Impactful and satisfying social care roles

By Alex Fox, the CEO of Shared Lives Plus, Vice Chair of Think Local, Act Personal and author of A new health and care system: escaping the invisible asylum (Policy Press) - and SCIE trustee.

A Unison survey of 1000 social workers, found that more than half are considering leaving the profession for a less stressful position. The reasons for this are unsurprising: cuts, workloads, form-filling, low pay. There are also Brexit and ‘hostile environment’ worries for a workforce of which 17% are migrant workers: around 250,000 people, according to Skills for Care estimates.

Lots has been written and said about the need to make social care roles more attractive. This usually focuses on pay (many roles are minimum wage) and the professionalisation of social care: most roles are unqualified and their low status is a factor in job satisfaction. I am sceptical of both these areas of focus, not because it would not be a good thing if social care workers were paid and respected more, but because they are symptoms of the problem, rather than causes. 

The most impactful and satisfying social care roles are those which take most time and are therefore too often seen as contingent on time and resources: forming meaningful relationships with people; enabling them to take part in activities which they enjoy or find meaningful; supporting people to get out of the house and connect with others; helping people to (re)build their skills and confidence to live well at home. During a time of staff shortages, cuts to care packages and increasingly high eligibility thresholds for support, there is an increasing gap between what many services aspire to offer, and what they are actually able to offer consistently and sustainably. The drive for professionalisation of social care can increase that gap rather than bridge it.

So the task facing us is not to tweak pay or conditions, but to reinvent social care as a public service that matters to people as much as the NHS does. There is a ‘chicken and egg’ challenge in this: it’s hard to reinvent a sector on no money, but it’s hard to win the public backing which leads to investment, without that reinvention.

So social care is in a difficult place, and at recent national conferences, I have felt a growing sense of a sector which cannot see a clear route to a future which is viable, let alone inspirational. But we also have some key strengths going for us, which offer a narrow but achievable route to that future.

Firstly, we are endlessly inventive. I’ve lost count of the number of social entrepreneurs I’ve been connected with in recent years, and Think Local, Act Personal’s ‘rainbow’ of community approaches is now a growing catalogue of groups and organisations who are changing how we think about what’s possible in support, inclusion and community development.

Secondly, people who use services and their families are a powerful resource and driver of change. We have seen how tens of thousands of people and families can reinvent social care themselves, using direct payments, creativity and love. The user-led movement has made huge strides and has co-designed practice, effective models of coproduction that are freely available to everyone. If every area committed to removing barriers to coproduction, and using existing approaches across their decision-making, the potential is huge.

Thirdly, our current systems are not just under-resourced, they in many cases actively prevent the kinds of change we most need to see, with dysfunctions which some councils have already demonstrated we could dismantle. For instance, we pilot new initiatives on short term funding, with no plan to transfer core resources into them from what doesn’t work as well: an approach that could have been designed to stymy innovation. Our failure to recognise, train, connect and back-up family carers could have been designed to reduce the capacity of a workforce which nevertheless creates more value than the NHS. Approaches to assessing disabled people could and in some areas have been replaced with help to plan. Punitive resource allocation and review systems which actively discourage people from demonstrating greater independence, could be replaced with asset-based approaches which share risk and responsibility more fairly and productively.

The Social Care Innovation Network, hosted by SCIE, TLAP and Skills for Care brings together 17 areas which have all achieved some kinds of change, and a similar number of innovative organisations which offer a human, connected and inspiring vision of what great support can look like. Together we are exploring how we could build a new idea of social care from the localised and small-scale successes which have already been achieved. As is so often the case in our sector, the level of ambition is huge, and the level of resourcing comparatively small. 

But every day, people who work in under-resourced social care roles, and disabled and older people with very limited means, together achieve goals that others have told them are impossible. They do that using the resources which matter most: creativity, determination and the drive to care for and about others. We owe it to them to build from their inspiration an achievable future for social care, in which people will always be able to bring, use and share those most human and precious capacities.

Alex Fox OBE is the CEO of Shared Lives Plus, Vice Chair of Think Local, Act Personal and author of A new health and care system: escaping the invisible asylum (Policy Press).

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