To unlock innovation, we need to work with the people who draw on care

Of course, innovation is still happening in health and social care, but it tends to be at the periphery. The problem is not so much a lack of innovation but finding ways for such approaches to take root more deeply in more places; all the while, the situation for social care becomes ever more challenging.  

It is more important than ever, therefore, to encourage innovation – the very best social care has to offer – to grow. This means we need to grow innovations like Shared Lives – a person-centred form of support where a Shared Lives carer shares their home with someone who needs support. Or micro enterprises, in the form of small community organisations that provide person-centred home care.  

Yet almost ten years after the Care Act 2014 – the landmark reforms to social care – and despite a further social care White Paper at the end of 2021, innovative approaches to social care have not grown to their potential.  

How can we change this?  

First, we need to tell commissioners stories about what a difference innovation can make; like the story Meg tells below of living in a Shared Lives household. 

From the ages of 17 to 25, I was in and out of hospital because of my poor mental health. At one point I spent over four years in hospital. It cost a huge amount and made me progressively less well and more institutionalised. The therapy I received was invaluable, but the environment massively slowed down my recovery, and caused a lot of stress. 

Being kept there when I was ready to move on became a hindrance. This pattern stopped when I found out about Shared Lives. I took the information to my consultant, used my voice, and told her: ‘This is what I want’. And that is what I got: an amazing Shared Lives home with a brilliant carer, Hayley, who encouraged me to speak up, express myself and stand up for what I believe in. My confidence increased massively. I’m pretty sure that without Shared Lives I’d have given up, and probably wouldn’t be here at all. Shared Lives really has saved my life. 

When I am meeting with professionals, they get tired of listening to jargon about policies and strategies. However, when someone who draws on support tells their story I see them stop and listen. They reconnect with why they got involved in health and social care in the first place. Statistics are important, but so are the stories. We need to have more people who draw on services speaking directly to managers and commissioners if we are to convince them to invest in innovative services. 

Second, we need to make the case for investment. This often means using evidence and statistics that demonstrate in real terms the effects of investment.  

Meg says: ‘We need to understand decision-makers need to be able to show that it [investment] improves things and saves money.’ 

In Shared Lives we have developed data on the cost and benefits of the model, showing its financial savings compared to residential care. This data is priceless when making the case for investment. Other innovations have data that is truly compelling when shared with decision-makers.  

Third, we need to find ways to organise our money around outcomes, rather than the delivery of narrowly defined outputs or activities. This is difficult to do in reality, as it means overcoming bureaucratic rules, but if money can be used to support specific outcomes – such as wellbeing or supporting people to live independently at home – it can lead to different kinds of services, often those that are more innovative, being commissioned. In Camden for example, they have created longer-term contracts that fund services supporting people to live independently, commissioning extensively from the voluntary sector.  

Finally, we need to put people who draw on support at the heart of discussions about commissioning and designing services – something sometimes called co-production.   

Meg notes that ‘When I am asked to complete an assessment form, I must answer 20 questions which tell them little about my life. If they had had me in the room when they were designing the form, we could have made it simpler and more useful.’ 

Meg knows the barriers stopping Shared Lives growing but is rarely asked for her views, and says: 

‘If you talk to most decision-makers in social care, you can tell they want to do things differently, but feel stuck. Telling your stories can help show them what is possible.’  

For more about Meg’s story see: Meg shared her life and found her voice – Care Talk