Social Care 2012: Where We Are

Over the next four posts I want to take a deeper look at the issue of social care. I'm hoping to include thoughts and views from others on Twitter, comments and email, so please feel free to add your own opinions, regardless of whether you agree or disagree with my views. I've been inspired to write in-depth on the topic because I believe that it is time to make social care personal.

You might think that personal experience is no basis on which to make (or even suggest) public policy. Policy absolutely must be based on research and evidence, on rigour and analysis. Debate about desired outcomes must be couched in what's best for society as a whole - mustn't it? Well, it's an argument that I understand, but when it comes to issues around social care, I can't help but feel that the focus on research and analysis is just serving to dehumanise what is at root a very human issue.

For me there are three main factors - professional, political and personal - that are driving the rising importance of social care. Firstly, at a professional level, the absence of housing organisations from the centre ground of social care debate continues to flummux me. From housing ministers (from all parts of the political spectrum), through the support organisations of the CIH and NHF, to (most) individual housing associations, the issue of the supply of new homes has way greater prominence than the issue of care and support for people living in existing ones. Yet, by any statistical analysis, the reverse should be true - while we argue about whether 150,000 or 250,000 new homes are needed each year to solve the supply crisis, there are in excess of 500,000 households receiving home-based social care each year.

Another factor that exists at a professional level, too, is that it saddens me that we continue not to learn the lessons of what makes a difference. Experience tells us that prevention is better for the person and cheaper for the provider than crisis intervention can ever be. History has revealed how "just in time" social care remains a pernicious bean-counter's myth. We need new voices in these debates and new partnerships need to be forged to make change happen.

Even then, there's no guarantee the new approach will stick: last year, I shared "Freda's story" which brought together police, social care and housing people in response to just such a crisis, we were united in our outrage that "the system" had failed Freda. Now, the chief superintendent and the main social work contact who were involved in that case have both moved on and so the energy and ability to create change inevitably dissipates.

Politically, I watch, hopeful but not expectant that some consensus will emerge about how the demographic forecasts and the financial ones can be reconciled to create a better social care system. But the facts are stark and there is no easy answer. More old people will rely on the taxes from fewer working people to fund their needs in old age; more old people will have less by way of family support - 20% of women born in 1964 are childless compared with half that number from a generation before; and medical advances mean that more old people will live to be very old, with a consequential impact on care levels and budgets.

Finally, at the personal level I have had three direct, and quite different, experiences of social care in the last 12 months. I've seen quality residential care, so I know it can be made to work. I've also witnessed the effect of the benign neglect of institutional incarceration; and I've seen the not-so-benign neglect of a profit-driven domiciliary care provider and the consequential hospital readmission of a sick and vulnerable old woman.

Over the next four posts, with your input, I'd like to address social care from these different angles, share what I've learned and experienced on the topic and suggest some ways forward, because the one thing that we all agree on when it comes to social care is that we can't go on like we are - can we?

Share your thoughts in the comments, on Twitter or to me directly by email. 

The Blindingly Obvious Blog Post

This week's blog was supposed to be the first in a four part series covering some thoughts on social care that were going to be better planned than the normal, slightly random, series of blogs that readers get. But, with questions of housing and housing supply competing right up there with Julian Assange for the domination of the post-Olympics, pre-Paralympics news agenda it seems as if topicality should trump considered opinion.

So what has the last week brought us? First there was the news that the Office of Fair Trading wasn't going to interfere in the merger process between two large North-West based associations. For those at Arena and Harvest, (now the rather curiously named "Your Housing Group") this is clearly good news, and for the rest of us it brings the relief that the swinging pendulum of regulation is not increasing its interference in our affairs.

Housing minister @grantshapps says PE sell off policy is "blindingly obvious". What do you think? bit.ly/PKOVzA t
— Hannah Fearn (@hannahfearn) August 20, 2012

Then on the same day, the Financial Times runs a front page piece about the Government, possibly, looking to underwrite housing association bonds. Wow! Good news if that can happen - it's "blindingly obvious" (for those not familiar with the relevance of this term, hang on) that if our borrowing costs can be cut - and long dated Government Gilts trade at 2.5%, well below our average cost of capital - then we can build more houses for the same rent. So I look forward to some announcement soon...

