Why we need to talk openly about social care

By Stephen Chandler | 22 May 2019

‘Panorama’ and ‘crisis’ – they are two words you would not usually expect a director of adult services to want to be closely associated with.

But later this month, the first of two one-hour specials will be broadcast on BBC1 under the title Crisis in Care – the result of the Panorama team spending 10 months following the work of adult social care teams at Somerset CC.

They followed a dozen case studies making their way through ‘the system’. You will see vulnerable people struggling to look after loved ones, people desperate for more support, those trying to get their heads around the convoluted back and forth between different agencies and, of course, the costs involved.

They filmed me at home preparing for some difficult meetings and decisions. As luck wouldn’t have it, they were with us during the most challenging year of budget setting that anyone at this authority can remember. We are now in a much stronger position, being able to top-up reserves and with robust plans for the coming year. But that positive bookend came too late to make these films.

I am among a handful of people outside of the BBC who have seen these films and even for someone who has spent a career in care, it is at times a difficult watch. Having an unflinching lens pointed at ageing and caring isn’t something you see often and at times it is heart-breaking.

There are things we would, given the choice, not want to put on screen – though I would add that our social work staff and those of care providers and voluntary groups come across incredibly well and I couldn’t be prouder of them.

This wasn’t some kind of undercover hatchet job. This was something we – as a council and me as a director of adult social services – signed-up for, open-eyed and well-aware of the potential pitfalls and lack of editorial control. Panorama came to Somerset because it knew of the heightened demographic pressures we face and the expected narrative was clear from the start – nationally the care system is under pressure, councils are struggling to meet the need with the funding available. That means difficult decisions for everyone, whether it is the family carer, social workers, care providers or the politicians with the unenviable task of making those big resource decisions.

So, why on earth did we decide to get involved? Without wishing to sound trite, we felt this was too important an issue and too rare an opportunity not to. The importance has been clear for at least the last couple of decades – the ageing population, more people living with long-term health conditions and central Government funding failing to keep pace.

In Somerset, in the next 10 years, around a third of our population will be aged over 65 compared to the national 21% and there is an extra urgency to this for rural counties like ours. We are already spending 38% of our budget on adult social care. The Local Government Association estimates that by 2025 the national adult social care funding gap will be around £3.5bn.

As the authority with responsibility for social care, we have a pivotal leadership role to play in how the ‘system’ in faces this challenge. We have confidence in what we do, in our staff and how we do things. And we are bold enough to see this as a rare chance to play a tangible role in putting this on the national agenda – and, who knows, maybe influencing some of the decision-makers.

This is a nettle that successive governments of various hues have failed to grasp. But this cannot continue. That brings me to the big positive we see coming from these programmes – the kick-starting of a proper debate about the future of care. The answer to the pressures on social care cannot just be financial. As a society, we need to talk openly about what we want for our loved ones (and ourselves for that matter) when we end up needing care.

These films talk frankly about both the financial cost and human cost of care – including the emotive subject of selling the family home to pay for care. What does care cost? Who pays? And who should pay? These things aren’t talked about enough and have to be part of the conversation.

And, straying into even more contentious and emotive territory, these films ask questions about what role we, as communities, neighbours and families, think we should be playing in supporting people as they need care? Big, difficult questions but ones which we – as a society – need to talk about and find answers to.

Stephen Chandler is director of adult services at Somerset CC

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