Social care at 70 is rediscovering its community roots

Here’s a blog I wrote for the Sustainable Health and Care Campaign with Rob Webster (CEO of South West Yorkshire Partnership NHS Foundation Trust and CEO Lead for West Yorkshire and Harrogate Health Care Partnership) and Glen Garrod (Executive Director of Adult Care and Community Wellbeing at Lincolnshire County Council and the President of the Association of Directors of Adult Social Services (ADASS))

We know that health inequalities persist across the country and stubbornly refuse to improve. Local NHS plans need to embrace the root causes of inequality – poverty, housing, education, employment, loneliness, and the environment all affect people’s health and the sustainability of communities. The results are most visible for NHS colleagues in a district or community psychiatric nurse’s caseload, the A&E and the GP surgery. Supporting people with comorbidity of social, mental and physical health needs should be the driver of the future health and care system. This will also mean creating the conditions for communities and community activists to be embraced in the solutions to bring greater control to people’s lives. This is central to making progress on health inequalities, not least because people in communities which experience health inequalities see them far more vividly than any outside expert can and community activists are often the most passionate about tackling them.

There is substantial and long standing evidence that a person’s life choices, where they live, and family support are critical to keeping them well. That link between place and wellbeing was at one time a key idea within social care. When Glen Garrod, now ADASS President, was a Community Service Volunteer in the early 1980s in Manchester, working at a youth centre and with local charities, he witnessed both the infamous Moss Side riots and how members of a tight-knit community would often help each other. Formal volunteering and informal ‘helping each other out’ were both powerful forces for good.

Approaches developed within the voluntary, community and social enterprise (VCSE) sector are increasingly recognised as a key bridge between the worlds of community, health and council services. In Shared Lives, people who need significant support are matched with a carefully recruited and trained Shared Lives carer. When a good match is found, the person moves in with their chosen Shared Lives carer, or visits them regularly for short breaks or day support. Shared Lives feels unique and personal to each household involved, but is also part of a CQC regulated national care sector. It was traditionally provided or commissioned by councils as a social care service for people with a disability and the elderly, but it is now being developed by NHS England and a growing band of clinical commissioning groups as a health service, helping people with mental ill health leave or stay out of hospital, for instance. People benefit from drawing on the informal support of a household and community, the regulated care provided under the auspices of a council or NHS contract, and a national VCSE network.

Imaginative areas are redefining the roles or services, of VCSE organisations and of civil society, in order to draw on all the resources available to them. For instance, it’s National Volunteers Week [at the time of writing this blog], yet many people who are actively involved in their communities would not consider themselves volunteers and social capital can be found in unlikely places. Athens, Greece has a daunting unemployment rate and over 2,000 derelict buildings in a country which has become synonymous with ‘austerity’. But it’s also where one man invented a new  [read more]

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