Rewriting social care
I’ve been working in adult social care for over 15 years, and I’ve spent a significant proportion of that time writing about it. I’ve summarised statutory guidance, policy documents, research articles, campaign reports, news stories and relevant blogs to produce a monthly Developments in Adult Social Care bulletin email. I’ve drafted and edited procedures, guidance documents, newsletters and briefings, and proof-read and rewritten web pages, factsheets and ‘standard letters’.
Much of my writing has been an attempt to explain the social care ‘system’ – trying first to make sense myself of all the complexities and processes and the associated jargon and acronyms, and then editing, rewriting and presenting information in a clear, concise and accessible form to support others to understand it too.
Now though, after years of trying to clarify and explain the process and bureaucracy of social care in plain language, I want to explore how the language of social care is a consequence of a failed system, and is indeed contributing to, and perpetuating, the failure of the ‘system’.
The failure of the ‘system’
There’s a growing acknowledgement that the social care system has failed at all levels. While many look to the Government for answers – not least in the form of a hefty injection of cash – money alone is far from the solution. The system has failed precisely because that’s what it is – a system. A huge, closed, complex bureaucracy. We’ve created waiting lists and signposts and assessments and eligibility determinations to ‘manage demand’, and pathways and processes to channel ‘service users’ down a pre-determined route (‘journey’) to achieve their ‘outcomes’ – with a ‘package’ of services as the solution at the end.
The system is breaking the budgets of local authorities, sapping the morale of those employed to sustain it, and causing unquantifiable pain to the people and families lost within it.
A better, brighter social care future
All hope is by no means lost, and there are increasing glimpses of a better, brighter social care future, in which social care and other public services ‘work with’ instead of ‘doing to’. We open doors rather than closing gates. We listen and learn rather than assess and prescribe. We concentrate on what’s good, what matters and what works, not on what’s wrong and what’s the matter. We look at what we can build on together in families and communities and teams, not what we can fix in isolation. We focus on possibilities, not risks – see potential, not problems. And we move from talking about costs and transactions and services, to focus on the value of our time, the spaces we can create, ideas we can share, and the relationships we can build.
We are all experts in our own lives, and equally we’re all vulnerable at times. We can all offer some form of support, and there are times when we all need help. We all have something to give, and we all have a whole lot to learn.
And while it may all sound idealistic, and even impossible to achieve, the stories of this very different social care world are told in reports by organisations including SCIE, TLAP, RiPfA and The Kings Fund, on websites including Social Care Future and Rightful lives, and in blogs by people including Alex Fox, Rob Mitchell and Elaine James, Helen Sanderson, Cormac Russell and Hilary Cottam. Organisations described in TLAP’s directory of Innovations in community-centred support are among those leading the way, while articles and broadcasts by journalists including Alison Holt, Jayne McCubbin, Saba Salman and Francis Ryan, and blogs, including those by Mark Neary, Sara Ryan and Wendy Mitchell, continue to remind us why such change is vital.
Words that make you go hmmm…
I’ve recently worked with Partners4Change who, as part of The Three Conversations® approach, introduced the concept of banned words. These are the words that describe the failed system of process, bureaucracy, transactions and services (‘screening’, ‘signposting’, ‘referral’, ‘assessment’, ‘eligibility’, ‘care package’). They are the labels that perpetuate the divide between the people who work in the system and the people who turn to it in need of some support (‘customer’, ‘service user’, ‘client’, ‘case’). They are the phrases that blame (‘challenging behaviour’, ‘refusal to engage’, ‘complex needs’, ‘bed blocking’, ‘non-complaint’, ‘hard to reach’).
As I explain in my first blog, in Sheffield we weren’t entirely convinced by the idea of banning words, so instead we talked of words that make you go hmmm… It’s those same words and phrases that I’m planning to explore in more detail here in an attempt to explain why they make me go hmmm, and why we need to stop using them. And hopefully before too long they’ll all be redundant anyway.
Rewriting social care is so much more than just providing a plain language guide to a complex system. That’s not what I’m aiming to do here, and anyway TLAP have got that covered with their comprehensive Care and Support Jargon Buster, and Mark Neary has done an excellent job of translating the jargon in his A-Z of Carespeak.
It’s also not about finding new words to rebrand the same old practice.
It’s about unpicking why the words and phrases that we still use every single day in the current world of social care perpetuate the system and dehumanise the people lost within it, and it’s about exploring an alternative vocabulary that describes a very different approach.
I firmly believe that the language we use reflects our values and our feelings and in turn the way we behave. The better, brighter social care future is one with people and communities and stories and relationships and dreams and love and good lives and hope at its heart. A whole new language. Social care rewritten.
I work in practice development in adult social care, but my background is in information and communications. I am by no means an expert- other than in my own life. However, I read a lot, listen and observe, reflect and learn continuously, and I’m passionate about the better, brighter social care future ahead.
My writing is in no way a criticism of colleagues working in social care. Nor is it based solely on my first-hand experience. It’s a personal reflection on the system as a whole, which we’ve all had a hand in creating and maintaining. I’ve played my part in perpetuating the bureaucracy and red tape by writing step-by-step procedures to describe processes designed to move people through the system, and explaining rather than challenging the complexity. But by analysing and unpicking the current language of social care, and exploring the vocabulary of the future social care world, I’m hoping to play a small part in a very big change for the better.