THE BLOG
09/02/2015 08:00 GMT | Updated 08/04/2015 06:59 BST

Call to Change the Way We Think About Care

It is with great diffidence that I suggest that a lot of the very welcome and well-informed debate about how to provide suitable care and support for older and disabled people has centred around the wrong question. It is not and never should be, about "how do I keep my mum from going into care?" That is simply the wrong question.

I think it was on West Wing that I first heard a politician faced with a tricky interview advised to challenge the premise of the question. Some eminent persons - pundits and politicians alike - seem to have taken this advice to extremes. To the extent that viewers and listeners sometimes wonder whether it is still possible to get a straight answer to a straight question.

So, it is with great diffidence that I suggest that a lot of the very welcome and well-informed debate about how to provide suitable care and support for older and disabled people has centred around the wrong question. It is not and never should be, about "how do I keep my mum from going into care?" That is simply the wrong question.

Disabled and older people should of course have a range of real choices for where they live and the type of support they receive. But we're not there yet. These two key decisions - where do I want to live? and what support do I need? - aren't always separate choices and this is irreparably damaging the perception of residential care.

Currently, when someone needs support with everyday living the focus is almost always on whether this can be delivered in their current home or whether they should move to what we currently call residential care. Often, the two options are presented to disabled and older people as complete opposites, a stark choice between 'own home' or 'care home' with nothing in between.

This shouldn't be the case. Housing with care is an essential part of the way we live now - it transforms lives, enabling independence and supporting people to maintain skills and confidence, as well as their social connections. It also, incidentally, has an essential role to play in keeping the NHS afloat, providing care and support outside hospital and preventing avoidable admissions.

That's why it's essential we change the way we think about it. Instead of talking about someone 'going into a care home', we should talk about them moving to a new home because it's the best choice for them.

As a member of the Commission on Residential Care I am optimistic we can make this a reality. To overcome the fear factor and create choices that reflects modern lifestyles, all the structures supporting housing with care - government funding, commissioning, regulation and planning - need to adapt. And so does the language.

Instead of a system geared towards this binary choice, underpinned by the idea that your care needs should dictate where you live, we need to create a 'continuum of care' featuring everything from "disabled-friendly" general housing to nursing homes supporting people with the most complex needs.

In the same way as we move to a house with another bedroom as our family grows, we might plan to move to a house with a wheelchair-accessible front door if our mobility is declining. No one should be forced to move to a care home simply because their local council hasn't planned for enough "disabled-friendly" homes in their area.

These are exactly the issues we've been discussing at Leonard Cheshire with people who receive care, people who provide care and people who are at the end of their tether about the gap between available public money and the number of people who need support. And one thing we all agreed upon. That wherever you choose to live, that's your home. And that's why you need your own front door. And for many, that's also why they are happy to see it as a choice. A choice to sell their current house and buy a lease or take a tenancy in housing with care. A positive choice.