Call for action – build on trust in adult social care

By RedQuadrant consultant Charley Maher

In my blog in April I discussed how, because of COVID-19, local authorities have experienced a significant increase in demand for packages of support and an increase in people requiring support in the community as they lost access to their informal networks of families, friends and communities.  To enable local authorities to respond to the most urgent and serious cases, volunteers, charities and third sector organisations have come together to respond to the crisis; food banks, befriending services, distributing packages, sharing creative ideas to reduce social isolation, etc.  Organisations unified as we started trusting one another, and relationships between sectors are strengthening.  This newfound trust has resulted in quicker and smoother solutions to immediate need as we see conversations between individuals and those who know them best. We can see communities, volunteers and third sector organisations being trusted to engage and respond with people they know.

There is the question of how councils will cope in the post-COVID world of adult social care, with the increase in demand, in business as usual community reviews and in people who use services? My suggested answer is to build on these new approaches of trusting providers, trusting care agencies and third sectors who have existing relationships with people.  If we can trust them in a crisis, can we extend this trust into the future thereby extending and continuing this sense of community and togetherness we see now?  As we utilise the resources and knowledge these organisations and providers have to respond to the crisis, can we see this as a new approach to implement in our services and practice? Can we simplify processes and remove some of the formalities and structures that serve as time-consuming and potential blockers to true conversation-based approaches?

Before the Covid crisis, we did some work with a London borough to research, coproduce and test a model whereby the third sector was able to carry out some of the statutory functions of adult social care. A public consultation with people who used services, carers and families were open to the concept, with reassurances around training and quality assurance with the local authority maintaining oversight and responsibility.  Ongoing consultation with the third sector demonstrated an appetite for providers and voluntary organisations to be more involved in the statutory functions and the belief that doing so would improve outcomes for individuals that use services. Piloting, with high levels of face to face training, ongoing support, point of contacts for advice and training,  provided evidence of the capabilities of the third sector to produce person centred, strengths based assessments and reviews with individuals which resulted in creative support plans and increased use of community resources as opposed to the default approach of formal services.

Public consultation and provider engagement and piloting shows us it is possible to develop and build on trusting relationships with care agencies and the third sector.  The COVID – 19 crisis has shown that local authorities have turned to providers and the third sector to support them and it has been this joined-up approach which has helped meet the increased needs.  Yet we can still see some hesitation around continuing with these trusting relationships.  Why?  Assessments and reviews are statutory functions.  They are important pieces of work with individuals which require skilled conversations and person-centred interactions, a broad knowledge base to encompass,  direct payments and financial considerations. And ultimately Local authorities remain responsible for these functions therefore it is understandable there may be hesitations around using providers and the third sector to complete them. The question then became; how do we reduce these uncertainties and support the development of these relationships with providers and the third sector?

As we suggested in the previous blog, this would require training and upskilling of voluntary and third sectors: the Care Act is clear that those undertaking assessments and reviews should have the skills to do so.  We have created a qualification specification with clear learning outcomes and training modules to as part of an accredited qualification to upskill providers, care agencies, and the third sector across adult social care. Before we progress this any further, we would like to engage with local authorities, providers, commissioners who are potentially interested in making greater use of the third sector for assessments and reviews: we are interested in working in a couple of areas to refine and develop the work we have undertaken to date on qualifications in this space.