Should social care keep people independent as well as safe?

Lancashire risks "losing sight of the person" needing care - Louise Taylor, executive director of adult services at Lancashire County Council
Lancashire risks "losing sight of the person" needing care - Louise Taylor, executive director of adult services at Lancashire County Council

Social care services have to be careful not to “rob” elderly people of their independence by being too risk averse when helping them to recover from a period of health, according to Lancashire’s adult services boss.

Louise Taylor, who is also the officer in charge of wellbeing at Lancashire County Council, told a meeting of health and local government officials that social care staff were tempted to adopt a “conservative” approach when faced with someone waiting to be discharged from a hospital bed.

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“We tend to respond to people by wrapping more and more things around them, so eventually we have lost sight of the person in the middle,” Ms. Taylor said.

“And what we can’t be sure is that we haven’t robbed someone of their ability to be more independent and get back to a state they were in previously.”

Figures presented to the Lancashire health and wellbeing board show that the county council refers fewer than 10 percent of people it encounters to community services, with the rest drawn into a more formal assessment process. For some comparable local authorities, more than 70 percent of departing hospital patients are offered alternatives to statutory support.

County hall is currently consulting on a new strategy for how it cares for its vulnerable adults. Members heard that Lancashire has witnessed a growth in residential care spaces, but a reduction in nursing beds - the reverse of what health bosses believe is necessary.

Many of the conditions which are causing people to need intervention from the council are avoidable - and reversible if they do occur, the meeting was told.

Lancashire County Council’s director of public health, Dr. Sakthi Karunanithi, told the meeting that he “really welcomed” a new approach to helping people remain independent. But he warned that the benefits would only contribute to around 20 percent of the improved health outcomes that were needed across the county.

“The other 80 percent is equally split between lifestyle choices and the impact of the economy and unemployment on health.

“Some stark figures are emerging which show that just because of ill health, our wealth creation is being negatively influenced,” Dr. Karunanithi added.

Louise Taylor told the meeting that the county also had to embrace new technology to help people with their health needs, adding that the county's current offering was below par.

“The population isn’t afraid of using it - the greatest fear tends to sit with [officials].

“My parents are both in their late 70s and have degenerative conditions - but on a daily basis, they are very happy and adept at going online and ordering services.

“However, they would struggle to do that if they contacted the county council. I think people need to be able to find out information in advance of needing it and be able to find it without having to call us and then go through an assessment,” Ms. Taylor added.

Board member Margaret France, who is also a Chorley councillor, said that when people do need more structured support in their own homes, there needed to be greater consistency in the people providing it.

“I’ve visited households where they never get the same carer on two consecutive days from some of the big agency providers.

“And something which might not be palatable - but which we have to face up to - is that there is often a big language difference between the people going in and doing the caring and the person being cared for.

“In order for it to work, it’s got to be someone who knows the person well and has good communication with them,” Cllr France added.