How can we improve people’s experience of social care?

5 Sep 2017 12:38 PM

Blog posted by: Paula Reid, Monday, 4 September 2017.

The National Institute of Health and Care Excellence (NICE) is currently consulting on standards to improve people’s experience of adult social care. 

We know that many people experiencing homelessness or living in supported housing can struggle to access services to address their care needs and want to ensure that everyone has a positive experience of social care. We are therefore looking for your views on some of the key principles in the consultation and the broader barriers to people accessing the social care services they need.

As social care services come under increased pressure, we know there can be a gap between what is written in legislation and guidance and what is happening on the ground. Our members see these challenges on a daily basis and the more information you can give us about what is happening locally, the stronger recommendations we can make to policy-makers.

We will use this information to draft a response to the NICE consultation to ensure their standards work to improve everyone’s experience of social care. Your responses will also help shape our future work on social care, including the green paper on social care funding expected later in the autumn and our membership of the Health and Wellbeing Alliance.

Access to services that respond to people’s circumstances

The standards reiterate that everyone should have access to social care services that are based on their needs and take account of their individual circumstances. Despite the 2014 Care Act introducing the right to an assessment for anyone with a care need, we know that people can struggle to access these assessments or articulate the support they would like to address their needs. For more information on this, read about the toolkit Voices of Stoke has developed to help people navigate the eligibility criteria in the assessment.

Once people have access to services, it is important that services can support people as individuals and use their strengths, preferences, and aspirations as a basis to provide that support. The standards also state that care planning processes should be responsive enough to adapt to changes in people’s circumstances. At a provider level, steps should be taken to involve people using services in designing, developing policies and protocols and improving services.

1. In your experience, what are the key barriers to people accessing social care services? How might these be addressed?
2. What more could be done to ensure that people’s individual choices and preferences are taken into account in the delivery of their care?
3. Do you have any good practice examples of people with lived experience being involved in the design of social care services?

Enabling people to be in control of their care

A key theme in the standards is ensuring that people are supported to maintain their independence as far as possible. This is demonstrated in a number of ways in the document, ranging from supporting people to make decisions about their care, through to people taking control of the funding for their own care. The standards are clear that services should not make assumptions about people’s mental capacity and that people should have access to independent advocacy, as well as any other support they might need to participate fully in their care. It should also be made clear to people by local authorities that they can control the funding of their care through personal budgets and direct payments. More work needs to be done to understand what the uptake of personal budgets and direct payments has been among different groups, and we would be interested in any experience members have had of them.

4. What more could be done to support people to make informed decisions about their care i.e. accessible information, personal budgets, advocacy?

Continuity of care

People experiencing multiple and complex needs can be in touch with many different support services at any one time, which can lead to unnecessary duplication or key things falling through the gaps between services. The standards recommend that local authorities and service providers should consider assigning people a named coordinator to liaise with these different services and act as the first point of contact. Transitions between services are also identified as a key point where there can be breaks in care and Homeless Link’s work on hospital discharge highlighted the delays that can arise from a lack of joined-up care. Within services, every effort should be made to minimise the changes in people’s support and, if these are unavoidable, people should be informed of the changes and there should be a thorough handover.

5. What can be done to minimise breaks in people’s care and smoother transitions through services?

If you have thoughts on any of these questions, or broader issues around social care you would like to raise, please contact Paula on paula.reid@homelesslink.org.uk by Thursday 28 September so we can make a submission to NICE ahead of their deadline.