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Covid-19 brought home some stark truisms about just how little central, and to a worrying extent, local government, understood about the social care that they were statutorily responsible for. There appeared a level of carelessness about a cohort of people who either received care and support or worked within the sector that meant as the darkest days of Covid-19 drew closer, the opportunities to make care count were missed.
Vic's blog is part of a series of blogs reflecting on the 75th anniversary of the National Assistance Act. To read more of these, please visit our project page.
This is not a new story, but potentially one of many years of carelessness. The forgotten decades of reform that The King’s Fund blog so aptly captured, leaving social care not just the Cinderella service, but perhaps more aptly Sleeping Beauty – tucked away to slumber while everyone else moved on.
The social care community has been ravaged by Covid-19. While the Inquiry team starts to unpick the implications of the handling of Covid-19, social care is having to learn to live with the daily consequences and it is clear that at least three things will never be the same again.
'The first is that people who receive care and support and the workforce who provide it have been fundamentally affected by Covid-19.'
The first is that people who receive care and support and the workforce who provide it have been fundamentally affected by Covid-19. Those who worked through the pandemic are left with the memories and trauma of an unthinkable time. They will often have spent much of the pandemic engaged in a series of battles, whether it be for the PPE (personal protective equipment) they required, advocating for health and support services that would not respond, accessing the testing and vaccination regimes, isolating as a result of Covid-19 or working in teams rapidly depleted by an ongoing workforce crisis. They will have had to deliver care behind a mask amid rules and restrictions that often had little recognition of the needs of the people they worked with, or the setting that they delivered care within. They were frustrated and exhausted. I hope they also felt proud of their dedication, but they are unlikely to have felt rewarded.
Those who received care and support through the pandemic will have found restrictions on their abilities to connect with families and friends, take part in educational or employment activities, gain access to medical and broader support services, and the impact of these restrictions will have generally gone on much longer for them than anyone else in wider society. I hope they will feel supported, but they are unlikely to have felt fairly treated.
'They understood that care was about people they knew and loved.'
The second change is the lasting impact Covid-19 has had on public perceptions of care. Time was, pre-Covid, that getting any stories about social care on the national news was noteworthy. This changed overnight, and it became commonplace for the news agenda to not just feature social care, but to lead with it and to hold relevant politicians and decision-makers to account about their actions. Perhaps for the first time, the wider public had a view on those who worked in care, they understood that just protecting the health service was not enough, and that care had a very important job to do supporting people with very complex levels of need and frailty. They understood that care was about people they knew and loved.
'Yes, social care was always political, but it was not popular politics and not an easy nut to crack.'
And finally, the world of politics. Adult social care is deemed to be one of the most heavily regulated sectors in England. We have often rationalised this level of scrutiny for the safeguarding role it plays, alongside the drive for quality. However, what became apparent very rapidly as Covid-19 hit, was that this level of scrutiny simply had not translated into a true understanding of what the provision of social care really meant. It was rapidly apparent that the tens of thousands of inspections, the intensive level of reporting and market oversight, the multiple ‘state-of-the-nation’ pronouncements about what was happening in social care had been sucked in, but never digested. Previous government attempts at reform had slowly risen to the top of the political pile, in latter decades maturing from ideological words to ready-/part-baked plans only after at least two terms in government.
However, Covid-19 has shown that ignoring the evidence, turning a blind eye to the words of commissioners and providers, and most importantly ignoring the voices of people receiving care and support leaves an unacceptable level of risk, meaning previous attempts at political ‘pass the parcel’ can no longer prevail.
As the wider world begins to accept the realities of long Covid for individuals and for society, it is vital that social care continues to articulate both the symptoms it is still experiencing, and the well-rehearsed reform-based cures. The Covid-19 legacy is complex, but perhaps after decades of dismissal, the real anniversary prize for the National Assistance Act is one where finally everyone accepts and understands that social care matters to us all.