How Can We Change The Public Perception Of Social Care?

"it always feels very unfair for the care professionals affected because our co-workers in the NHS can enjoy mostly positive media coverage"

Our perception of social care is shaped by the media. Stories tend to be about one of three negative themes - care home profiteering, harm or neglect. It’s time this changed.

Social Care Is The Poor Relation In Terms Of Media Profile

In general, the media look for a soundbite to get clicks and often use headlines to create fear.

When this strategy is aimed at social care it always feels very unfair for the care professionals affected because our co-workers in the NHS can enjoy mostly positive media coverage.

There are over 1.5 million of us working in social care in the UK. We do a difficult job and yet we don’t have the mostly-positive media profile that our work warrants.

Care homes serve an important need in providing long term care in a well-managed residential setting.

They free up hospital beds, enabling nurses and doctors and other professionals to come to one setting and provide services in an organized way. This is far easier than visiting an individual’s homes.

It has an important place as a model of social support and has specific advantages over home care.

Care homes offer individual safety and foster a sense of community. In this way they lessen social isolation and improve mental health and emotional well-being etc.

This is all seldom reported on.

Instead, there seems to be three main themes or media tropes the mainstream press jumps on that harms the perception of social care and care homes in the UK.

At a national level, the media has continued with its negative bias toward care homes – usually focusing on alleged profiteering, then abuse, then the number of people dying in care homes during the pandemic.

All three perspectives have elements of truth but all require context.

#1: Care Home Operators Are Profiteering From Those In Need

Firstly, “profiteering”: the press tend to lament that private operators are making profit from care; there’s an inference perhaps that it should be under the NHS.

Actually, most councils sold off their care homes around 20 years ago – a combination of raising money for public finances and upon considering the high liabilities of running these services.

Entrepreneurs borrowed money off the banks to buy these homes and so the private sector began operating groups of ex council homes.

The private sector has brought much needed capital to further develop these homes and build further homes over the following years, as demand has grown.

Doubtless there are social care providers running their care homes purely as a business but there are many benevolent and skillful operators out there too.

#2: Stories Of Abuse Of Residents In Care Are Given Disproportionate Coverage

The second negative bias towards care homes has been with alleged harm to residents – this is usually based on the reporting about incidences of safeguarding or alleged abuse.

There are incidences of extreme abuse e.g. Winterbourne view which rightly led to changes in the law.

This is never acceptable and but what is missed here is both the scale of those living in care homes (approx. 420,000 - same as the population of a large UK city) and the definition of “abuse”.

If an older person falls and hurts themselves in a care home or doesn’t take a pill, it may well be considered “neglect” and “abuse” by the care home yet if the same is done at their own home, it is not considered abuse.

Context matters.

#3: You Stand A High Chance Of Dying In A Care Home

The third issue, specifically about people dying in care homes is partly true. But, of course, context is crucial.

After all, those with long term care needs and high levels of dependency will live in a care home at a certain point when the effort to safely care for them goes beyond home care calls or the family.

This means if they get covid, for example, they are already the most physically vulnerable people in society.

Many of the earlier deaths in care homes from covid came from the action of the government influencing care providers to take residents who were not tested. In retrospect, a poor decision.

These residents unfortunately brought covid to the home leading to many further deaths – it was not primarily due to the actions or neglect of the care provider.

The second wave of deaths relates to the increase in the risk of transmission with the newer variants of covid (all across the UK) and the fact that care home residents are often highly physically vulnerable already. This was not related to the care home model or setting.

CHANGING THE STORY - WHAT THE MEDIA COULD REPORT ON MORE

So, how can we change this?

I think if all reports of social care / care homes recognised just two points, it would go someway to temper and balance coverage.

#1: The Demand On Social Care Is Growing And It’s Due To A Societal Change

One of the main things missing in the balance of coverage around care homes is the fact that people are living far longer all across the developed world.

This leads to an increasing need for care facilities for those who can’t look after themselves safely but don’t need hospital treatment.

A socially mobile society often means the needs of an elderly person are beyond the support bubble they might have had in previous times (family, friends, neighbours).

This is a societal change.

#2: The Challenges And Complexity Of The Job Need To Be Understood

Next is the fact that there are many in care facilities who have very difficult needs to manage.

Care receivers may hit the carers, bite or slap without obvious cause. It may relate to dementia with challenging behaviour.

Often, these are unmet needs being expressed in an unusual way and with staff kindness and sensitivity and good training, these individuals will often settle and feel better. In some cases, they won’t and require specialist care.

Stories about staff being hit / punched by residents are common within some of these services though it is not deemed abuse.

It is a tough side of care to work in and requires resilient, loving people who can see the person, overlook the behavior, knowing it is often part of the resident’s medical condition.

Specialist services can do much to skillfully help support those with these complex needs.