Where I live the council lists over 400 care and support organisations. They range from very health specific support groups and peer support networks, through to leisure and social clubs, including bingo and history clubs for older people. Then there are a plethora of more formal providers of care: home care, residential and day care providers. And these lists do not include the NHS services that are available if you receiving treatment. There is a lot going on locally, to say the least, and the council is clearly working hard to map what's around and give people options and opportunities for engagement and participation.
All of these community resources, the social networks that bind people together, should of course be celebrated. If we are truly going to promote self-care and independence in older age, then we need more resources like these.
But just like when you need to book a holiday or buy a present, the choice online can be bewildering. And what if you don't have the comfort of time to pick and choose the care you need? Or what if you aren't online or can't read or understand the choices available?
In research we conducted for the Department of Health on what the hallmarks of how good integrated care should be in 2020, people told us a critical one is "seeing fewer people, who know more about your care need." In other words, people want someone who can help them pull together, in one coherent package, all of the care and support they need. This is not always the case currently. People with multiple long term conditions, often caring for someone else themselves, find it a real struggle to locate the services they need, forcing them into situations when they are relying on expensive and inappropriate care they may not even need.
Enter the care co-ordinator. Care co-ordinators (or care navigators as they are sometimes called) increasingly play a vital role in helping people navigate the complex landscape of care and support to help them find the care that is right for them. Primarily focused on ensuring that older people receive timely and person-centred care, care co-ordinators can also help people understand the benefits system, adapt their homes, manage their money and meet new friends. They are at the frontline of a new preventative care system, which seeks to keep people healthy and independent at home for longer. And if the ambitions set out in Sustainability and Transformation Plans (many of which talk about increasing the number of care co-ordinators) are to be realised, they are set to grow rapidly in number.
This must be a good thing, as there is growing evidence of their positive impact. But they will need lots of help if they are to be successful. In Redcar and Cleveland, community co-ordinators - in this case called 'agents' - work with older and vulnerable people to connect them to a range of community resources, such as friendship groups and social clubs. In Torbay, the British Red Cross has developed a group of volunteers to support people for up to 12 weeks by offering practical and emotional support; and by helping people to link up with the most relevant services and social activities in the area. This aims to help them feel less lonely, more independent and more involved in their community.
However, there is a clear need to develop further the infrastructure to support care co-ordination. The technology they need - access to regularly updated directories - is still lacking. Then there is the problem of capacity. Demographic trends will continue to place huge demands on local services. It is difficult to see how we can grow the care co-ordinating workforce to meet demand without increased investment. Volunteers are part of the solution, but they are insufficient on their own.
A former Trustee of SCIE and service user, Ann Macfarlane OBE, used to describe to us her irritation that health and social care staff often underestimated her capacity to find her own forms of support. She would tell us: "I don't spend all my life in hospital you know; I do things in the community". She is right of course. There is a whole community out there; you just need to know where to look. For people who need care and support in an ever more complex world, care co-ordinators can point the way.