And then there was Boris news. It seems as if the housing market in London might not present quite such easy investment options for affordable housing as the Mayoral Office might have hoped. Sites at affordable prices and with planning consent seem to be a bit thin on the ground; there's talk of allocations not being able to be spent "down south". Could it be that the HCA will need to move resources away from London if the full National Affordable Housing Programme is to be spent? If so, @grantshapps, there are plenty of oven-ready sites up here in the North-West, so please direct it to us, so we can do our bit to get Britain building again.

You might think it was "blindingly obvious" to do that rather than let the money slip away from housing, just as you might think it was "blindingly obvious" that these areas never needed the Government's support for their affordable programmes anyway. And my source for that? Nothing other than the real turkey of the week - the report from the Policy Exchange suggesting that all social housing property which has a value above the regional median for house prices should be sold, not re-let, when it becomes vacant. The maths is compelling - sell a big house in Westminster, and build 10 small ones, without grant, in a place with below average house prices, and presumably that was why @grantshapps was quoted all over the press as saying the idea was "blindingly obvious" (see here, here and here for coverage).

I can actually think of some very good business reasons why selling property when it becomes empty is a good idea: cash would keep coming in and if it was genuinely only high value property that was sold, receipts would exceed cost of replacement supply; our reputation as a landlord would be one who only ever let newly-built homes (attractive to any prospective customer); our life-cycle repair costs would be substantially lower - Decent Homes repair thresholds and the associated expenditure would become irrelevant as only a tiny minority of tenancies would last 20 years. The bean-counters would be very happy indeed.

But, as @IsabelHardman at the Spectator said, it "would see a gradual shift towards a Parisian model of the social housing ringing a city in only the cheaper areas. Those areas are the ones with poorer job prospects, which increases the risk of tenants who are unemployed remaining so." As we've seen with so many other financially driven ventures into social policy - from A4E to G4S - understanding maths is no pathway to understanding real value for the tax payer. Not so "blindingly obvious" after all perhaps?

The Olympic Legacy For Housing

Although I was born in London, I've lived elsewhere for twice as much time as I have in that city - leaving it as I did shortly before my 19th birthday. But it remains much more "my" city than either Manchester or Liverpool, the two great Northern cities where I've worked for the best part of 30 years. So it's been especially interesting to follow the Olympics and observe what it's been doing for the area.

Just to prove I was there!

Over this last weekend I was one of the lucky ones in the great ticket lottery with both a handball Bronze medal match to witness and a closing ceremony ticket. As a result I got a chance to see not just a partying London, but also the associated regeneration close up.

Twitter seems pretty divided over the artistic merits of the Spice Girl reunion and the closing ceremony doesn't seem to have ignited a swell of national pride in the same way as the Danny Boyle's opening ceremony did. More to the point for the purposes of this blog, much the same can be discerned in the comments about the economic and social benefits of the physical regeneration.

The naysayers' arguments about benefit for local communities being small, about prices being too high, about flats being prioritised over family houses don't stand up for me. It will bring new homes for many and made a dramatic change from the Hackney Marshes I remember. Seeing it first hand I think it is a powerful reminder of the transformational power of Government investment.

The news agenda is rightfully concerned about capitalising on the sporting and health impact of the games at the moment, but in the long term the regeneration of our country needs reflection, analysis and action too. Surely it's not too much to hope that amongst the MPs who went to the games were some who recognise the housing, health, employment and economic benefits that regeneration brings to communities and restores the word to the lexicon of policy discourse. 

Why Punish Those Who Arrest Crime?

Greetings from an Olympic Borough. I'm writing this as the curtain comes down on the Olympic football events played here in Trafford as part of London 2012. OK, maybe it should have been Team GB playing Brazil tonight but insider knowledge (and a quick glance at our track record) suggested that penalties were always going to be a struggle. Quite a few local lads were known to have benefited from free Olympic balls as wayward shots evaded the fence around their training ground in Partington. It didn't bode well.

