Strengths-based approaches: bridging the gap in adult social care

At a recent event hosted by the IMPACT centre for implementing evidence in adult social care at Birmingham University, a group including the outgoing and incoming Chief Social Workers and some of the leading proponents of strengths-based approaches explored how far strengths-based working has come, and the work left to do after years of practice development in this area.

Most councils and provider organisations now describe their approach to adult social care as ‘strengths-based’ but, like many terms which have become embedded into the lexicon of the sector, what that means and how real it is varies enormously.

Strengths-based working has long been a contested term. I led a small group of charities which campaigned successfully to get strengths-based language into the Care Act and statutory guidance on assessment a decade ago. It was controversial: some felt that including mention of strengths in assessment and planning legislation would create a loophole to enable cash-strapped councils to avoid duties to meet need.

That tension between building strengths and meeting needs remains at the heart of our social care system: the best outcome is for a person to build their independence and capacity as far as they can, but the system requires a line between who is eligible and who is ineligible for state-funded support, and that is always based on that person’s level of need.

At the IMPACT event I was struck by Self Directed Futures’ Rachel Mason’s description of social care as: being seen as a system that people get sent to, when what she was looking for – as the mother of two adult sons with autism (and an expert on self-directed support) – was the availability of a wide range of resources in the community, with services and benefits as a safety net underneath that community-based life, not placed distantly behind barriers and gatekeepers.

It’s hard to envisage a state-funded support system without any reference to needs-based eligibility. The nearest I can think of is universal income, which remains a distant prospect. Councils are under increasing pressure to deliver financial sustainability, and this cannot be achieved by more rigid assessment and monitoring of people’s needs, but through the success of local partners in translating a vision for strengths-based approaches into real gains in independence. There is a gap to be bridged between strengths and needs, and I’ve seen two local areas doing that already.

Many areas have made strides in taking a more human approach, having conversations with people rather than doing assessment to them, and building a richer picture of people’s lives and goals. But most struggle to turn that into real change in how people with eligible needs are supported, and the level of independence they achieve. They have great strengths-based conversations but then offer traditional support services which do not enable people to maintain or build as much capacity and independence as they could. Our Valuing Good Lives programme finds unrealised opportunities for independence in up to 50% of people’s support packages. Our work on prevention and the ‘front door’ finds people being channelled into service support who would benefit more from help to self-care, sustain family caring, or connect with others.

I think those missed opportunities illustrate the biggest remaining challenge for strengths-based approaches: to extend them beyond practice into a whole-system, place-based approach. We need prevention strategies that align council ‘front doors’ and the VCSE sector around building people’s capacity; commissioning that builds strengths-based approaches into the provider market; housing strategies that develop housing options that enable people to remain in or move into the community; and data and finance systems that capture the outcomes, costs and savings of strengths-based working.

At next week’s ADASS Spring Seminar we’ll be hosting a workshop with three councils that have created the space for change within their complex systems and we’ll be sharing our learning about what enables that change to become embedded and scaled. Strengths-based practice is an important starting point, but on its own it doesn’t create high enough consistent gains in individual independence, or the kind of step change that we need across our complex systems. As the pressures on social care mount, it’s time to raise our level of ambition and embed enabling, empowering and connecting into every aspect of our services, systems and communities.