Social services are responsible for the provision of care, help with daily life activities, and community and relationship-based programmes. Looking ahead, one of the most pressing social and political challenges for social care services in the next 10 years will be to put them on an equal footing with health care when it comes to ensuring universal and free access.
As a response to the damage to care homes caused by the Covid-19 pandemic, several governments have commissioned independent reviews into adult social care or have started to rethink and propose new models of care for people with long-term support needs. The European Commission’s proposal for a care strategy in cooperation with national governments could be an incentive for national authorities though the lack of detail regarding implementation monitoring may hamper fulfilling its objectives.
A Publicly funded and managed social care service
A feasible and affordable model that can guarantee a national publicly funded social care service involves the following key components.
Workforce registration and accreditation
The Care Strategy focuses on improving wages supported by strong social dialogue. While this is an important element, there are others which are key to ensure the workforce is well supported, such as the improvement staff to population ratios, new and alternative ways of recruiting, and registration and accreditation of social care workers.
Such a registration process, which previous ESN reports have highlighted is now being implemented in several EU countries, can be linked to training and career development opportunities and also recognises the practical skills and experience acquired in an informal context. This in turn would improve quality of care and therefore benefit care workers, their employers and service users.
The Commission can play a much stronger role in this area by supporting countries to work towards the harmonization of qualifications in social work and social care in a similar vein to the work done in the area of healthcare.
The right to self-determination
The increasing number and diversity of requirements and expectations of people with long-term care needs implicates a focus on the provision of person-centred care. This involves giving the person effective choice and control over their lives and real alternatives when it comes to their care and support taking into account not only their needs, but also values, assets and wishes.
This implies building a service where each person receives the care they need when they need it based on fair contribution throughout their lives according to their financial possibilities. But it also entails a system that encourages self-care, prevention, rehabilitation, and mutual support.
The challenge is being able to present the social care system as fair and reliable, because if national governments manage to do so, citizens will feel confident that public services respond to their needs and be assured that they will be able to receive a social return on their investments.
People who have long-term care needs should continue to live and actively contribute to their communities. For more than 40 years, people who need some form of care have been speaking out loud about where and how they want to live and be supported.
The change should be an integral part of the wider transformation of social services, for which European policies and national recovery and resilience funds can be a crucial driver and resource. This transformation includes strengthening and supporting services to generate ecosystems of care, in which support is designed alongside a continuum which includes home care, technology improvements at home, day care, emergency care, residential facilities and respite care.
People with long-term care needs may interact with health and social care services, hence it is key that both systems are as closely aligned as possible and can speak to each other. This involves not only information exchange but the ability to use that information. Therefore, public authorities should invest in safe and reliable interoperable systems that allow for the exchange and sharing of data across the pathway of a person’s care.
Technology and innovation driven
The ways in which care is organised can improve more quickly and systematically through the integration of new technologies that help people receive more effective, versatile, safe and supportive care. Technology could help bring costs down in the long run but it is also a source of wealth and competitiveness of the country as a whole.
Funding of care services is a key concern across public social services in Europe. However, the focus is often too narrowly based on cost-efficiency, without recognising that the percentage of GDP invested in care and social services has decreased over the years. A needs-based, locally delivered and publicly funded social care service for people with long-term needs is possible on par with the national health service receiving centralised funding from national government. This shift should involve the right to quality care for all those who may need care and support at a certain time in their lives. A care guarantee for all, recognised in future European Recommendations would bring together European initiatives on children, youth, disability, and long-term care.