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THE BIG INTERVIEW: Kathryn Smith CEO of the Social Care Institute for Excellence

Kathryn SmithII

CEO, Kathryn Smith, explains how the Social Care Institute for Excellence (SCIE) shares innovation and best practice to make people’s lives better.

Having begun her career working in a care home at the age of 13, Kathryn has devoted her life to working in care.

“Starting at that age wouldn’t be legal now but it was then,” Kathryn reflected. “I seemed to have found my vocation and calling so I carried on working in care homes.”

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From here, Kathryn worked her way up through the care career ladder, managing care homes for local authorities and spending a couple of years as an inspector before moving back to local government as a senior manager and assistant director in the social services department.

Kathryn moved on to the charity sector in 2010 working as a Director of Services at Scope before joining the Alzheimer’s Society where she spent eight years, firstly as Director of Operations before becoming Chief Operating Officer.

She joined SCIE, which marks its 20th anniversary this year, as CEO in May 2020, after the onset of the COVID-19 pandemic, having been approached by a recruitment agency.

“I’d been at the Alzheimer’s Society for quite a long time,” Kathryn explained.

“I’d loved my time there but it was time to move on and I liked the idea that SCIE had the potential to really impact social care across the whole spectrum and obviously it has a clear commitment to co-production, which sits well within my values and principles and the way I want to work.

“SCIE has an incredible reach for quite a small organisation and I really believed in the difference we could make and the support we can provide to commissioners, providers and people that draw on care and support to continually improve social care.

“I also felt during my interview there was a desire for SCIE to be more influential than they might have been previously as well, and that’s something that really appealed to me because we produce an awful lot of evidence through research and work with people that draw on care and support. We should use that evidence and that research to help to inform what social care should look like in the future. My whole career has been in social care. I’ve never done anything else, so it felt an obvious next step for me.”

Kathryn hit the ground running after joining the agency by immediately looking at its strategy and vision and how it could make a difference.

It is one of Kathryn’s main aims to broaden the reach of SCIE to further share best practice. The CEO told CHP she was also keen to look at how the organisation can be more influential in policy terms and raise its profile in the media.

“I think one of the things that is quite crucial is that people who are not currently drawing on care and support might not know about specialist media and so they might only hear about things from reading it in a mainstream paper or on the news, or something like that, so we’re trying to broaden some of our messages across more mainstream media,” the SCIE CEO said.

Kathryn noted SCIE will also be reviewing its influence and marketing strategy as time goes on in order to expand its reach.

The agency has three key strategy areas, which Kathryn summarised as: “local, national and everywhere”.

She summed up the ‘local’ element as looking at “how we can support local services to provide the best quality, personalised care that can really make the difference to people’s outcomes”.

On a national level, SCIE seeks to influence public policy and national action to be “truly informed by the lived experience of people drawing on care and support”.

Thirdly, ‘everywhere’ is about keeping people safe and ensuring that organisations in care and support have the right safeguarding policy, procedures and training.

Additionally to its three strategic themes, SCIE has specific themes such as co-production that run through everything it does.

This incorporates a strengths-based approach that encourages organisations to help people focus on their strengths rather than areas of difficulty so that they can also help themselves to live the life they want to lead.

“We also want to look at how we can tackle inequality across social care,” Kathryn added, noting the pandemic had shone a light on this area.

“There are still lots of examples of inequality across social care and we want to look at the evidence around that and what we can do to address that.

“It’s a fairly early programme that we’re looking at but it’s something that we’d really like to get more involved in.”

Helping to provide joined up services by working across Integrated Care Systems is a further major aim of the organisation.

“How we can support integration and integrated care systems is one of the key themes that we’ve been involved in for quite a while,” Kathryn noted.

“When you are a recipient of care and support you don’t care who the individual that’s supporting you works for. You just want a good service.

“We’ve heard stories of people having to tell their stories hundreds of times to different people and agencies in order to get the support they need.

“If they need it across different systems, they’ve almost got to start again.”

SCIE works with a number of individuals and organisations on developing and embedding innovation, including people with lived experience, as on its Social Futures initiative, the Department of Health and Social Care (DHSC), NICE, NHS, local authorities and charities.

