Social care: what's in a name?

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Social care is all around us. More than 1.5 million people in England are employed to provide social care to older and disabled people. And these numbers are dwarfed by almost 6 million unpaid carers – family members and friends who give up their time to help with a range of tasks, from cooking to personal care.

But despite this, ‘social care’ is a phrase you don’t hear much in everyday life. Last year, when my 94-year-old grandmother's health was deteriorating and she needed support with washing, getting in and out of bed and other day-to-day tasks, I remember noticing that no one in my family used the term social care. Instead, the talk during this difficult time was about ‘speaking to the council to get someone in to help Gran’, and ‘finding a carer who will come around to the house’.

So why don’t we use the term social care very much outside of professional circles and the media? And does it matter if we don’t?

There are a couple of reasons why it doesn’t trip off most people’s tongues. First, it is an umbrella term that includes a broad range of activities associated with the tasks of everyday living, and can be replaced with more specific terms such as ‘going into a care home’ or ‘home help’.

Second, social care doesn’t have the recognisable brand that the NHS does, and research suggests that it isn’t widely understood. A survey carried out by Britain Thinks for Age UK in 2015 showed that many members of the public ‘have never heard of social care… do not understand what it is, what aspects of care it covers, how to access it or how, if at all, the social care system aligns with the NHS’.

Other research also hints at a lack of awareness of social care. In surveys such as those by Ipsos MORI and in the British Social Attitudes survey, when people are asked whether health and care services have improved or about their overall satisfaction with services, the percentage who answer ‘don’t know’ is much higher for questions about social care services than for those about general practice or hospital care.

As my colleague and social care policy expert Richard Humphries reflected at the end of last year: 'A troubled NHS easily commands public attention through visual images of overflowing hospitals and queuing ambulances. But when the social care system is “full”, few notice, the consequences scattered silently and invisibly across thousands of homes and families. It makes little noise on the radar of political and public concern.’

In recent months, social care has risen up the political agenda. The crisis in social care – and the injection of funds for social care in the Spring Budget plus the promise of a Green Paper – has given the issue more prominence in national debate. And it seems likely that social care will feature prominently in the general election campaign over the coming weeks. 

But it would be easy to assume, from reading news stories alone, that social care was just about older people and hospital discharges. In reality, of course, it is much, much more than that, covering a range of activities to enable people of all ages, with a range of needs, to live their lives to the fullest.

It’s not just the public who have a limited knowledge of social care. I'm struck by how many of us working within health have a quite basic understanding.

Last year, our fellow in social care policy, Patrick Hall, gave an overview of social care in a seminar for staff from The King’s Fund. We all learnt a lot, and the seed of an idea emerged: could we produce some content for professionals, patients, service users and others that would simply explain what social care is and how it works? After all, making sense of a complex policy environment is one of our organisational goals.

Inspired by some really creative examples, we decided to shoot some short videos as the centrepiece of a package of content explaining social care. As much social care happens in people's homes it felt right to set our videos outside the office environment, and we decided on a kitchen – often central to a home and the place where things are organised and discussed, where food is prepared and cups of tea drunk. We tasked Patrick with using these surroundings to explain, in his own way, what social care is.

We hope you find these videos useful, and that they prompt you to dip into our more in-depth commentary and analysis, including an updated short history of social care funding timeline. The format may be light, but the rationale and purpose could not be more serious: improving understanding of social care, and helping to raise it – and keep it – up the national agenda.

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Pearl Baker

Independent Mental Health Advocate & Advisor/Carer/DWP Appointee/Deputy to COP,
Comment date
12 May 2017
As a Deputy for the COP for a 99 year old relative and RPR for DoLS i have 'battled' with a system regarding my request for a CHC assessment. It is important to know how the systems 'WORK'? I am now on the fourth request for CHC Funding? each time there is a change in NHS Provider, Nursing Home throughout the First Stage PROCESS. 'CHECKLIST' It starts all over again.

My request for a CHC assessment was first REFUSED by the Dr in an NHS Hospital, I reminded him it was not his decision, it was a process: first a 'CHECKLIST', if you pass this it continues to the second stage, a lengthily Full Assessment. I was present, it took five hours, going through each domain of 12, scoring each domain separately, confusing, as many of these domains overlap with each other.

As a RPR for DoLS and a COP Deputy it is important to understand your responsibility to your client: the exercise yesterday identified serious errors, mostly within the Nursing/Care Home patients Records, firstly the RPR was NOT informed of All the difficulties they were experiencing in Nursing my client, secondly their understanding that 'Care Plan' meetings are important for us, responsible as per a COURT ORDER

I have put together my own 'Care Plan' format, taking into account the 12 domains, this would make it easier for CHC Assessors, 'Care Plan' meetings on a monthly basis (i understood this was taking place) but i was not invited? this MUST change.

The CQC have a responsibility to those in Residential placements, they must start understanding their Inspections are NOT 'fit for purpose' as i discovered yesterday.

I am a CARER of more than one individual, yet West Berkshire Council refuse to accept my Carers Status.

I am concerned that those individuals living in the Community placed into Supported Accommodation and subject to a COP Order for 'Property and Finance' are exposed to POOR Health and Social Care, as my media campaign EXPOSED.

My Media campaign via the Guardian Newspaper exposed serious Failings by the above LA. West Berkshire Council, and L & Q Housing Association, resulting in the refurbishment of these one bedroom flats, but little has changed.

i will leave you with the phrase HEALTH & SOCIAL CARE; what's in a name? it means for most absolutely NOTHING.

George Coxon

Various H&SC specialist & care home owner,
Comment date
11 May 2017
So important to raise and keep raising this as we approach the #GE2017 so much ambiguity about the nature and term 'social care'. I've been (and still am) an NHS protagonist as clinician, manager, commissioner at trust, primary care, health authority and PCT level prior to migrating more to a social care world. It's reassuring that more people use the term 'health&socialcare' these days but the line in ridiculously blurred and inconsistent. Areas S uch as when CHC funding requests are made for many of the >85yr older folk living in care homes with complex health care needs (previously those who would have been in a nursing home) result in lots of time spent in the process and huge resource pressure & many not getting NHS funding that is none means tested that is hard to rationalise. This leaves care compromised and families disadvantaged too. We need some courageous discussion about this prior to the 8th June with constructive, credible and creative commitments to address the challenge. Last point the

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