Today seems like an important moment to repost this blog, based on our extensive research & development with people who draw on support to live our lives - some basic rules when talking about social care #LivesNotBeds socialcarefuture.org.uk/want-to-help-c…
1. It's about us & people we love & care about, not beds, visits, packages, blockages, flows
2. Be about creating something good, not something less bad
3. Sell the brownie, not the ingredients - how does social care improve our lives?
4. Ignite supportive, pro-social values - avoid creating threat & insecurity, and expunge 'vulnerable' from your vocabulary - tee up self-direction, reciprocity & belonging
5. Speak of and to a 'larger us', don't invoke 'them & us'
And last but not least

6. Remember: position social care as the solution, not the problem

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More from @neilmcrowther

Jan 10
We're at a really dangerous moment for people who have cause to call on the NHS or draw on social care, not simply because those 'systems' or so overstretched, but because as at the start of the pandemic, we're elevating them & the pressures *they* face as the primary concern
We might assume these are entirely aligned goals, but as we saw from discharge to care homes at the start of the pandemic, they are not always. Political & media optics are shaping strategy e.g. buying tens of thousands of care home 'beds' when only suitable for a small %
But it runs deeper than that. Anyone who has been in hospital or been with an older family member in hospital will have felt acutely that sense of powerlessness. It is *the* most vulnerable situation one can be in. At a time like this that asymmetry of power can tip even further
Read 7 tweets
Jan 9
There are people stranded in hospital, being made less fit & well by that experience, not because they can't go home, but because diagnostics are logjammed so decisions about their treatment/fitness to go are being delayed & if they did go home, their only route back is via A&E
And noone wants to go back to the start of that queue. So...invest in speeding up diagnostics & where on balance it's safe to do so, discharge to a quick outpatient appointment. Otherwise the irony is that the NHS is making more people unwell than it is aiding recovery.
NHS has to think about the whole person & their health & wellbeing, not just the presenting 'issue' in making decisions about discharge. People are being harmed by being kept in 'beds' in ways that will more likely see them rebound to A&E soon after they go home.
Read 4 tweets
Mar 2, 2022
Some further observations on the historic departure points when it comes to 'person centred care as it relates to people with dementia & people with learning disabilities - comparing Kitwood's 'essential psychological needs' with John O'Brien's '5 accomplishments'
The key omission in Kitwood's list is, for me, choice & control, including over where & with who to live, and it's the loss of control that permits institutionalisation - physically & behaviorally - and the 'malignant social psychology' therein.
I see control as a psychological need, fundamental to personhood & wellbeing, as well as a right - as O'Brien expresses it. However, I'm struck that advocates for independent living (and I count myself among them) have (a) elevated choice as the primary principle...
Read 8 tweets
Mar 1, 2022
Despite us having one piece of social care legislation, centred on wellbeing & person-centred support, it's clear that our thinking & expectations on social care & older people are dramatically different from that concerning working-age people.
Is this because there are objective differences in relation to what people are looking for & need, linked to age, or is it about ageism? Or 'stageism' (social care in older age being linked to declining health & dying)? Or impairment (dementia)?
'Cultural models' about social care are dominated by its association with ageing and the idea that becoming older equates with becoming more vulnerable & dependent. That makes it hard to position social care as a vehicle through which to lead the life you want to lead.
Read 7 tweets
Feb 28, 2022
One of the most important tips @anatosaurus shares about communicating effectively for social change is to 'sell the brownie, not the ingredients'. That is, what are the benefits we'll experience in the way we live our lives as a result of changing a policy or practice?
To those ends, I'm struck that, when talking about 'personalised care' we constantly slip into talking about the ingredients - personal budgets, person centred planning, co-production, strength based approaches, social prescribing, personal assistance - not the 'brownie'
And in particular, we talk about choice and control *over support*, while losing sight of the prize, which is choice and control over how we are able to live our lives. As a result, we don't measure the performance/impact of 'social care' against any measures of living well
Read 5 tweets

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