After the heated and often confused debate about social care during our strange general election, we need to ensure that the Green Paper promised before the election is not only delivered but also moves beyond the question of who pays what, to set out what that money should pay for: support which enables people to live safely, purposely and well, in their own homes (or, failing that, a place which can become home), with people they love.
This is a long way away from the care most often highlighted, delivered on a shoe string by people whose capacity to care is sorely tested by low pay, long hours and constricted roles. But social care which is social as well as caring is not out of reach. It already exists, even where .
Shared Lives is a little-known model of support, in which approved Shared Lives carers are matched with disabled adults or older people, and share family life with them. An adult with a learning disability or mental health problem might move in with their Shared Lives carer, living as part of their household, sometimes for many years. One woman describes how her longstanding mental health condition saw her constantly turning up at A&E or resident in a hospital ward. Living with a Shared Lives carer gave her the motivation as well as the support to stay well and her use of hospitals has dropped dramatically. Other people regularly visit their chosen Shared Lives carer for short breaks, which might otherwise be taken in a care home, bringing the two families together into a more resilient support network.
There is a tendency to dismiss innovations like Shared Lives as small-scale. It is now used by 14,000 people in nearly every area of the UK. This is a fraction of the number of people who get support, but Shared Lives is one of six innovations which have formed links with each other to demonstrate that, collectively, they could form the core of our long-term support system for adults, rather than the subjects of endless short term pilots, whilst ‘core business’ remains unchanged.
The six include Local Area Coordinators who are embedded into a neighbourhood to reach out to people who might otherwise slip towards crisis, connecting them to their friends and neighbours so that they have a better chance of living well in their own homes. Homeshare brings together young people who need somewhere to live and can offer a little help with older people who have a spare room. Like Shared Lives it is based on matching people who make a positive choice to share housing and social lives, as well as to help each other out.
Community Catalysts supports ordinary people to form a wide range of tiny, highly personalised health and care enterprises. In Somerset, one coordinator has helped over 170 tiny enterprises to start and sustain home care in a rural area which traditional agencies struggle to reach.
Wellbeing Teams help people think about ways to secure the help at home they need, bringing together paid and informal sources of support such as Community Circles and even helping people in residential care return home. Community Circles are a way for people to form stable, long-lasting circles of support around an adult who might otherwise rely entirely on stop-start services with ever-changing staff rotas, and start to fall down the gaps.
Each of these models on its own cannot offer people everything they need to live well, but together, they start to form a very different support system. It is that new system, not just the question of how to pay for the current one, which should form the heart of the Green Paper.