Shouldn't hard work and success be rewarded?

Even so, it's been a great games and unlike London, there's evidence that tourist numbers are up in the North West, so there's been an economic and morale boost from the Olympic goldrush. I learned of more good news today. All crime in Trafford is down 14.1% compared with this time last year - and no, that's not a quirk from the "riot effect" from last year as Trafford saw only the merest ripple from those troubles. As if that wasn't enough, instances of anti-social behaviour have dropped by a staggering 30%. So what's been going on?

Simply put, some cracking partnership work. Great links between different teams from the police, council and landlords; getting tough on crime and criminals and an increase in preventative initiatives such as our CleanStart programme which has slashed recidivism among Trafford's persistent and prolific offenders. Building on that partnership work we are now moving to co-located teams, co-ordinated intelligence and collaborative leadership. Whisper it quietly, but might this just be a bit of public service redesign that is actually delivering results?

So in a climate where "payment by results" is a favourite Government method to incentivise improvement, it is a little perverse that these outstanding results may have the paradoxical effect of punishment not reward. We all know that police numbers will have to reduce as austerity bites and that may jeopardise some of the gains that we have made. But the truly curious thing I learned today is that precisely because Trafford's crime stats are so impressive we may face a disproportionately large cut. That just seems bizarre. I hope the Police Commissioner candidates in November's elections are reading and taking note. 

What do you think? Should we encourage the progress that's been made, or is it just a harsh reality of the times we live in?

Is There A Positive Side To Public Sector Austerity?

The world may be agog at The Olympics (and Friday’s spectacular was rather uplifting, wasn’t it?) but the view from where I sit is still overwhelmingly dominated by public service reform. You may all think that this new age of austerity has no redeeming features whatsoever, and on a cold, wet and gloomy day that is more redolent of late Autumn than high Summer, I must say I could be tempted to subscribe to that view.

Impressive - but is it as impressive as public service co-operation

But, I came back from the UN determined that in comparative terms, the UK had little to gloom about and in keeping with that “glass half full” mindset, I wanted to share some highlights of one of the most hopeful meetings about partnership that I’ve been to for quite a while.  For whatever else public sector austerity has done already, and will do in future, it is clear to me that it has created a burning platform for change.

In a room today, I was with colleagues from the council, police, fire, probation, health, education, as well as housing organisations. We were there to explore what partnership meant and heard examples of how service managers had woken up, smelled the coffee, realised that things could not continue as they were and simply got on with changing them – in ways that were both better for customers and more efficient for providers. As a certain meerkat might say: “Simples”.

Examples we heard included co-location of police, housing and council staff with huge benefits in terms of tackling persistent offenders; improved engagement of offenders as probation services were provided in neighbourhoods where offenders lived, rather than expecting them to make difficult journeys via public transport to a central location; and how the “trust in the uniform” enabled the fire service to effectively signpost people to the right services.

These changes weren’t the result of big strategies - in many cases, they’d been started by the “low-downs” not the “high-ups”; there had been no weighty deliberations by executives and boards, but they clearly pointed the way to a different kind of future in which new thinking about organisational roles and boundaries can deliver quick wins. In the discussions that followed, I was amazed and delighted as ideas on how to build on these changes flowed. Not once was there an organisational defensiveness, and I don’t even think that the word “budget” was used at all.

By the end of two hours, there was a list of further simple things we could make happen: closer links between the fire service and housing to identify at-risk families; better integration of sheltered scheme managers into the social and health care the residents in their schemes receive; more opportunities to share information; and a plan to train together managerial cohorts from across partner organisations in order to develop Trafford’s New Ways Of Seeing.

And as I drove away, I started to think about the values that those new managers were going to need. I came up with three: curiosity, boldness and experimentation without harm. It's not a complete list, but it’s a start. What would yours be?