Opinion

Why one size doesn’t fit all

Martin Walker, Policy Advisor, Think Local Act Personal.

Martin Walker, Policy Advisor, Think Local Act Personal

There is much activity at the moment in the policy world focused on developing the adult social care workforce to support the shift to personalised care and support. From my work with people who draw on care and support, I wonder whether the balance of effort is completely right.

Care and support is a people business and, as we know, whilst we all need shoes, we wear different sizes. Taking a step from shoes to social care, the significance of this analogy is that whilst we have certain basic universal needs in common, each of us is different and this difference makes life all the richer. That has been the thrust of social care policy for over two decades; to personalise care and support by enabling people to have more choice and control. This goal really plays out when we start to think about equipping the workforce to support this aim.

The current workforce reforms aim to introduce a national care workforce pathway with defined roles, underpinned by a standardised approach to learning and development with the new care certificate as the basic qualification. Whilst no-one would quibble with the need for workers who undertake highly skilled work to be competent, when I’ve talked to people who draw on different kinds of care and support, this is not their starting point. They are interested in what makes folks tick: their qualities, interests, characteristics; and their values. The training and skilling can come; getting the right kind of people is what is essential. So, if we are going to improve the quality of services and create an environment conducive to personalised care and support, we may need to expand the scope of what will contribute to success.

Severe problems with recruitment and retention make it difficult for providers to have the time or incentive to engage in values-based recruitment. Whilst these challenges are real, there are some areas where there is the potential for positive change. It is encouraging that the Care Quality Commission’s new single assessment framework includes I statements from TLAP’s Making It Real[1]. This describes what good care and support looks and feels like from the perspective of people who draw on care and support, based on the right values and behaviours. I was also interested to look at a research informed tool to support value-based recruitment developed by the University of York[2], to add to existing resources from Skills for Care; all useful stuff for providers wanting to ‘make it real’.

These approaches are consistent with what I hear repeatedly, that the answers lie with those who draw on care and support and workers.  From the work I have been involved in at TLAP I have seen some councils begin to really listen to what people and practitioners are saying, and as a result of these rich conversations changes have been agreed which neither necessarily envisaged at the beginning. This is real co-production.

There is a compelling need to embed a co-productive approach to developing the workforce and agreeing a common set of values for personalised care and support would greatly help this.  At the service level, many providers would I suspect welcome having some time and resource to invest in co-producing approaches to developing their own workforce. This is something that should be built into local approaches to workforce planning and development, with the support of councils and Integrated Care Systems. TLAP and other organisations like SCIE and Skills for Care have lots of resources and guidance that can help organisations get better at co-production[3]. In this way we should be able to shape a workforce that truly puts people at the centre.

[1] https://www.thinklocalactpersonal.org.uk/makingitreal/

[2] https://curiousaboutcare.org.uk/

[3] https://www.thinklocalactpersonal.org.uk/Browse/Co-production/

[1] https://www.thinklocalactpersonal.org.uk/makingitreal/

[2] https://curiousaboutcare.org.uk/

[3] https://www.thinklocalactpersonal.org.uk/Browse/Co-production/

Kirsty

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