5 quick ideas on social care


1. Modular half-way houses in each town/village/suburb in the country.

The NHS is under enormous pressure for bed space as a result of the lack of available social care facilities. There are huge numbers of people well enough to be discharged from hospital but not well enough to return to living alone. They do not need nursing or specialist care, simply someone to look after them. The budgets do not exist for live in care for every individual so often they are waiting for a space to open up in a care home.

So could we add bed capacity quickly and alter it with demand? Perhaps the solution would be an area in each population centre dedicated to care modules - individual stand alone units that are transportable and can simply connect into site services. Clustering these homes together allows dedicated on site carers longer with each patient, allows onsite meal preparation and service and allows district nurses to visit and advise on health issues.

Modular design would allow mass manufacturing, rapid deployment and financial economies of scale. Clever space saving design , off grid water and energy supplies and low environmental impact would ensure these could be placed anywhere that space for them existed.

2. Communal spaces

Britain has lots of social spaces, we have beautiful parks, lovely country walks, pretty villages and amazing cities. However we also have a northern European maritime climate. Once it rains almost all these places become inaccessible to the elderly or disabled. The only inside spaces are commercially owned, and often rely on private transportation to reach them.

Too much development is commercially driven. We need to use the planning system and design experts to create housing that connects to shared public spaces that are accessible to all and usable every day and night of the year. Places like Montreal are designed with underground connecting networks of tunnels linking areas of the city and allowing people to move around in comfort in the bitter winter. These spaces become gathering places giving social contact to all.

But how could a council justify this to the taxpayer? One week in a care home costs the council around £600, nursing homes even more. A hospital stay costs that every night. If we can reduce the amount of time people spend in the social care system by investing in infrastructure that keeps people healthier for longer, with less intervention the payback will happen,

3. Tech

Just about everyone who works in a people facing role always says "you can't replace me with a robot". That is true, and it isn't the aim of technology. The human aspect of care will always be required but it can be massively aided by technology. For example in the near future an elderly person may be wearing a monitoring device that will send an alert at signs of a raised temperature or irregular heartbeat. Arranging help automatically for a home visit, updating a shared database between NHS and care giver that medicine has been prescribed, alerting nominated friends/family about the visit.
And when we say tech we don't just mean cutting edge technology, it could be as simple as lighter walking frames or home adaptations.

4. Adoption and fostering

Social care often concentrates on the elderly but young people, though less numerous, often require specialist support through periods of their life. A residential care home can cost £50k-£200k a year per child depending on the level of support they require. Fostering placements are around £25-£40k per child per year. 24 hour support and care is expensive and the adoption process is the preferred method of both giving the children a loving family and removing the cost of care from the state.

There is a large social cost for those who fail to find adoptive homes. Children's homes can often turn into care - prison pipelines. 1% of children in the UK are in care at any time in their childhood but 33% of male prisoners and 61% of female have been in care.

There are huge variations in the imprisonment rate by county and by care home. Getting it wrong is a huge social cost and council's should ensure those homes in their areas are using the best possible measures.


5. Entrepreneurial state

Mariana Mazzucato's book "The entrepreneurial state" shows how innovation isn't limited to the private sector, in fact it is often the public sector who drive innovation. We are often too timid in the public sector to assert our expertise in certain areas, to commission research and to capture the value we have created. When care facilities are required why are we waiting on private equity to provide buildings when they are going to be entirely funded from the public purse. If we in the public sector are financing the project, and it is profitable for a private provider to run the service then why are we not doing it ourselves based on our actual requirements?


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