Support in the Community

Let's concentrate on the right place to live and the right support.

Get that razor out

Author: Mark Humble

I am a social worker by trade and not a philosopher however I have always been fascinated by the idea of Occam's Razor. Occam was a 14th century philosopher who developed the idea that very often the simplest explanation or solution is usually the right one. Not a direct quote but ‘if it looks like a duck and quacks like a duck, it's probably a duck’ or if you hear the distant sound of hooves it's likely to be horses and not a man with two halves of coconuts are good examples of this type of thinking.

I have been thinking about how we solve the problem of the large numbers of people with a learning disability still imprisoned within inpatient hospitals, very often with no real chance of being set free.

Without a doubt the solution is a complicated one and involves a number of systems working together effectively, expertly summed up in the quote "it's not rocket science, it's much more complicated than that".

However, I think one of the reasons there hasn’t been much progress is that it is seen as so complex and complicated, and when people try to address every aspect of what's needed an inertia sets into the system and everyone feels powerless, and as a consequence nothing changes.

Using Occam's Razor I think we can break down the solution to freeing people from inpatient services down to two things: the right place to live and the right support.

I get that these things in themselves can be complicated and differ from individual to individual. However if we start simple and build on these two things, we might start to see progress.

In terms of the right place to live, we simply need to speak to individuals and organisations that can help identify and supply the right accommodation in the right place for the right people. Whether that’s the people who build accommodation, rent out accommodation or who supply mortgages. The system needs to be clear what it needs and ask the housing experts what they need to meet the demand.

In terms of the right support, there is much more to support than paid staff, however a key part of many people's lives is built on good paid support. There are many facets to what good support looks like, however a key element is having a person available to provide that support. The question then is what the system needs to do to ensure that there are the right staff with the right skills and knowledge available.

This does raise some questions about pay, progression and making working within health and social care ‘sexy’ and an active choice for people. I can't count the number of times I have heard people say, “I get paid more in ASDA (other shops are available) why would I work in social care for less pay”. I know most people who work in health and care don’t simply do it for the money, however if we are serious about making sure we have the right support that people need, we need to make sure that we have the staff needed to at least give people a fighting chance.

Unless we address these very real issues and stop putting up smoke screens and trying to do things on the cheap, I really don’t think things will ever change. People are leaving the health and social care industry in droves, and we are doing little to recruit other than simply advertising.

The real transformation needed to ensure that people can live in their communities can be driven by these two things: accommodation and support, however to do so will involve some investment and a rethink about how we see the value of care and support workers, however once people are living in and being supported in their communities effectively there will be less of a need to provide as much in patient provision.


The publisher is Citizen Network Research. Support in the Community © Mark Humble 2024.

Article | 29.01.24

Deinstitutionalisation, Inclusion, intellectual disabilities, England, Article

Also see