling to cope.”

Let me quote a little more from her feature: “Six consecutive years of local authority budget cuts have seen 26 per cent fewer people getting help, and no-one has a full picture of what has happened to those older people – around a million strong according to Care UK – who are no longer entitled to publicly funded care. The human and financial costs to them and those who care for them are mounting.”

On the issue of district nurses providing community-based health services that are essential to keeping people with chronic, complex conditions well enough to live independently –there was a 28 per cent reduction in their numbers between 2009 and 2014, despite increased demands.

Sorkin begs the question what our response should be and points to leadership, well, system leadership (new sound bite) as an answer.

She mentions “doing what you can with the resources available.” What resources. Have my members any left?

She also promotes the Leadership Qualities Framework (LQF) for Adult Social Care “central to the section on Managing Resources, using resources effectively and minimising waste.”

All the right words and phrases are there . . . innovation, encouraging improvement, and creating a climate of continuous service.

Successful examples are cited in the West Midlands: New Outlook, a small care provider, teaming up with Nehemiah Housing Association to place a greater emphasis on wellbeing amongst residents and service users.

Results, she says, for the programme that has been running for only about a year, show emergency ambulance calls from the sites where the programme is operating dropped by 66 per cent between 2014 and 2015.

I don’t doubt good practice will always turn in good results and that Sorkin is right to point out the benefits of such management programmes. See http://www.caretalk.co.uk/how-social-care-takes-the-lead-in-prevention/ for the full list of improvements.

But for many care providers they’re well passed this rescue point. As someone said: “You can’t use an umbrella in a typhoon.”

Great leadership, hard choices, programmes of smart thinking, so many of my members have been there, done that, got the T-shirt and are still drowning.

Ultimately, all business needs the oil of finance – proper, fair rates for a proper job. Local authorities don’t want to, or can’t pay it; in many of the poorer areas (like mine) self-funders are thin on the ground and without the necessary viscosity of money the engines of care seize.

 

 

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