Reflections on ADASS Summer seminar and the session I co-presented: ‘How to deliver good adult social care - despite Covid’
I’ve visited eight adult social care departments this year, and talked with front line staff in all of them. One thing that’s struck me is the frequency with which the Care Act 2014 comes up in conversation.
Not in terms of legal compliance – but in relation to whether a particular approach matches the spirit of the Care Act, in promoting a more preventative approach and giving people the right information to make choices about their care. Four years since it was enacted, practitioners clearly still feel vindicated by the principles behind the Act. I can’t think of another piece of legislation that has become owned by staff in quite the same way (I’m open to challenge on this – perhaps financial advisers still debate spirit of the Taxation of Pensions Act 2014?).
When we run staff surveys with local authority clients, one phrase that often seems to resonate strongly with practitioners is ‘I see the role of Adult Social Care as helping people to remain as independent as possible’. In the surveys we have conducted this year, over 90% of respondents agreed with that statement.
Supporting independence by managing demand is a win-win for local authorities; it’s an opportunity to improve people’s lives and save money. Managing demand is supported by legislation and by staff. And yet our analysis shows that £3 billion of the £14 billion spent on adult social care each year goes on unnecessary care – demand which could have been prevented, delayed or reduced in line with Care Act principles. Something is clearly being lost in translation between practitioners’ desire to promote independence and what is happening on the front line.
So how can local authorities make the most of the demand management opportunity?
1. Understand where your demand is coming from – and where it’s going
The factors influencing demand are complex, and no two areas are the same. Understanding demand means looking at the demand arriving on your doorstep. Where is it coming from? How does your structure shape assumptions about what will happen to people? Which gaps in services prolong and amplify demand? Our Target Demand System helps councils to answer these questions, while our EDGEWORK approach recognises that there are very few linear cause and effect relationships in public services, and enables councils to understand what they can influence as well as control.
2. Be clear – knowing that change is needed is not enough
At IMPOWER we often use the ADKAR framework as a model for change when we work with teams. The power of this model is that it recognises that even if staff know that the change is needed and want to change, that isn’t enough. Organisations must help staff to know what the change means for them; give them the tools to put change into practice; and reinforce it through recognition and support. Too many authorities designed new ‘Care Act compliant’ policies, or organised one-off training on strengths-based practice, and then moved on without really embedding the change.
3. Get the whole leadership team on board
Demand management savings don’t materialise through the interactions between care staff and residents; and they aren’t implemented by adult social care departments alone. Too often positive practice is undermined by other factors: council communications that promote long-term care as a positive lifestyle choice; commissioning arrangements that make it much easier for practitioners to source a long-term care package than a cheaper, more creative alternative; or a continued demand for short-term, cashable savings in the community-based services that offer longer-term demand management benefits. Embedding change needs a whole-Council approach that is reinforced from Council Members to the front line; and a sense of collective responsibility across all Council services.
If you know that you need to embrace demand management but you’re not sure where to start, then please do get in touch.