The Big Picture: What do we want from adult social care reform?

For social workers under pressure day-to-day, there is usually little time to think about the wider issues and policies of social care.

But the government’s promise of a green paper for a new adult care and support system requires serious thought if it is to improve services, as well as fund them better.


It’s a rare chance therefore to ask two important questions: who do we want care for and what kind of care do we want?

Social workers feel they have enough people with complex enough needs on their books already. But the need for care will touch every family at some point – whether learning or physical disability, mental health, chronic conditions or old age. These needs are often specific – with many people needing different services, whether from health, housing or welfare services as well as social services. And some families on middle-incomes and paying for their own care are receiving a worse deal than those getting help from the local council. As well as those already working in or using the sector, a new system must have the support of the wider public.

So a new system should look to provide a universal service of information, advice and personal support, whatever people’s ability to pay for their actual care, and whatever their type of care need. And it should promote a more joined-up adult service, which brings together services supporting people’s need for health, housing, employment and skills, as well as care and support.


Second, what kind of care do we want? When people first used the word care, it had two meanings. One meaning was a burden that dragged people down the other was a force that enabled humans to achieve their full potential.

Individual budgets, already coming into local authorities everywhere, hope to promote the second meaning of care. But doing this also must mean changes to how we assess people’s needs, how councils promote the availability and quality of services that are out there, and how we assess how well services are doing.

Aiming for the second meaning of care – supporting people to participate fully and equally in society – helps us to frame the question of how much we want to spend on care and for a more generous award. To enable social care to go far beyond providing a Cinderella-style, tick-box service, this green paper must think outside the box.

Sophie Moullin is a research fellow at the Institute for Public Policy Research.

She is author of Just Care? A fresh approach to adult services available to download at

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