Kathryn chairs a fortnightly meeting of social care organisations, including Skills for Care, the Local Government Association and the CQC.

“We get together so that we can discuss current issues and look at how each of us has a part to play,” Kathryn explained.

“We work very closely with Skills for Care, for example, and support their messaging on providing investment in the workforce.”

Before its funding was paused because of COVID, SCIE, along with Think Local Act Personal (TLAP) and Shared Lives Plus, developed the Innovation Network to help local areas take innovative approaches to social care through working with innovative providers, commissioners and interested citizens.

“I am really passionate about the need for innovation,” Kathryn stressed.

“How a person’s social care needs were met 60 years ago isn’t necessarily the right way to meet them now, so for us it’s very important that we continue to innovate and hear from people that are accessing care and support about what works for them, what would make a difference and what outcomes they are looking for.

“One of the things that I think is always difficult for any provider or commissioner of care is how to really do that innovation at the same time as they’re trying to get on with the day job.

“They’ve still got a job to do, their staff are still very busy and hardworking, and people still need the care and support, so having that ability and time to truly innovate at the same time is quite challenging.

“I’d like to look at how SCIE can really help to support that innovation and share that good practice and networking so that people are not all having to reinvent the wheel and we’re giving potentially some of the answers out to people to help them to really make a difference in those areas.”

Introducing innovation to develop a more preventative approach to social care is a key aim for SCIE.

“One of the issues with social care for some people is that by the time they’re able to get the support they need they’re needing quite significant support and that means that, for example, they might be advised to move to a care home or they might find themselves in hospital long term or something like that,” Kathryn explained.

“Actually most people would choose to they live in their own homes for longer. If we can look at more innovative models then we can try to work to prevent the need for longer-term care and support.

“Our Beyond COVID-19 report last year looked at how to get investment and focus away from remedial and acute services into services that look at prevention and what the best models of housing care and technology are to support people to live the lives they choose in the places they choose to live in.

“It’s not a new idea as such but I think it’s got lost a little over the years as the funding situation has got more and more difficult and that’s where we really need to bring that focus and investment back.”

In housing, the agency is leading a new commission to develop an evidence-based vision and roadmap for housing in the future of care and support, which Kathryn hopes will conclude shortly.

“That’s looking at where people want to live and how they want the care provided as they enter into old age,” Kathryn said.

Funded by the Dunhill Medical Trust, the Commission on the Role of Housing in the Future of Care and Support will review progress of the 2014 Commission on Residential Care’s recommendations, taking account of COVID-19, and will consider all forms of housing services that provide care and support, including care homes (both residential and nursing) and housing with care (supported living, extra care, shared lives and home share).

With SCIE’s Beyond COVID-19 report having also called for a shift to a long-term, sustainable funding system for social care and investment in the workforce, CHP asked Kathryn whether she had seen any progress in these areas.

While noting the PM’s announcement in September was “lacking in detail”, Kathryn welcomed the fact that the government had finally “grasped the nettle” on social care funding.

“I’m pleased to see that nettle has been grasped and that we’ve got a proposal to go forward,” she said.

The SCIE head called for social care funding to be ring-fenced, however, and noted that the £5.4bn on offer was clearly inadequate.

“Reports have shown that just to stabilise the existing system would require just over £6bn and £14bn is needed to meet future demand by 2030,” Kathryn highlighted.

“We’ve expressed our disappointment about the lack of ring-fencing for social care but what’s more important is what we do with it.

“Real reform needs to have a long-term view and protect people against the higher cost of care in the future but actually not just for the sake of the money for the sake of people’s lifestyles and independence and choice.”

Kathryn said a long-term sustainable future for social care came down to establishing a preventative approach.

“The conversations that I’ve had indicate the DHSC genuinely wants to engage with organisations like ourselves and with people that access care and support to move to the next stage which is about what will the social care reforms look like,” she said.

“This isn’t going to happen overnight. This is going to be a long-term social care reform and we want to see something like the 10-year NHS Plan for social care and we want to have an input into that.

