The future of adult social care

The first Care Conversation event of 2010 heard from Julia Unwin, Chief Executive of the Joseph Rowntree Foundation and Joseph Rowntree Housing Trust.

There was no dispute about the major global challenge posed by an ageing population, Julia Unwin told the seminar. ‘We know exactly what’s coming down the track.’ Everyone was likely to need some form of care, she said – ‘what kind, and how much of it, are the great unknowns’.

Joseph Rowntree was in a unique position to inform this debate in that it both funded social policy research and was a registered provider of care services, she said – an organisation that searched for the reasons behind problems and demonstrated solutions.

While no one in the sector could be in any doubt about the ‘public spending cliff’ they were approaching – with the public finance situation ‘as tight as it could possibly be’ – the three main political parties were at least talking seriously about issues of adult social care, she said, and there were sustained calls for a ‘full and fair settlement for older people’.

What was needed was a new approach, she stressed. ‘Plan A has not worked. It’s given us a scary old age – something we’d rather not discuss. Plan B needs to be fair, sustainable and transparent. These are not buzzwords – they’re a real test of what Plan B would look like.’

While she acknowledged that there could be no silver bullet, Joseph Rowntree was suggesting one potential plank of Plan B with its new report Equity Release. This looked at ways to make it easier for older people to use their housing equity to pay for care that would allow them to remain in their own homes, perhaps via a ‘trusted intermediary’ such as a housing association or local authority. ‘Staying at home is not right for everyone, but those who want to need the right support,’ she said ‘The voices of older people who need support are largely unheard in the system,’ she told the seminar. ‘They most often move into care at a point of crisis, without that sense that they could choose or think ahead.’ They were also frequently regarded as commodities rather than citizens or consumers, with those with high support needs – such as people suffering from dementia – seen in terms of being a burden or a risk.

All of this meant that it was essential to learn from existing best practice and discover what made some residential care work so well, she said. It was also important to look internationally to find out which societies were best at addressing these issues, as well as look at alternative models like co-ownership and ways to be creative about involving the wider community, for example in early detection of dementia. Another key issue was how to make working in a care home a more attractive role.

It was also essential to raise expectations, she told delegates. ‘It’s not enough just to talk about dignity and respect. We must be guided by the voices of those in care and those who need care. It’s a debate that none of us can avoid and that the main political parties need to address.’