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Sharing the Journey: The Challenge of Delivering the Social Care Future Vision

We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing things that matter to us. That's the social care future we seek. #socialcarefuture

Today, Medequip, like most of the organisations working to make and distribute Community Equipment, is guided by a mission statement and an overarching purpose, in addition to providing a return to shareholders.

But is it enough to focus on vulnerability, independence, physical impairments and all the things we associate with other people?

The statement above was produced by Social Care Future. Not an organisation, but a movement of people who draw on social care and their allies, whose primary goal is to reframe social care as something that affects us all. In summary, working to achieve the objective of ‘a gloriously ordinary life’ everyone should have the right to enjoy.

Medequip and the Social Care Future Community of Practice

At Medequip, we know that over 10% of our staff live with a long-term condition. If you add to that number those who provide care and support to family members, friends and neighbours, those who are active in their communities and those that are seriously ill from time to time, it’s a significant part of our community.

So, we were really pleased to be invited alongside with other organisations to develop and co-present a workshop session for the Social Care Future Community of Practice in November 2022.

Inspired by a powerful presentation by Jennifer Pearl https://www.thinklocalactpersonal.org.uk/Blog/Title-Co-production-and-community-equipment-provision/ and working with other people who draw on care, Community Catalysts and Think Personal, Act Local, we planned a session that would challenge ourselves and others to think about how the Community Equipment services, however they are delivered could help achieve the Social Care Future vision.

Recognising the challenges

We are all aware of the long-term debates on how things should be organised in the health and social care systems. We also know there will be more people with more complex support needs and that there are financial and workforce limitations.

But we also know from talking to people, that they want things to be better today and tomorrow.

If not, their basic quality of life and dignity are compromised.

The workshop session gave us a valuable opportunity to share our ideas, frustrations, inspirations and work-arounds, identifying things we could do quickly to make a real difference.

Key learning points from the workshop session

For the services we provide:

  • If we want to understand how community equipment services can support the Social Care Future vision, we have to learn to work alongside people who use services at every step.
  • We need to be aware that people currently experience a variety of different models of community equipment service, with different service standards and targets.
  • Most services are under strain, and find it hard to support individual outcomes with their level of funding and staff. In these situations the focus can shift to managing activity speeds and controlling costs, either through limiting equipment on ‘the catalogue’ or by setting up ‘spend panels’.
  • There are some particular challenges with ‘specials’, those items that are not included in the main list of items that can be prescribed and delivered.
  • Community Equipment services are fundamental to many aspects of how the health and social care system works. Therefore, they need to be considered by commissioners when they launch new initiatives, e.g. to speed up hospital discharge, use more residential and nursing care beds, or provide support to people with more complex needs in their own homes.

Listening to the individuals

  • Peoples’ time is important so flexibility and real-time updates are as important as delivery speeds and waiting times.
  • We need more focus on checking in with people and doing inclusive reviews as there is a lot of anecdotal evidence of equipment not being used properly, or at all.
  • Peoples’ real experiences can be of poor communication and coordination between the services that are supposed to support them. Problems with equipment delivery or use can be a symptom of this.
  • There needs to be both more information, and more support, for people who choose, or have to, make their own arrangements.

Listening to the people working to make improvements - things we need to share

  • General information sharing through websites and other online resources as well as opportunities to learn from each other.
  • Specific information on activity levels, pricing models, equipment costs, and recycling rates.
  • Processes for the management of specials including benchmarking information.
  • Experience of using demonstration smart homes or smart spaces for people to try equipment before they buy it.
  • Experience of different methods of collecting feedback (including the Medequip co-produced feedback survey)
  • Examples of business cases that can be used to model an evidenced best practice, eg cost avoidance, budget savings, prevention approaches, the whole life cost of better quality equipment, the impact on other budget areas of an underperforming, or underbudgeted community equipment service.
  • Information from many pilot projects, for example where doublehanded care has been reduced by the provision of equipment and training.

So what can we do next to make real improvements?

  • Shift the focus to outcomes and what difference the service makes to people - don’t just count spending and measure activity.
  • Check your communication strategy and plan is built around what people using services have said they need and would find useful.
  • Make sure you and your partner organisations, including voluntary and community sector organisations, are communicating well together.
  • Share your learning and make sure you have allowed time for your staff to learn from each other, from people who use services and from people in other organisations.
  • Think how the organisation is helping people who want to make their own arrangements for equipment and technology. What local arrangements are there for people to see and try equipment and technology?
  • Training on the preventative benefits of simple aids to daily living should be provided more widely.
  • Refresh and restate your commitment to co-production with people who use services, prescribers and providers. Sign up to the Social Care Future movement and attend future events at https://socialcarefuture.org.uk/join-in/
  • Use the Think Local, Act Personal ‘Making it Real’ framework when you are monitoring or reviewing the services you commission or provide. https://www.thinklocalactpersonal.org.uk/makingitreal/

Make it personal every time. Adult social care impacts on the lives of over 10 million people in England alone, and at some point, most of us will provide care for a loved one, or need care ourselves.

Medequip will continue to promote the Social Care Future vision whenever, and wherever we can. We see direct references to it, and the language it uses popping up with the statutory services we work with and in some invitation to tender documents.

The vision was used by Sarah McClinton, the President of the Association of Directors of Adult Social Services in her opening address to their conference in November 2022.

It informed the Church of England Archbishops’ Commission, "Care and Support Reimagined" Care and Support Reimagined A National Care Covenant for England (Summary).pdf (churchofengland.org) and has been included within the approach proposed by the Labour Party.

Medequip is not a campaigning organisation, but we have a view on what works and what doesn’t.

We hope our statutory and voluntary sector partners will work with the people who use our services, Medequip, or whoever provides community equipment, to keep improving.

After all, who is not moved by the Social Care Future vision, with its emphasis on home, love and community?

And who wouldn’t want “a gloriously ordinary life”?

(A version of this article first appeared in the membership newsletter of the National Association of Equipment Providers in March 2023)

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