Lasting change

“Despite the urgency, lasting change takes much longer than we appreciate.

Darn.

One way to counteract our impatience is to shift from ‘Chronos’ to ‘Kairos’ time. Chronos time is sequential time, measured by the clock and which seems to be speeding up. Kairos time bends and stretches, sometimes it even seems to stand still. Chronos is measured by the clock which many of us try to beat. Kairos unfolds like the seasons, following a natural rhythm and waiting for the right moment.”

Al Etmanski [1]

This blog is the last in my series exploring social care and time. In this series, I’ve shown how Chronos time dominates our practice, with its focus on speed and efficiency, and dominates the language of social care reform. I’ve discussed how we need to shift practice to Kairos time, building connections and staying present and alongside. Making space to listen to stories and taking time to pause and reflect. And I’ve considered the importance of ‘me time’ and my time.

I’ve hopefully shown that if we’re ever going to achieve more relational, human ways of working, we must move away from the industrialised, institutionalised ‘care system’ dominated by the clock, to a world where we have a different relationship with time. And if we’re ever going to achieve lasting change, we need to move away from the crisis communications to tell a different story of social care and of social care reform. A compelling story of hope and opportunity rather than crisis and despair. Of the value of great support instead of the growing cost of care. Of the agency we all have and the part we can all play. Of us, not ‘them and us’.

In this final blog, I want to focus on shifting the narrative of social care reform, and to explore this different, ‘Kairos time’ language of change.

A guiding vision

“We face many challenges as a result of Covid-19, but we are also presented with a huge opportunity to rethink, redesign and reorientate care. Rather than simply reinforcing and protecting what we have, we have an opportunity to do something fundamentally different. We have the chance to reimagine the care that we all want for ourselves and our families. Care and support that meets our needs and wants. To design care that is fit for the future we want.”

Association of Directors of Adults Social Services [2]

The dominant narrative of social care reform isn’t working. It’s a narrative devoid of hope. Its focus is on fixing a broken system rather than imagining a better, brighter future. On the growing cost of care, not the value of great support. On emphasizing how bad things are, rather than how good things could be. On what investment will avoid, not enable.

There’s no sense of opportunity, or possibility. The core messages are all around reducing (the burden on the NHS / waiting times / demand / workforce shortages) and preventing (deterioration of services / sale of homes to pay for care / market collapse / widespread catastrophe), not creating or building.

So… is it time to stop talking about ‘reform’? Because this language suggests fixing. Restructuring. Reinforcing what we have. Improving services and structures and systems and a ‘sector’, not improving people’s experiences and building better lives.

And is it time to stop talking about ‘care’? Is the term too deeply aligned in public and political consciousness with the NHS and care homes and providers and services and ‘the vulnerable’ and wrinkly hands and ‘ticking timebombs’ and crisis and abuse and cost and decline and despair?

Should we be talking instead about wellbeing and belonging?

About good lives, well lived?

About what matters to all of us?

“To create change we need a guiding vision, and the vision we must aim for is good lives well lived. This bold vision – which creates a sense of purpose, sparks our energy and sets a shared direction of travel – returns us to the original intentions of the welfare state and reinvents them for our time.”

Hilary Cottam [3]

Singing from the same songbook

“The words we use matter. When we share our vision and truth, we can build powerful movements and win public policy and transformative changes we’ve been calling for. To do this, and create the space for massive gains, we need to sing from the same songbook – communities, allies and organisations alike. It’s all about repetition – we tell our stories and show others how to repeat them. When we repeat effective messages we can shift public support and win transformative change.”

Passing the message stick [4]

As well as lacking vision, the dominant narrative lacks coherence. As I said in my previous blog, it’s a confused and contradictory rhetoric where older people are simultaneously blamed as the cause of the crisis and presented as the victims, and where younger adults have no presence at all. Where campaigns to encourage more people to work in social care vie with commentary about how arduous and challenging ‘care work’ is.

If we want to win hearts and minds, and build public support for change, we need a shared vocabulary and a core message.

We need to sing from the same songbook.

Don’t 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 the things that matter to us? [5]

We all need to tell our story

“Stories make, prop up, and bring down systems. Stories shape how we understand the world, our place in it, and our ability to change it.”

Ella Saltmarshe [6]

Where stories feature in communications calling for reform, they are stories of institutions and stories of abuse. Ely hospital. Winterbourne View. Muckamore Abbey. Whorlton Hall. Edenfield Centre. Shocking, distressing stories that need and deserve to be told. But they’ve been told, again and again, and will no doubt – and heartbreakingly – continue to be told, unless we make space for different stories.

These different stories are stories of difference. They offer glimpses of what’s possible. Make that imagined future a little bit more tangible. Help turn those dreams into reality. Help illustrate the path and illuminate the destination.

Human stories about human rights and about the role that brilliant care and support can play in creating and sustaining gloriously ordinary and equal lives.

