The RSA uses cookies on this website. By using this website you are agreeing to our use of cookies. To find out more read our cookie policy and privacy policy. More Info

Radical Home Care: how self-management could save social care


  • Public services
  • Social care
  • Transform
  • Buurtzorg

This briefing paper examines the challenges facing social care in the UK and how ‘self-managed’ teams can address them, based on a number of case studies of innovation in social care from across the country.


  • Ensure that people are aware of their social care rights, that frontline staff have the knowledge, skills and time to explain people’s options.
  • Develop systems with reduced bureaucracy that do not prevent swift action that can lead to better care and more preventative support for those accessing social care.
  • End the use of the ‘time and task’ commissioning in home care that prevents true relationship-centred care and services working in an outcomes focused way.
  • Move towards a model of commissioning that better reflects the complexity of the system.
  • Build and enable trusting relationships between commissioners, providers and staff to enable self-managing services to develop and thrive.
  • When commissioning new services, enable them to develop, and avoid overly prescriptive “pilots” that are designed to achieve unrealistic outcomes.
  • The Care Quality Commission must drastically review its model to ensure that it doesn’t crush innovation.

Download Radical Home Care (pdf, 0.4MB)

Read Ruth's blog on 4 social care challenges we can tackle with self-management

pdf 473.5 KB


Picture of Ruth Hannan
Joint Head of Programme, People and Places