Social care bosses call for 'down-sizing' of care homes and more home care

More home care and a shift away from long-term support in care homes is recommended by the Association of Directors of Adult Social Services in England (ADASS).

A report by ADASS calls for a down-sizing of care homes with more care provided to people in their own homes.

ADASS president James Bullion stated in the report: 'We have the opportunity to be radical, to be person-centred and to be transformative. We must seize this opportunity with both hands'.

‘Down-sizing’ care homes

The ADASS report stated: ‘For too long care has been built around organisations and buildings such as hospitals, day care centres and care homes.

‘The future must be about what works for us as individuals and our families, with a whole series of local organisations working together to organise care and support that enables us to work, stay independent at home, and be as engaged in our communities as we want.

‘More of this care is likely to be provided in our own homes and will be integrated into specialist housing and care packages akin to current extra care provision.

‘Any short-term support (particularly in the immediate post-Covid-19 period) for particular types of care provision should be tied to a commitment to participate in the reform conversation and where necessary to downsizing particular types of provision, such as potentially some forms of care home provision’.

'Home First'

The report stated that 'reform must be underpinned by the Home First principle', with 'a much stronger emphasis' on some existing types of care and support which are housing based, such as ‘supported living’ and ‘extra care housing’, as well as new and innovative forms of care.

'In turn, this may mean a shift away from existing types of residential care, for example, a lesser reliance on long stay, larger scale care homes although they may continue to play a key role in reablement and short-term care.’

The report calls for a two-year funding settlement in 2020 to ensure the short-term sustainability and continuity of care that ‘creates the space for us all to undertake the ‘national conversation’ to shape a new ‘person-centred’ vision for adult social care.

ADASS' nine recommendations

The ADASS report makes nine recommendations. These are:

• A public conversation about adult social care reform

• Locally-determined integrated care with local authorities co-ordinating care and support.

• A complete review of how care markets operate and the suitability, sufficiency, sustainability, social value and quality of provision, with a consideration of regulation.

• Address current system inequalities that adversely impact people with learning disabilities, mental health and substance misuse issues, older people, women, BAME communities and those at end of their lives.

• Housing to become central to care. Support working age disabled people, rough sleepers, homeless people and others to keep their own homes.

• A workforce strategy offering fair national care wages, training and career progression and greater support for informal carers.

• Prioritise access to technological solutions to ensure older and disabled people, families, carers and staff have access to digital and technological solutions that benefit them.

• A cross-government strategy to enable people with care needs to live a good life. Meaning not just what DHSC can do but what the Cabinet Office, MHCLG, BEIS, DWP and other departments across Whitehall can do.

• A funded, managed ‘transition’ from current care system to the new system to ensure service continuity for people with care needs.