Colourful, beautiful stories of love and belonging and desire and joy and meaning and purpose and compassion and inclusion and laughter and tears and living and dying.

“The point is.. we all need to tell our story.”

Glyn Butcher [7]

Us’ not ‘them

“The great news is that these approaches can already be seen in glimpses of the future around the country. To command public and hence political support they need to be presented as for ‘us’ not ‘them’, about good communities and lives for all of us.”

Martin Routledge [8]

I’ve written before that while the NHS is seen as being for all of us – ‘our NHS’, social care is for ‘others’. The dominant narrative of reform – and the accompanying images – perpetuate this othering. ‘Ageing population’. ‘Bed blockers’. ‘Vulnerable patients’. ‘Elderly residents’. ‘Service users’. ‘Inmates’. ‘Those’.

And in turn this othering elicits a variety of responses – sympathy, pity, charity – or often no engagement or response at all.

Gord Tulloch and Sarah Schulman write that “we need to spend more time changing the way people think and feel about the people we support.” [9] We need to spend more time focusing on the fact that we are the people we support, and we all have a right to an equal life.

“Empathy exists when we stop talking about putting the patient at the centre and we realise that we are the patient.”

Sir Harry Burns [10]

We are the change

“Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.”

Barack Obama [11]

In the dominant narrative of social care reform, the prime minister has all the agency, and ‘only the government can fix this’. But in our Kairos time change, we are all actors. We’re all agents of change.

‘Coproduction’ is key here. We’ll only ever achieve meaningful and sustainable change if we share stories with each other as equals.

Good conversations about better futures should mirror good conversations at an individual level, focusing on what matters, what good looks like, and how we can work together to achieve it.

“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”

Margaret Mead [12]

Listening to stories takes time

“Listening to stories takes time, but stories are abundant and in this rich, unruly mix we find the seeds of ideas that can be grown”.

Hilary Cottam [13]

We need to ensure there are opportunities and platforms for people to share their own stories, and we need to create the spaces for listening.

We need a diverse range of people to be heard, and a diverse range of people need to listen.

And when stories have been shared and heard, and barriers start to come down, and trusted relationships begin to form, and energy starts to build, and momentum begins to grow, and the seeds of ideas start to emerge, we need to make sure the conditions are in place for those seeds of ideas to grow and to flourish.

Small, but ambitious

“The only kind of change you can make happen suddenly, on a large scale, is destruction, whereas creation of anything real and valuable starts small, but ambitious.”

Alex Fox [14]

In the dominant narrative, ‘big’ change is required.

Large scale whole system fix social care now.

But so often it’s the littlest things in the smallest places closest to home that make the biggest difference.

The tiny seeds of ideas and little acts of kindness and curiosity and challenge that create gentle ripples and then bigger waves, meandering through our consciousness and our conversations and our cultures, flowing and connecting and creating change along the way.

Because the change we need most begins in hearts and minds. This isn’t change we can describe in a plan or schedule with a calendar or measure by a clock. It’s messy and organic and experimental and fluid and evolving and human.

Lasting change takes much longer than we appreciate, but the sooner we start to tell a different story, the closer we’ll get to reaching out and touching our North Star.

“it’s worth remembering that it is often the small steps, not the giant leaps, that bring about the most lasting change.”

Queen Elizabeth II [15]

References

[1] Slow change, Al Etmanski, 23 June 2015

[2] Adult social care – shaping a better future, Association of Directors of Adults Social Services, July 2020

[3] Radical Help, Hilary Cottam, 2018

[4] Full guide – Passing the Message Stick: A guide for changing the story on self-determination and justice, Passing the Message Stick, 2021

[5] Social Care Future

[6] Using Story to Change Systems. Ella Saltmarshe, Stanford Social Innovation Review, 20 February 2018

[7] The point is.. we all need to tell our story, Bryony Shannon, Twitter, 12 October 2022

[8] Social care and the leadership contest: what next? Martin Routledge, The MJ, 25 July 2022

[9] The trampoline effect: redesigning our social safety nets, Gord Tulloch and Sarah Schulman, Reach Press, 2020

[10] How our human library experiment helped shift perceptions, Tony Stacey and Juliann Hall, Inside Housing, 29 August 2019

[11] Barack Obama’s Feb. 5 Speech, New York Times, 5 February 2008

[12] Widely quoted online

[13] Radical help, Hilary Cottam, Virago, 2018

[14] A new health and care system, Alex Fox, Policy Press, 2018

[15] Small steps can bring lasting change in the world, the Queen says in her Christmas Day message, ITV News, 25 December 2019

2 thoughts on “Lasting change

  1. Love these sentiments and this blog makes the case for action now, by all of us, to ‘start small, think big’ and redesign OUR social care with humanity and compassion. Thanks Bryony for making the case so eloquently! Jenny

    Liked by 1 person

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