One of the things I love about Christmas is sharing.
I like sharing gifts. (The Hannan family love buying gifts, we’re those people who start Christmas shopping in August.) I like sharing time with friends and family. I like sharing my home with people. I like sharing in other people’s joy.
Christmas is about sharing with the people that you know best. For people with lived experience of social care, it also means sharing their most intimate moments with people they barely know. Those who need support with personal care and their families are often expected to share every detail of their life with people who are strangers.
This type of sharing is important to enable those in need of support to live well, in a place they call home and to do things they want to do to. But this type of sharing requires trust and equality in a way that my gift of the latest WH Lung album doesn’t.
This Christmas, how can we give the gift of fair sharing to those who are expected to share whether they like it or not?
The power gap in social care
Sharing is something that is at the heart of social care. But there is often a power disparity with this sharing. The message that many people with lived experience receive is ‘I know best, not you’.
In a place where you need support to do all the things that most people take for granted, sharing can be challenging.
We must put our trust in strangers who may have more knowledge and power than us. We must share details about our life we may not have shared with anyone, and they may want to know more than we feel comfortable sharing. We must first trust that we are being told about all our rights, our choices and opportunities to live a full life.
Suddenly, sharing becomes more complicated.
Re-organising social care to make decisions together
Following the election, there is now a realistic chance that there will be a review of social care and how it can meet the needs of the population. This presents an opportunity to look at some of the fundamentals that underpin how it’s designed, organised, supported, and provided.
It’s crucial that we not only talking about funding but also, shaping. To do this it is crucial we share the space with those who really know what they want and need. People with lived experience know what a good experience of home care is. Care workers know what good work feels like. A review of social care has to share the space with these groups as well as those working to create good spaces for both of these groups.
In 2017, The King’s Fund found that GPs spent 68 million contact hours with patients. Care workers had 249 million contact hours. Who should decide how this time is spent?
It’s vital that we do everything we can to give staff the values, knowledge and skills to recognise the power they hold, what that means, and how to build relationships that acknowledge and share this.
How do we do this? There are a number of organisations that try to help care workers develop the skills to co-produce decisions with those with lived experience - a way of truly sharing decision making and power. But it’s important this isn’t just lip service.
Take the “Hello My Name is” campaign by Kate Granger. It’s hard to believe that we would have had to develop a campaign that reminded medical professionals to say hello to patients! But it does exist.
Values-led recruitment in social care
The RSA is supporting the Wellbeing Teams model.
One part of it is ‘values-led’ recruitment, where people are hired based on their values and not their experience. The values that Wellbeing Teams identify as key to the role are used to design job descriptions. People don’t send in CVs, they have a conversation. If in that conversation they demonstrate that they are warm, friendly and excited by the role they are invited to a workshop day. (Many organisations describe themselves as using values-based recruitment but are still recruiting from CVs.)
The workshop days are co-produced with older people with lived experience of care services. It’s all about giving care workers the chance to learn from each other to understand the value of co-production.
The RSA has a long history of sharing ideas and convening spaces to enable this to happen. We’re hoping to do this in 2020 by creating a space where those in social care can learn and share ideas about self-management and the benefits it can offer.
It’s also work that’s being done by RSA Fellows. Wellbeing Teams created the Open Teams platform to share resources from those already working in a self-managing way. And RSA Fellow Andy Brogan of Easier Inc is creating an ideas sharing platform for Next Stage Radicals.
Putting the focus back on relationships in social care this Christmas
Many care workers will try to make Christmas special for those they are supporting. But this is often squeezed in around their regular visits with a wish to bring a little joy into people’s lives at Christmas.
At Wellbeing Teams this is central to how things are done – staff work together to support their clients to have the Christmas they truly want. The focus is on relationships. That focus comes from being values-led, making co-production central, and letting care workers manage their own time. It creates a space where those who are working on Christmas and those they are visiting can get the most out of the day.
It’s a simple idea really – sharing power with care staff more equally allows them to share power more equally with the people they support.
Fair sharing of power between care workers and clients should be a simple idea as well, but at the moment it feels like a radical one. The election result presents an opportunity to re-think how we structure social care, not just how we fund it. In this season of sharing, it’s time to share the power.
As we emerge from Covid-19, Ruth Hannan argues there is an opportunity to shift from short-term solutions to approaches based on deeper understanding of citizens’ needs and which focus on systemic change.
People in the most deprived areas of England are dying at a rate higher than those in the least deprived, partly due to economic security and working conditions. The government must raise sick pay to stop this injustice.