It would be easy, but misleading, to say that social care is in crisis. Somehow in many parts ofÂ EnglandÂ the system staggers on, using devolution to its advantage. A number of councils have adopted improved ways of working.
However, the sustainability of the system is increasingly being called into question. Whether itâ€™s theÂ Adass budget survey, research by theÂ Kingâ€™s Fund and Nuffield Trust, or my report for theÂ Carers TrustÂ on the Care Act, the message is broadly the same: the system is running on empty, and people are suffering the consequences.
Why has this not exploded into a major political issue? Most MPs acknowledge that social care is unfinished business, but this has not translated into sufficient political pressure. At a basic level, this is because most people make no distinction between social care, care and support and what the NHS does. It still comes as a shock to many families that social care is not free. Most people make no care plans because they have discounted the chances of ever needing it.
Today the most visible advocate for social care funding is the NHS England boss, Simon Stevens. He told the NHS Confederation conference earlier this year that social care, rather than the NHS, should be at the front of the queue for financial aid. Of course there is a healthy dose of self-interest in this. Health and social care are two sides of the same coin â€“ underinvest in one and you undermine the other.
The untimely death of the Adass president, Harold Bodmer, has robbed social care of an important voice. In hisÂ inaugural addressÂ to his fellow directors Bodmer called for a â€œsocial movementâ€ for social care, saying:
What we save will impact on people. Letâ€™s not deceive ourselves about this. The key is how we do it, how we have an honest debate with the public about the resources we have available and what this means.
Bodmerâ€™s challenge was the right one. There is an urgent need for a sustained effort to raise the profile of social care and turn it from the preoccupation of care charities, care businesses and care commissioners into a social movement.
Amid the gloom there are always surprises. I visited Winchester to find out more about theÂ Argenti consortium, a partnership between PA Consulting and Hampshire county council aimed at developing a new approach to technology enabled care (TEC).
The partnership has taken a developmental approach, framing the tender as being about delivering a reengineered service where TEC is integral, not a bolted on afterthought.
The team at Hants and PA recognised that to succeed they had to redesign services, be innovative in the way they identified people for the service, and provide credible evidence of the benefits. Bringing together the right expertise to redesign business processes, understand what the technology could do and manage the change was key.
They developed a benefits realisation model that is an integral part of social workersâ€™ assessment and care planning. Using this approach, an audit of 650 older people who had TECÂ found its deployment made an average net saving of Â£840 for the local authority over the course of a year.
A separate piece of analysisÂ compared the weekly cost to local authorities of all older people with TEC in January 2014 with the weekly cost of their service a year later. The same comparison was undertaken for all older people supported to live at home without TEC.
The results from this analysis identified that packages of care for people with TEC increased at a lower rate than for people without it. TEC also appeared to be the most effective at delaying an increase in care for people with a small to medium (up to Â£150 week) package of care. These findings supported those from the original audit.
Of course, the job of councils is not simply to buy telecare kit in a smarter way, but to transform the care offer using technology. It is therefore important not to be dazzled by the kit, but to realise its benefits. I haveÂ writtenÂ about the need for service redesign before, with examples in Kent, Shropshire and North Tyneside.
This month I will be chairing a thinktank convened by the TEC industryâ€™s trade body, theÂ TSA, bringing together social care and health commissioners, along with industry and business process redesign experts, to draw up a practical agenda for realising the benefits of TEC. The thinktankâ€™s report will be launched at theÂ International Technology Enabled Care ConferenceÂ in October.
There is no single simple solution to the challenges facing social care. But those councils looking to do things differently need to think about the contribution technology enabled care can make. It can make a difference.
Nearest tube: Elephant & Castle underground station (Northern and Bakerloo lines).
Nearest Railway Station: Elephant & Castle
Buses from Elephant and Castle: ask bus driver for Burgess Park. Bus numbers: 12, 171, 148, 176, 68, 484, 42, 40, 45