This research, commissioned by the Department of Health and published by the Social Care Institute for Excellence (SCIE), is the first to explore how social care can be delivered in a sustainable way. The report calls for a fundamental rethink in the approach to social care so that pressing challenges such as climate change, spending cuts and an ageing population can be addressed simultaneously.
Social care is frequently seen as a ‘Cinderella’ service’ – that is, it is underfunded and not very glamorous, but its environmental and social footprint is enormous. Currently around £16 billion is spent on adult social care in the UK, which is provided by around 13,000 different organisations, with 1.3 million employees. Social care is provided to vulnerable adults and people over the age of 65 in their own homes and in other settings.
The research team reviewed existing policies and then looked at examples of good practice in order to learn lessons that could be implemented across the whole of this sector.
Dr Simon Evans explains, “We are at a crossroads at the moment in terms of how we commission and deliver social care. If we are to deliver social care in a sustainable way we must find ways to meet a range of demands, including the fiscal crisis, an ageing population and the issue of climate change.
“This research breaks new ground by taking a whole-systems approach to the economic, environmental and social impact of adult social care. The current system is very complex, with services being commissioned from many different providers. Despite this our findings suggest that in many areas social care can become more sustainable. The range of measures that can be implemented include reducing care miles, adopting sustainable procurement practices and providing preventative services that reduce the need for higher levels of support.
“We were particularly interested in examples of services that tackled sustainability holistically by considering the environmental, economic and social impacts of services. For example, Cornwall Council has developed an innovative workshop for vulnerable adults that refurbishes £26,000 worth of equipment such as walking aids and aids for independent living each year, which are returned to local hospitals to be re-used. This project provides a triple win – providing employment for service users and an income stream for the project, offering a much-needed service to the NHS and re-using resources.
In Bristol, where there is an over-arching approach to sustainability across all services, mileage expenditure in social care has been reduced by 20 per cent through better planning of home visits and linking journey destinations. The service is also saving £66,000 annually on its fuel bills as a result of its programme to improve the energy efficiency of its buildings. This has both economic and environmental benefits.
The report also highlights the benefits of new and innovative models of care and support based on co-production, localism and mutualism. The current government is placing more emphasis on localism and this will have implications for how services are delivered. The current fiscal crisis adds urgency to the drive to make public services sustainable in the broadest sense by considering how services can achieve improved social well-being and reduced environmental impact with less money.
Another issue, which the teams says needs further research, is the effect of climate change on vulnerable adults. Extreme weather events – such as cold weather, flooding or heat waves, have a disproportionate effect on those who depend on social care, and more needs to be known about how to design services so that they are more resilient to these events.
ISHE was selected to carry out the research, as the only research institute which brings together the key themes of environment, sustainability and health. Academics have expertise in key areas, but also work across disciplines to enable linked issues to be addressed.
Altogether the report made nine recommendations which the Department of Health are currently considering.
See the full report at:Sustainable Systems of Social Care, Social Care Institute of Excellence, 2010