16 March 2021
One of the many things that the COVID pandemic has done is reveal, starkly, the inequalities that exist in terms of vulnerable people experiencing equal life chances. For example, the pandemic has evidenced that people with learning disabilities had been given “do not resuscitate” orders during the second wave of the pandemic, in spite of widespread condemnation of the practice last year. We also learned that 59.5 per cent of deaths from COVID were made up by people with disabilities. Together with this we also discovered that the risk of death from COVID was more than three times greater for severely disabled people than the rest of the population. The latest figures also show that for people with a medically diagnosed learning disability, the risk of death involving COVID last year was 3.7 times greater compared with people who did not have a learning disability.
These figures, collated by the Office for National Statistics, reveal not just inequalities in terms of how disabled people have been treated during the pandemic, but that disabled people were already disadvantaged by continual cuts to the social care budget thereby being placed in a vulnerable position when the pandemic hit. People with diagnosed health conditions and disabilities were at greater risk to the virus and the enforced isolation caused by the need to shield exacerbated this risk. Disabled people had not been a priority pre-pandemic, and this continued to be the case during the pandemic. It took the likes of Jo Whiley to bring this fact to the attention of the wider population when she highlighted the fact that she had been prioritised for the COVID vaccination ahead of her severally disabled sister Frances.
What the pandemic has also done is highlight the fact, underlined by the figures above, that it is not only older people who are in receipt of – or require; social care. Disabled people, people with learning disabilities, autistic people; have a need for social care that empowers them to successfully lead ordinary lives. Social care isn’t just about people living in care homes – it’s also about people looking to grow and build their lives in the communities in which they live – communities of which they are a part. What the wider population have come to see, by way of the pandemic, however, is that vulnerable people are often hidden from view, their needs not apparent, not living as an integral and valued part of the community. An intrinsic right to privacy is appropriate, that support is discrete is also appropriate however being side-lined, ignored, isolated and disadvantaged is not.
It is clear, therefore, and should no longer be news to anyone with eyes to see or ears to hear that what we commonly call social care needs serious change. Clearly the current system is not enabling or empowering people to experience life from a level playing field. Disabled people do not stand at the starting line alongside the rest of the population and in fact, disabled people are not only behind the starting line, they have many more hurdles to clear to get to the finishing line – a finishing line that should be the fulfilment of individual goals and ambition. This is an injustice that needs to be addressed once and for all.
For some considerable time, national organisations like the Centre for Welfare Reform, Social Care Future and Think Local Act Personal have campaigned to see disabled people living in a place they call home, as active participants within their local community where they make valued contributions and where the community is empowered and enabled to meet the needs of the people within it. This may sound like utopia, but actually it’s a basic human right; it’s a matter of social justice.
So, what does this mean for local social care providers such as You First? And what does it mean for people like me, the CEO of such organisations?
It is evident that social care exists in an extraordinarily difficult environment, but at the same time there is an incredibly exciting opportunity for forward thinking social care providers to trailblaze new ways of doing things that support and enable people to lead lives that they are in charge of and that deliver upon their own personal ambition and goals. To do this, providers have to think less about traditional approaches and embrace methods and ways of support that facilitate people living lives that are truly self-directed in every sense, from how their support is funded and who controls this personal budget through to experiencing the fulfilment of their ambitions. This will challenge some providers to "let go" - a crucial but difficult lesson to learn. This isn’t about the survival of a business or market sector, it’s about real people leading real lives that are meaningful and make sense to them.
Somerset, I am both proud and pleased to say, recognises the need for change and as such I am determined that You First will be at the forefront of that change. It is my honest belief that over the next 5 years the entire social care landscape in our county will change in a way that sees vulnerable people taking control of their support in ways that we've not seen before. Somerset is getting radical, and it's about time! It is also evident that much of the country is watching what happens in Somerset as we are going to set a blueprint in terms of what self-directed support really looks like.
The need to change will challenge providers of traditional support and for some this will be uncomfortable and for others it may be one change too many. You First, in our 7 years of operation, has never been a traditional provider and everything we do is about vulnerable people exercising choice and control over their lives in a genuine way - we have no tolerance for tokenism. We also have the ability to flex. I keep the management structure lean so that I can invest properly in Support Workers and this facilitates the delivery of quality support that so that decision making is as close to the individual as possible.
Part of this is my commitment to self-managed teams, and this is major piece of work I want to see roll out this year. Self-managed teams are small teams of people, built around the person, chosen by the person, who, with the person supported as the team leader, work together, managing themselves, in a way that sees the person supported achieving and experiencing the outcomes they set for themselves. This builds genuine relationship - the bedrock of social care. This brings the power of choice and control closer to the person supported than any other form of support.
You First has a glowing reputation in terms of managing support for people with complex needs. Our offer is very broad: learning disabilities, autism, mental health, young mum's with LD - a rich tapestry of support. You First has a proven track record of working closely with Micro Providers that not only facilitates a mixed economy of care but also ensures that individuals receive support they are in charge of and that meets holistic need. I am determined that You First will expand upon this and will have a role supporting Micro Providers to deliver support whilst we focus our attention on our specialism – successfully delivering complex support. We will do this by holding Individual Service Funds, a dynamic form of Personal Budget. This is central to You First’s vision of the future; building the ability for people to choose how and by whom their support is funded, managed and delivered. I can finally see a real way for disabled people firmly holding the steering wheel of their lives and it’s exciting!
As the CEO of You First I recognise that there is the opportunity to be involved in something dynamic, radical and something that will really see people empowered to take control of their lives. It's also about being part of the future, as opposed to holding on to something that harks back to the past. This takes courage – I am going to have to let go of stuff. This is why I am building a radical team around me as I want to be surrounded by free thinking individuals who dare ask the difficult questions and who challenge the status quo.
I am determined that You First will be at the table with local Commissioners of social care and we will help usher in a new, dynamic and sustainable way of doing things that actually delivers on what people want. If we keep doing more of what we've always done, we will get more of what we've always got. Change in social care is needed if people are to truly lead independent, empowered lives, lives that enable them to enjoy and experience the outcomes they set for themselves.
You First will be part of this change.