New Adass president Jenny Owen believes that the current model of adult social care is unsustainable but at a time of economic crisis how can it be improved? Amy Taylor reports
The new president of the Association of Directors of Adult Social Services, Jenny Owen, will have her hands full over the coming months. The imminent publication of the adult social care green paper, the economic crisis and the run-up to a general election create a unique backdrop to her appointment this week – something she is very aware of.
“We need to make the most of the green paper as a one-off opportunity,” she says. Adass needs to build public awareness of the green paper and adult social care as a way of making it a manifesto issue for all the parties, she adds.
The government has predicted a £6bn funding gap for adult social care in 20 years, but how it plans to close this gap is as yet unknown. Owen says Adass put in an initial position to the Department of Health and is now waiting for the green paper’s publication before reacting again. She sees helping to shape the new system as one of the key themes of her presidency.
“It’s going to be important for Adass to help lead that debate so people have a strong voice about what it is that they want from the system and what it’s for,” she says.
Owen, who is executive director of adults, health and community well-being at Essex Council, says the current model is not only unsustainable but unfair and it’s this that needs to be changed. For example she asks why someone with an acute illness such as heart disease qualifies for free care (on the NHS) but those with Parkinson’s or dementia do not. “We need to put the principles and the values right before we start thinking about the funding model,”she says. “We have to have a system that’s fair.”
The lack of a national set of eligibility criteria is another part of the system Owen believes needs reform. She says that the current model where individuals with the same needs but living in different areas can qualify for different levels of service, “doesn’t make any sense” to people and needs to be changed.
The Commission for Social Care Inspection’s 2007-8 State of Social Care in England report, published in January, highlighted the lack of help offered to those who fund their own care. Owen agrees that councils need to improve their service to self-funders, and says they should be treated on a par with those who rely on the state.
Several organisations suggested a universal offer in their submissions to the government’s consultation on the green paper last year. Some argued that the minimum should consist of a right to access to information and advice for all, regardless of their financial situation.
English councils are working to provide such a service under the Putting People First initiative, a three-year government led programme to personalise support for adults in social care that began 18 months ago. Adass is studying how councils are progressing.
Other parts of the initiative, which is backed by £520m of funding, include giving service users more choice and control.
The British Association of Social Workers has said the personalisation agenda in this programme is a threat to social work. It argues that some councils are excluding social workers from the agenda by narrowly focusing on increasing the use of direct payments and individual budgets rather than the principles of the initiative. Other critics also point to evidence that work with people with low level needs is going to non-qualified workers when it would have previously gone to qualified social workers.
Owen disagrees with BASW. She sees the qualified social worker post changing rather than facing possible erosion. In Essex this has meant qualified workers in the assessment team moving towards carrying out the more complex work, with long-term care management continuing to require the expertise of a social worker, she says.
“I think the role will change. If you think about the overall social care workforce, qualified social workers are a very small part of it. We need to make the role right for the future so we need to think about its tasks alongside putting people at the centre [of services]. I personally don’t think that goes against people’s expertise,” she says.
In Essex, all new service users are offered individual budgets as a matter of course. Owen says training for staff is essential to making this work and that this is the case for the whole of the personalisation agenda if it’s to be successful.
“When we mainstream this new system there is a big danger that we might make it as bureaucratic as the old one. When you introduce different ways of working they take time to get right. We did an enormous amount of training for our staff.”
Impact of recession
Owen enters her presidency at one of the worst economic periods for many years and so helping councils to support their clients in these circumstances will be another theme of her tenure. “Councils need to be aware that as unemployment increases more people will become entitled to free or partially free care,” she says.
She says that Adass has been thinking about how the economic recession will impact on social care services and to respond to issues such as pressure on housing and loss of charging.
Safeguarding is Owen’s final priority. The Baby P case and failings at Doncaster children’s services have led to a focus on child protection but the recent joint ombudsmen’s report on neglect of people with learning disabilities shows the importance of safeguarding for adults also. Owen says the ombudsmen’s report brought up “serious issues” and councils need to improve their performance.
“It is important for all of us because the last CSCI report on safeguarding inspections shows there’s a lot we need to do to make sure our services are focused sufficiently on keeping people safe.”
Increased taxation at a time of economic decline is unlikely to be popular with voters and some fear the government may simply tweak the old adult social care system rather than overhaul it.
Owen says this would represent a missed opportunity and is something she and Adass will work hard to avoid.
This article is published in the 23 April issue of Community Care magazine under the heading Opportunity of a lifetime