Social Care Association’s Nick Johnson on personalisation

What experience informs what you do now?

Being number six of 10 children, I guess I was a skilled group worker when I arrived in social work. But once qualified, in the 1970s, I spent four and a half years in Papua New Guinea with VSO. It was a life-changing experience. I ended up running an indigenous theatre company. I lived very much as a minority person, and sensed some of the minority and cultural differences that people coming to England face.

Is the culture in developing countries to place great respect and value upon elders?

Absolutely – as there was in this country when I first qualified. I had an elderly neighbour for whom I had a high regard. I thoroughly enjoy meeting older people and finding out about their lives. For example, a couple of years ago in Cornwall I met a woman who had been an administrator on the Beveridge Commission in 1941 (an inquiry into social services, whose report in 1942 became the foundation for the British welfare state) who must be the only person involved left alive. I regret not going back and filming her talking about it.

What do older people want?

I recently did some work in a London borough with 1,100 older people. The striking thing about it is that individuals were modest in their comments compared to those in focus groups. People in a group are much more confident to say “this was rubbish”. They generally didn’t care who provided the care so long as it came when they said it was coming, and if it wasn’t coming that they were told in good time. But they did feel that if services were provided by the local authority they knew that the town hall was accountable – that was the key difference.

So, how will older people get what they want?

I definitely feel the solution lies with community development and growth. What communities need more than anything is to recognise and know each other – then you won’t ill-treat people because they are somebody else’s granny and granddad. In Scotland I challenged social care staff to name the neighbours on their street. How well do you know them? And how many of them would you leave your front door key with? We have forgotten our connections and we live this island life – which I find slightly disturbing.

Are individualised budgets the way forward?

There are predictions that 50% of social care spending will be in the hands of private individuals in 10 years’ time. That begs questions: how do you control the budget – afterall it is still ratepayers’ money. Innovation is marvellous but you have to be aware you are using public money. We have 500 people on individual budgets and that’s fine until you industrialise it and you’ve got 5,000 or 50,000, what happens then?

We can all reflect back to the Community Care Act 1990 when we had budgets for individual solutions. But the moment we industrialised it, community care managers bought places in residential homes because they were quick solutions and it removed people from their caseload. So, I’m interested to see how that will develop because at the moment I can’t visualise it.

How can we solve that?

Initiatives laid out in visionary terms need similar visionary solutions to make them happen. Will a service user-led system be a service user-monitored system? At the moment that isn’t in the discussion. And where there have been excellent service user-controlled direct payment support systems such as in Lambeth, when it came to re-tendering they were too expensive and they lost to a national charity. Is that what we are trying to do?

What is the Social Care Association’s role in this?

With 80% of the sector’s workforce in not-for-profit and private providers you have a lot of people unsupported by, for example, trade unions. I met a home carer for a private company who caught two buses from her home to do a half hour call – and didn’t get paid for the travel – time or fare – either way just to earn a half-hour salary. So we provide similar types of support to those staff while promoting best practice.

Further information

Social Care Association

Direct payments and individual budgets

Personalised care: Disabled people taking charge of their lives

Contact the author

Graham Hopkins