“Assuming that DHSC are as good as their word and do work with us and with others on the detail of that, hopefully it will bring us something that we’ve looked for a long time.”

While the PM’s announcement of the health and social care levy has signalled some progress on funding, commentators have noted it does nothing to tackle the recruitment crisis engulfing the sector, which the SCIE boss noted was being driven by a lack of parity of esteem with the NHS.

“The NHS delivers an absolutely vital service and the people working within it deliver a vital service but so does social care and we want social care to be seen as the professional service it is and to have that parity of esteem both within pay and rewards, and professionalism and training,” Kathryn noted.

“It’s always a worry when people can get more money serving food in McDonald’s or stacking shelves in a supermarket than they can for delivering such an important and responsible job as being a carer.

“I recall managing a care home many years ago when a retail park opened up nearby and we lost many of our staff to Tesco because they could pay a higher rate than us. I don’t think things have moved on from then in terms of care staff pay, so I think the funding is of course an issue because it links to pay and it links to that framework but there is also something about how we professionalise and recognise the workforce and how we provide that succession planning.”

Kathryn is, of course, the perfect example of the career opportunities that can be gained in social care.

“I literally worked my way up from the bottom,” she told us.

“I was a care assistant and I’ve done pretty much every single job on the way up to getting there and it’s not without its challenges.

“I’ve literally never had any qualifications funded by an employer or an organisation. I’ve had to pay for that myself along the way, whereas if I was moving into nursing or if I’d been a doctor that kind of career path would have been laid out for me and that training would have been provided there, so I think that’s the difference that we’d like to see within social care as well.

“There is a career path and there is training linked to that career path but I think what we’ve got now is a very inconsistent approach because some care providers and some local authorities will provide that internally themselves but it’s not a nationally recognised programme.

“I think there were some attempts on that around about the time I was an inspector with the Care Standards Act when they brought in NVQ level qualifications in the form of the registered managers qualification, but I don’t think we’ve gone beyond that really so once people have moved up to perhaps being a care home manager what are the options for them next and how do they get the training and qualifications to move on?

“That’s something about professionalising the social care workforce that we are very keen on supporting Skills for Care’s findings on.”

Looking at SCIE’s work going forward, Kathryn said the resumption of funding for SCIE’s Innovation Network would be key.

“We need to get back with the innovation and hopefully with the PM’s funding announcement there will be some commitment to that innovation whether it be through SCIE or through somebody else,” she noted.

When CHP asked what kind of commitments she would like to see from the government in terms of funding innovation going forward, Kathryn highlighted the need for an Innovation Fund to enable the sector to scale up to the most effective and preventative models of care, housing and technology.

“I personally visited care services across the country before lockdown and saw some wonderful examples of innovation locally that could be scaled up that could be offered nationally so we want to see that fund available and that network to support that sharing of good practice,” Kathryn stressed.

Given the relatively modest commitments within the PM’s announcement, the SCIE CEO was realistic about the level of funding that may be made available for innovation, however.

“How much I might think should be available for innovation is probably not going to be available but I do think there needs to be some work done to consider how that funding should be split across the various aspects,” Kathryn noted.

“What’s important to consider is what support can be given to commissioners to local authorities and to others that are committed to providing care and support, to be able to carry on delivering the day job whilst this innovation is happening behind the scenes ready for them to implement.”

Kathryn highlighted finding local solutions to issues as a further key focus for SCIE going forward.

“We want to work with local people to come up with the right solutions for their area, to share good practice with them that we’ve found elsewhere and to be able to give them the headspace to unleash their own creativity and to hear from local people that access care and support directly what would make a difference to them and would make their lives better,” Kathryn stressed.

The CEO said the SCIE would also focus on developing new commissioning models.

“We’ve pulled together a network of local authority directors social services directors and we get them together every now and again to look at what kind of support and what kind of difference we could make to them,” she explained.

“LAs have commissioned us directly to look at their own commissioning model. We’ve built up quite a good offer in that way and that’s definitely something that we want to roll out and do more and more of.”

With social care reform finally making progress, SCIE looks set to play its role in developing a sector that is truly fit for the 21st century.

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The author Lee Peart

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