A future for social care?

Here is my blog for Social Care Futures, the event and movement which will be based around a gathering in Manchester, alongside but independent of the annual National Children and Adults Services conference:

What do you do when the cause you are campaigning for fails to register with the public? When it is at best misunderstood or seen as one of life’s necessary evils and at worst seen as a permanent bad news generator, peppered with crises?

That’s the rather depressing problem facing campaigners for a better valued, better funded social care system. None of those public perceptions are fair. We can all quote stories of great social care, of lives being changed by sheer creativity, of inspirational compassion and, in my view, of some of the most radical transformation of any public service sector. But polls, focus groups and research agree: the public is still very hazy about what social care is, with those who do have an idea tending to believe it’s something provided free on the NHS. Social care is only guaranteed to make the news when it is being talked about as going bust, or when there has been an abuse scandal.

It was fascinating then, to be in a crowded room with the organisers and supporters of Social Care Future, the gathering planned to take place in parallel to the annual National Children and Adults Services conference in Manchester. We were hearing from The Frameworks Institute about their ground-breaking work with Joseph Rowntree Foundation (JRF) on reframing the issue of poverty and how to tackle it. The public has some well-worn and cliched ideas about poverty, including that it’s often do with people’s bad choices, including people who could work choosing not to, that there’s no such thing as ‘real’ poverty in the UK any more. Research shows that these are not true: poverty is real and can be desperate, people are born into and trapped in poverty, by low paid work and rising housing costs as much as worklessness, and so on. But messages about poverty as a problem, even a crisis, were not cutting through, even though they were based on real evidence, painstakingly gathered, because humans don’t easily change our deeply-felt beliefs through hearing facts, statistics or reasoned arguments. But reframing the issue of poverty has made a real difference to how JRF could get its research-based messages through to different audiences. The reframing process (set out here) includes appealing to people’s values, rather than relying on economic or other more abstract arguments: poverty ‘just isn’t right’ and shouldn’t be happening in a decent society. It also involved using some simple, visual images that make sense to people. In the case of poverty, JRF used ‘restricts and restraints’: poverty is rarely the result solely of bad choices: inequality and the hard end of our economy keeps hard-working people trapped in low incomes. They also used the idea of strong currents – the low wage, high housing cost economy, and life events like becoming disabled – which people cannot swim against however hard they try.

It was a compelling presentation about a successful campaign, whose messages could be found in previously indifferent or hostile papers. So what should we take from it for social care?

Firstly, that, whilst the crisis in social care is real and causing misery and suffering, if that is all the public hear about social care, it may not be motivating people and the politicians they elect to aim for change. In fact, a message that something is in permanent crisis, particularly when the public is unclear or ambivalent about it in the first place, may create a sense of hopelessness: nothing can fix it, so why throw good money after bad? That can’t be to say that stories about the crisis shouldn’t be told, but it suggests we also need a strong, consistent story about the good that social care does. We need to offer people solutions to the crisis – not just solutions to public service economic problems but also showing how social care is the solution to life events which any of us could experience ourselves or in our families.

There were two exciting and hopeful lessons from the session for me. One is that the flip side of the public not understanding and engaging with social care is that we – the social care sector – create and control a lot of the messages. We don’t have to compete with deeply, embedded or oft-repeated unhelpful messages, we just have to get our own messages right. Secondly, that we have all the elements that are needed to change people’s minds: social care is vital, is delivered by caring people and can transform lives. The vast majority would agree that supporting disabled and older people to live good lives is simply the right thing to do: we can appeal to that sense of fairness. And we have an increasing number of new or emerging approaches to care and support which enable people to live well in their own homes and communities, which work, which people love and which are affordable.

Many in our sector will baulk at the idea of telling a positive story about social care, when they can see the impact of cuts and witness too often tragedies caused by poor care which ruin or even end lives. We should be suspicious of spin and any story we tell has to be grounded firmly in fact. But I came out of that room feeling that perhaps we have the means to change how our sector is perceived, supported and ultimately invested in, if only we used them. What would our new story look like? We clearly need to invest in the research and testing to find which messages work, but perhaps they will be about the fact that social care, ignored by so many for so much of their lives, is actually about all of us:

All of us at different times in our lives need help to live well. Without well-funded social care, there will be times when we or our relatives find ourselves lonely, not able to work or stuck in the house: social care is how we make sure there are no times when we are shut out of life. It’s just as precious as the NHS: it’s the service that ensures older and disabled people can take a full part in life.

We have already invented kinds of social care which could be futures which people will be inspired by, not scared of. That’s one of the reasons why Social Care Future is so important right now.