At Turning Point we have long believed in person-centred services. We work with people with complex needs, including those affected by substance misuse, mental health problems, unemployment and those with a learning disability. We support people in a range of settings including registered care homes, Supported Living and through community outreach work.

We have welcomed the introduction of direct payments and personal budgets that provide greater choice. Such schemes in social care should also be linked to ones in health and housing and people should have access to support to manage their money if necessary. Integrated services are particularly important for people with complex needs, as many already face barriers when accessing services, and many services are not designed with them in mind. The divide between health and social care may exist in service provision and policy, but it certainly doesn’t exist in people’s lives.

The inverse care law states that those who need support the most tend to get it the least and it’s when services are inaccessible that people can become vulnerable to crisis. People cannot be expected to adjust to existing service models that don’t suit their needs and we should not talk about hard to reach groups, but instead focus on improving hard to reach services.

I welcome plans in the social care white paper and draft bill to focus on tackling social isolation, support local networks and encourage more community involvement in services. At Turning Point we strongly believe in involving communities in the design and delivery of services. It’s our way of ensuring truly personalised support is available, which also helps with the challenge of reversing the inverse care law. Our Connected Care model of community led commissioning was designed to address the gaps in service provision for those with complex needs and has so far delivered 13 projects across England and engaged with over 140,000 people. It centres on teams of local residents who research community need and engage with commissioners and frontline staff. Recommendations for improved service design and delivery are then turned into reality by local people and commissioners working together.

Choice and personalisation also require effective commissioning and our work has shown us that commissioning and procurement are different things. Commissioning is the process by which the needs of a community are understood, from which procurement follows. These early stages are important to get right if services are to meet the needs of the people using them.

In a time of economic difficulties and spending cuts, it’s important to note that Connected Care has a key economic benefit. A cost benefit analysis of our work in Basildon estimated that improved service delivery could realise savings of £4 for every £1 invested. The advantages for communities are also clear, with people able to benefit from integrated services that they can better engage with and use.

Connected Care projects have resulted in the creation of social enterprises supporting socially excluded people and vulnerable older people, carers’ groups and community time banks and all the projects have brought the needs of communities, including their most vulnerable and isolated members, to the attention of commissioners. Many local residents have become more involved in their communities and have set up family support groups, older people’s luncheon clubs and social activity clubs, meaning the projects help to build community resilience and social capital. Directly involving the people who will be using services in their design and delivery is, I believe, a key way of achieving personalisation. Connected Care gives people more than a budget and a choice between services, but a chance to shape the services that they want from the ground up.

The government has demonstrated commitment to integration and personalisation – which are undeniably two important elements of high quality services. I particularly welcome plans for a national minimum eligibility threshold, improved portability of care provision and putting individual wellbeing at the centre of the system and I look forward to seeing them implemented.

There is much to be optimistic about but I cannot avoid mentioning the issue of funding. The government’s proposals must be accompanied by financial commitments, as the anxiety felt by those reliant on the system is only growing. We know that reform will be expensive, but the costs of doing nothing will be far higher. The government should ensure that its ambitious set of reforms that could greatly improve the whole system are realised. Recent news reports suggest that ministers may be close to agreeing too many of the Dilnot Commission’s recommendations, so I remain hopeful.

We have the chance to turn our care system around, not only for the increasing numbers of older people who use it, but also for the many younger and working age people who require social care services. Clarity on funding will enable badly needed reform to happen, but of course the solution is not about money alone. Turning Point also remains aware that only through integration, personalisation and responding to the wishes and needs of the people that use our services will those services remain relevant and effective. 

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About The Authors

Victor Adebowale

Victor Olufemi Adebowale, Baron Adebowale, CBE is the Chief Executive of the social care enterprise Turning Point and ...