Abigail Melville, RSA – Does the future for Care lie in skills, technology, social networks – or all of these?

Abigail-Melville2By Abigail Melville

If we are looking for future employment for our young people then the care sector, currently worth £43 billion and growing, should be an obvious candidate. Yet concern about the poor quality of jobs kept coming up during our policy commission on community resilience, jobs and growth. Three interrelated issues relate directly to the concerns of cooperative local councils.

  • First, how to make care anattractive career for young people as we know this is one of the few sectors of the economy that is set to grow.
  • Second, how to improve the quality of care provided at home as the demographic time bomb means we need people to be living happy, independent lives for as long as possible.
  • Third, how to manage ever increasing demand at a time when council budgets are being slashed and the NHS is facing massive financial challenges of its own.

Councils running social care are in danger of being caught in a spiral of decline. The poor quality of jobs in the care sector – low paid, low skilled and being squeezed further by cuts to social care budgets – which in turn leads to a poor quality of care and makes it harder to present the care sector as an attractive career for young people. And as cuts continue we are in danger of locking ourselves into a low skill, low pay economy with a huge productivity problem.

Cooperative councils are determined to reverse the trend. Oldham’s Care mutual treats staff well, pays proper wages and asks people to accept a small increase in the price of their care – which they seem happy to pay for an improved service.

Proper pay and conditions linked with good training and standards must be part of the solution. Sector wide skills improvement is crucial. But I can’t see how skills improvement alone can overcome the need to increase the productivity of investment in care.

The new Care Act has the potential to revolutionise the way councils deliver services, but disruption of the market could escalate fees, making the social care financial hole even deeper than people currently imagine.

Combined with improving standards we also need to find ways to reduce the costs of caring for people. Some people have intensive needs and do require one-to-one personal support. But for many others, we need to enable one skilled person to be responsible for the care of more people without being physically present.

How do we achieve this? There seem to be two options. Making better use of technology, such as assistive care. Or using resources that exist in the community such as volunteering and buddy schemes. More likely it will require a combination of the two.

Can we build a new model of care built on high skill and high quality where we use new technology, allied with social networks and recipricol relationships, to overcome the productivity problem?

As cooperative councils we naturally think about how to involve families and communities in supporting individuals. I remember how isolated I felt when I lost my first baby (I was on maternity leave with no baby to look after) and how desperate I was to meet older women who might have experience of stillbirth. Why don’t we pair young women struggling with problems with infertility, pregnancy and childbirth (and the associated mental health problems) with isolated elderly women who can offer invaluable advice and support?

Developments in e-health – remote monitoring technologies, patient self-management, new ways of being in touch, smart appliances, all suggest that solutions to keeping people safe and well at home may lie in technological innovation. And we know how to do innovation – bringing citizens and users together with skilled professionals and disruptive technologists and developing new solutions which we can prototype, test and share.

So could these be the ingredients that need to come together? High standards, good training, community engagement, social links, new technology, co-production with carers and those needing care, professionals on board, innovation. Easy!

We would love to know who in the Network is working on this. Please send us any examples of innovation or good practice that we can share through the CCIN website and newsletter. If you would like to write a response to this blog please let us know.

Abigail Melville is the RSA’s CCIN lead.