Future of Social Care – National Care Service: work to be done

• Written by: Isabella Goldie — Deafblind Scotland — Chief Executive
• Published: 6th October 2021

Isabella Goldie from Deafblind Scotland reflects on specialist care and work to be done within the national care service.

In reading the National Care Service for Scotland Consultation it strikes me that there are some big ideas, in what is already an ambitious proposition. One thread that runs throughout is the implications for the workforce. Although the adoption of new systems/processes such as the proposed Community Health and Social Care Boards will be important, it will fall to the energy and commitment of people to make this happen. Whether working in planning to embed ethical approaches to commissioning, or in frontline roles bringing life to new models of care.

Adopting new models of care where the centrality of relationships is acknowledged is a strong starting point and critically important for deafblind people.  The absence of specialist support and communication barriers can make it impossible to interact with others in the nuanced way needed to form good quality relationships.

Furthermore, our engagement with the world is wider than immediate friends and family; from the neighbourhoods in which we live to the navigation of a series of services and systems across society. For this reason, the workforce will need to feel competent in negotiating family dynamics but also in supporting people as citizens.

I am heartened to see a focus on prevention and early intervention in the proposals, as taking this broader view creates real opportunities to explore wider life domains, identify individual strengths, but also potential assets in people’s social and physical environment. A strength of the concept of Getting it Right for Everyone, is the principle that this is a service for all, evidenced by the articulation of the adoption of universal approaches to support people at points in their life when failing to do so may result in higher support needs further downstream. Deafblind people have told us that earlier intervention to support them through the traumatic transition to a second sensory loss could have enabled them to retain much higher levels of independence and social connectedness.

It is a rare for deafblind people to start life with a dual sensory loss, with most acquiring at least a second sensory loss later in life. All too often we meet people too late to provide the transitional support that could have helped the most.

Avoiding failure demand has been a concept debated at least since the Christie Report, but it does require an integrated system that is willing to allow for cost savings later in an individual’s life-course but also across other systems. We have fallen short on this effective integration and turning this around will require a shift in power dynamics between commissioners and service providers that I am pleased to see has been acknowledged. Further financial investment will also help take away some of the perverse incentives to plan and commission care that is narrow, short-term and task-focused rather than rights-based and outcome enabling.

An area where we will need to see significant improvements is the development of the social care workforce. In Deafblind Scotland staff members undertake 3-4 years training to develop specialist skills. This highly skilled workforce will not be unique. Others working alongside people with complex health, social and communication needs such as within the fields of Autism, Dementia and Learning Disability perhaps also feeling that their skill level has not been fully recognised. However, there is plenty to welcome in proposals related to the social care workforce, with strong indications that in the future they will receive the appropriate financial recognition. But we can’t stop there. We need to acknowledge that some of this workforce are now as highly skilled as their counterparts in healthcare, although are not valued as ‘professionals’ in the same way.

With proposals that include the adoption of a national approach for those requiring more specialist support, we need to understand that for this to be effective we will need to recognise and further enhance those workforce specialist skills. At this important turning point if we can succeed in establishing social care as an attractive and rewarding career opportunity on a par with healthcare we might just begin to realise our ambitions of creating a National Care Service that does ‘Get it Right for Everyone’.

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