Persist and survive

By James Bullion | 21 October 2020

For colleagues working in adult social care, the last six months have felt relentless and at times brutal. COVID-19 has hit those of us who have care and support needs, those who care for family members who do, and those who work in adult social care particularly hard. The pandemic has also disproportionately affected those in domestically abusive circumstances, those from Black, Asian and minority ethnic communities, people with learning disabilities and those from poorer communities.

From high rates of COVID-19 in care homes, to people too scared to continue receiving care in their own homes, to those who can no longer access day services, the cost has been high for all concerned. COVID-19 has changed almost everything we have come to take for granted in how care is delivered and experienced.

That is why Professor Aisha Ahmad’s recent Twitter thread about how we can power through ‘the six-month wall’ really struck a chord with me about how many in adult social care are feeling right now.

Writing about COVID-19 and reflecting on her own extensive experiences of leading relief efforts in areas of the world that have experienced disasters, Professor Ahmad states: ‘The six-month mark in any sustained crisis is always difficult. We have all adjusted to this “new normal”, but might now feel like we’re running out of steam? Yet, at best, we are only one-third the way through this marathon. How can we keep going?’

Through a series of thought-provoking and personally reassuring tweets, Professor Ahmad tells us it is OK to struggle at the stage at which we find ourselves now.

Over the last six months we have all had to deal with difficult, unprecedented issues for which all of the contingency planning in the world could never have fully prepared us. We have had to take life-changing decisions, adjust to new ways of working, fundamentally change how we deliver and experience life-enabling services and balance work and family life along the way. In our working lives we have largely been running on adrenalin as the distinction between weekdays and weekends, working hours and personal time blurred and, in many cases, all but disappeared.

Many care settings have been locked down, seeing family members discouraged, whether in care homes or at home; millions have been shielded, many families are tired or at the end of their tether, and many social care staff are exhausted.

Yet as Professor Ahmad states, we need to prepare for another six to 12 months of this. The cold weather and the prospect of winter have brought home to many of us just how difficult this really going to be.

I believe many of us have been subconsciously sustained in our efforts by the promise of reform, a workable funding model and of a better future for all. It was therefore a blow to hear from ministers that we are unlikely to see a social care White Paper until next year. This delay makes everything even more uncertain.

I suggest that getting through the six-month wall and facing down the next six to 12 months would be psychologically easier if we had a sense of what comes next.

In the absence of positive news regarding funding and reform, how do we keep going? Again, Professor Ahmad is helpful in sharing her experiences and charting a course for us. This includes keeping to our usual routines and obligations, giving ourselves some ‘shore leave’ where we can, looking after our minds and bodies, being realistic, avoiding social media (ahem) and rising above the fear. There is much to commend in all this.

It is important we acknowledge the adaptability that people with care and support needs, their families and our staff have shown. The community response has been tremendous and it is vital we collectively acknowledge the shifts that have taken place over the course of the last six months, with more of us taking on caring responsibilities. Recognition of the role played by those working in adult social care is equally essential.

One of the positives of the pandemic is that politicians and commentators now readily talk about social care and the contribution of those working in it, when previously they would only have mentioned colleagues working in the NHS. That is why it was important to see so many people from social care acknowledged in the recent Queen’s Birthday Honours list.

As we navigate what will undoubtedly be one of the most difficult winters any of us can remember, it is vital that we really listen to people with care and support needs about what matters to them. We need to approach with humanity the complex questions about balancing the need to keep people safe from COVID-19 with the desire to keep them connected within their families and communities. None of this will be easy, but the starting point must be conversations about what the individual wants.

We must also prioritise families and carers. We need to give people a break. Social care needs to be prioritised so we can offer practical respite care, so people can access universal support for health care needs and the necessary day-to-day support for personal care which maintains their independence.

During the second wave we are likely to be better prepared. We should also take heart that Britain has seen social care in a new light – as an essential service – and that recognition means it should be impossible for it to be ignored, and for the tawdry level of public underfunding to continue for much longer.

For all the fear, there is always hope. We will get through and beyond the six-month wall and survive the next six to 12 months by working together and looking out for each other. We then need a vision for a better future.

James Bullion is president of the Association of Directors of Adult Social Services and executive director of adult social services at Norfolk CC

@JamesBullion

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