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Telling it how it is

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Connecting jigsaw pieces

Reflections on TLAP’s report

A few months ago, I wondered whether the TLAP insight group was a foolhardy enterprise or demonstrated remarkable foresight. With the publication of the group’s report into the effects of the pandemic on people who access care and support through the lens of personalisation, I offer a few observations on the journey and thoughts for the future.

The initial idea was to explore the impact of Care Act easements, but early on the group felt that it was important to widen the scope to include the impact of COVID-19 on people accessing care and support, including unpaid carers. This decision has been vindicated, in that it has proven quite difficult to establish a comprehensive picture of the impact of easements in the eight council areas that used them.

Trying to build a picture of the affects of COVID-19 across the country was a big ambition with a big ask. Thankfully, our partners and other allies responded by providing access to research, data and intelligence to help us produce a rapid evidence review. The volume of material that emerged from this collaborative effort shines a much needed light on people’s lives.

Our intention remains to seek understanding rather than apportion blame. I believe the care and support sector can learn lessons from this review that may point to a better future. This includes if and when councils face difficult decisions on whether or not to make use of Care Act easements in response to the continuing pandemic.

Human figures standing on interlocking jigsaw pieces holding hands
We need more, not less personalisation and co-production.

How it could be different

The recommendations in our report set out a vision of how care and support services need to change:

  • We need more, not less personalisation and co-production. If councils and other parts of the statutory sector work with and alongside people (including providers) you are likely to get a better result.
  • In some areas, care and support became more responsive and flexible, less driven by process and restrictive practice. These approaches need to be built on and taken up more widely, whilst ensuring they are Care Act proof.
  • There is inevitably going to be lasting change to the way support is provided. We need to capture the best of what this terrible time has taught us.
Great care must be taken to avoid worsening digital exclusion.

Inclusivity is vital

How and what support is provided needs to be ‘renegotiated’ along the principle of a ‘life not a service’. The expanded use of digital technology is here to stay, both as a way of working and as the means of delivering support. But great care must be taken to avoid worsening digital exclusion and failing to recognise that an essential component of successful care and support is rooted in the continuity of personal relationships.

In redesigning support, such as day services, we need the voice and backing of people (including family carers) as equal partners to influence the shaping of support. That means more investment in co-production with people and families.

The long-term outlook is bigger than formal social care. We have seen communities come together to look out for one another with the spontaneous growth of mutual aid and neighbourhood support. However, not all people with care and support needs appear to have been included.

We need to develop an understanding of what government (local and national) and business can do to create conditions where neighbours and community groups look out for and support each other, so that everyone is included. This means taking practical action to address care and health inequalities.

These are challenging and difficult times right now. We owe it to ourselves and future generations to take this hard learning to inform and inspire a better, fairer and more personalised way of organising care and support.

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  1. Comment by Michael Patrick Byatt posted on

    Integration of nhs local government and social care providers from referral to assessment and care package placements at practitioners and local framework alongside empowering digital and access to personal information for patients and service users