Local government reorganisation – the impact on adult social care

The government’s proposed Local Government Reforms for England will redraw the map of councils, replacing the remaining ‘two tier’ councils (which have a large county council and a set of smaller borough councils sharing responsibility for the county’s public services, economy and housing) into single unitary authorities. Those in turn will be grouped into Strategic Authorities with directly elected mayors at the helm. What does this mean for adult social care?

Adult social care is widely and consistently talked about as being in crisis: not enough money, not enough workers with the right skills, costs spiralling out of control. As a result, older people get stuck in hospital when they are well enough to return home with the right support, and many younger disabled people are not able to live with the independence that other adults take for granted. Perhaps because social care has been neglected for so long, the sector itself – including people who draw on support, workers, and leaders – have not waited for long-promised reforms but have drawn up their own vision for a more hopeful social care future: one that enables people to live well in a place called home, in welcoming communities, doing things that are meaningful to us, with people we love.

That all sounds a long way from questions about the shape of local government bureaucracy, but as our report with Social Care Future on ‘fixing adult social care’s plumbing and wiring’ highlighted, real change in public services requires both cultural and practical shifts – what IMPOWER calls ‘head and heart’.

So, what does that shared vision for social care need from councils, and will these reforms take us nearer or further away from it?

As the ‘Think Local Act Personal’ social care reform partnership’s name suggests, great social care is tailored to each individual and rooted in communities. We need effective, responsive, professional services when we need them, but most of us prefer to live our lives with as little intrusion by councils and services as possible, supporting ourselves and each other where we can. This means that great councils are shaped around their local communities, and work in partnership with each neighbourhood’s community groups and local assets like leisure services, GP practices and libraries. Some of the new councils will cover smaller areas. With only one unitary rather than a county council and a district council sharing responsibilities, they should feel simpler. However, some will be larger, and some will be divided in two, making joining the new lines of control up with what people consider to be their neighbourhood more difficult in some places.

Developing, acquiring or adapting the right housing to enable people to live independently is a challenge for all councils we work with. For some counties, social care is being run at county level whilst housing is the responsibility of several districts., This won’t be the case in a unitary.

Reforms will therefore bring both gains and losses for a social care system already under huge strain and are already increasingly taking up councils’ bandwidth as thousands of council workers’ own futures get caught up in the uncertainty brought by any major restructure.

Our clients are already taking decisive action to reform adult social care, because neither their citizens nor the creaking system itself can wait for radical change. If there are areas where the looming reforms become a reason for inaction, people will suffer, family carers will slip into crisis, and the new councils will inherit spiralling budgets. That lack of ‘bandwidth’ for anything other than creating functional new organisations is my biggest fear for these reforms.

The biggest opportunity it seems to me, is to place reforming public services at the heart of the ambition for this renewed version of local government. People care little about changes to council structures but care a lot about the services they and their families rely on. Our experience is that transformation projects need buy-in from workers and people who use the services. People contribute most when they feel a sense of shared ownership; changes that are ‘co-produced’ with people and workers are the changes that stick.

By co-producing these new organisations with communities, councils can build a shared ambition with those who rely on their vital services, and with the most poorly reached and served groups and communities. The Local Government Reform White Paper acknowledges that people’s trust in democracy and local government is declining. These reforms (and the mooted delays to local elections they entail) will not rebuild trust on their own. But if areas use them to engage local people in shaping the future of the services that matter most to them, they could genuinely change relationships between communities and councils.