Research: towards a sustainable future with social care

Robin Miller and Helen Dickinson investigate the case for protecting social and environmental resources with new approaches to delivering social care

KEY WORDS: Adult social care ❙ Sustainable development ❙ Personalisation

AUTHORS: Simon Evans, Sarah Hills and Lucy Grimshaw

Title: Sustainable Systems of Social Care, Social Care Institute for Excellence, 2010, 76 pages

Aim: To explore the opportunities and challenges of delivering a model of adult social care that meets the individual needs of current and future generations while protecting and enhancing the environment.

Methodology: A mapping of key strategies and policies relating to sustainable development was followed by interviews with commissioners, providers and service users in several local authority case study sites.

Conclusion: Adult social care can be delivered in a more sustainable way but this requires vision and commitment from local leaders, commissioners and providers to look across the whole system and co-produce creative solutions with service users. The relationship with personalisation is complex – community-based models could contribute to sustainability but more individualistic approaches could have negative impacts.

What is sustainable development?

Sustainable development is a strategic approach to development that aims to improve the quality of life and meet the needs of current and future generations while protecting and enhancing the environment on which we all depend. It considers not only an environmental agenda but also its connection with social justice, human health and well-being and economic development.

Research objectives

Sustainable development has had a lower profile within adult social care than in other areas of government policy, such as health. This research aims to generate discussions by exploring the opportunities and challenges that a sustainable model (see table) will present, and by highlighting examples of good practice in social care.

Findings

The overall finding of the report is that a more sustainable approach to social care is achievable. From research into four case studies, examples of good practice show that sustainability is already being implemented in some areas. For example, a community-based meals service in Camden, London, uses locally sourced foods delivered by energy efficient vans; IT systems in Cornwall enable frontline social care workers and managers to have meetings through video and teleconferencing rather than making car journeys; and in Bristol the environmental audit system has led to measures including more energy-efficient buildings and increased recycling of office equipment and food waste. Sustainable models can have health and social benefits too.

For instance, gardening clubs within older people’s care homes bring together residents with volunteers from the local area, encourage residents to remain active and provide a local source of fresh fruit and vegetables. Timebanking within mental health day services enables members to earn credits by supporting other people and contributing to service delivery – these credits can then be used to access community resources.

Personalisation

The research also identifies important issues regarding the potential impact of personalisation. The case studies showed personalisation has potential to significantly contribute to sustainability, for instance by enabling people to access community resources through walking or public transport rather than being transported to a day service some way from their home.

Community-based models encouraging people to develop shared solutions with neighbours also have considerable potential. However, there is a danger that personalisation, through its promotion of more individually determined solutions, could lead to a damaging environmental impact.

For example, if people living in the same street choose different providers to deliver community meals, this could increase the carbon emissions in comparison with a single provider delivering to all. Furthermore, people accessing services may not always recognise or prioritise sustainability in their purchasing decisions.

Recommendations

Drawing on the policy mapping and case studies, the authors propose nine features as pre-conditions for a sustainable system of social care and provide a number of recommendations.

These include a clear government strategy and action plan focused on adult social care; local authorities and health services to ensure that local stakeholders are engaged with this agenda; and for personalisation to be implemented carefully and imaginatively.

Critique

This research provides an excellent starting point for local and national discussions regarding sustainability and adult social care. Through summarising the national policy context and reflecting on the experience of areas which have begun to shape local strategy and practice, it should prove useful for commissioners and senior policy makers in particular. The report acknowledges that more research is required, particularly in relation to the views of people who use services.

If personalisation is going to be the future basis of adult social care services, in England at least, then it is undoubtedly the key to sustainability being achieved. This raises important issues about the degree to which people who access services should be expected to consider the wider needs of society in developing their care packages and making purchasing decisions.

Further work could also be done with social care providers – while there are examples in the report of practice within direct provision, the focus appears to be mainly on local authority commissioners and leaders. It would be interesting to learn further of the experiences of providers and give more practical examples of how they have considered and addressed these issues.

Finally, examining the reality of the financial savings of such initiatives would support senior managers considering the potential of an “invest to save” or preventative approach to funding services.

Practice implications

For senior managers

● To recognise the importance of the issue and ensure that it is embedded throughout the whole of the social care system, and considered by strategic partnerships

For commissioners

● To engage with people using services and providers to identify creative solutions to promoting sustainability

For providers

● To audit their services and identify opportunities to reduce the environmental impact of their services and increase community capacity

For social care professionals

● Implement practical steps to make their own practice “greener” eg, plan visits to reduce use of cars, increase recycling of office goods and consider holding ‘virtual’ meetings through teleconference calls or video technology

● Be aware of environmental issues within the local community and consider their potential impact within the assessment and care planning process

● Discuss issues related to sustainability with people designing their own support plan. This could include opportunities to share resources with other people.

Further reading

Independence, community and environment – Final report of the Sustainable Social Care Learning Network (2010)

A better return: setting the foundations for intelligent commissioning to achieve value for money (2009)

Saving carbon, improving health: NHS carbon reduction strategy for England (2009)

About the authors: Robin Miller is a senior fellow and Helen Dickinson is a lecturer at the University of Birmingham’s Health Services Management Centre.

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