Implementing the Care Act 2014: Building social resources to prevent, reduce or delay needs for care and support in adult social care in England

Many local authorities have been looking at how to enable people to live better, with stronger connections in their families and communities - thereby helping to prevent, reduce or delay their need for social care services. 

We used a national survey to find out how different English local authorities were taking this agenda forward, and also what difficulties they were facing. We then looked in more depth at the experience of 7 local authorities in taking this agenda forward.  

Local Authority Case Studies

A diverse mix of case studies were selected in terms of geography and approach – and included examples of:

• Local Area Co-ordination / Neighbourhood Networking
• Asset Based Community Development
• Family Group Conferencing
• Strengths based conversations at point of first contact
• Targeted use of personal budgets

Since the Care Act, some local authorities have developed a new vision of how they should engage with citizens and communities. Instead of assessing people’s eligibility for increasingly scarce social care services, they are seeking to work co-productively with people to enable them to find solutions to their difficulties, build effective support systems, or achieve their aspirations. This means engaging with people in ways that do not encourage people to be dependent on care services - ‘doing with’ rather than ‘doing to’ or ‘doing for’. A new language is emerging which emphasises people’s strengths and assets, mobilising resources and building capability.

Financial pressures were seen as the biggest driver for investing in prevention activity, but also as the most frequent barrier to implementing this as a coherent strategy. It could be hard to carve out additional money for prevention while overall budgets were having to be tightened.  

From our research in Case Study sites, our main finding was that ‘you have to be radical to be effective’ – piecemeal change delivered little and was often not sustained. Three approaches emerged as particularly promising:

• Strengths-based approaches, such as ‘Three Conversations’, offer a collaborative approach to finding solutions that enable people to have a ‘good life’, often with relatively little involvement of care services.
• Local Area Coordination builds capability and connectivity in the community, with people supporting each other around their interests and aspirations.
• Family Group Conferencing brings together people with their family and friends to agree support arrangements that will help them to have the sort of life that they want.  

We found that strengths-based approaches could reduce the use of residential and nursing care, and community capacity building linked to lower expenditure on social care and health services.

Researcher team

• Professor Jerry Tew (Principal investigator), School of Social Policy, University of Birmingham
• Professor Jon Glasby, School of Social Policy, University of Birmingham
• Professor Robin Miller, School of Social Policy, University of Birmingham
• Dr Karen Newbigging, School of Social Policy, University of Birmingham
• Dr Denise Tanner, School of Social Policy, University of Birmingham
• Dr Sandhya Duggal, School of Social Policy, University of Birmingham
• Francesca Tomaselli, School of Social Policy, University of Birmingham (Administrator)
• Dr Philip Kinghorn, Institute of Applied Health Research, University of Birmingham
• Dr Marco Ercolani, Department of Economics, University of Birmingham
• Dr Sarah Carr, School of Social Policy, University of Birmingham
• Clenton Farquharson (PPI Lead)

The research was supported by a Lived Experience Advisory Panel with representation from each of the Case Study sites.