For more than 40 years, people who need some form of care have been speaking out loud about where and how they want to live and be supported. Children who may not be able to remain with their families, or adults with disability or care needs, wish to live in a family environment in their neighbourhoods, as if they were at home. They do not wish to live separated from their peers or their communities but as close as possible to where their connections and close ones are.
Yet UNICEF has estimated that approximately 8 million children worldwide live in institutions, while there is no data on the estimated millions of older people who spend the last years of their life in residential facilities that bear little resemblance to a home. The unspeakable tragedy that we experienced during Covid-19 in older people’s care homes across Europe has underscored even more how important it is to change the current model of care.
This change should be an integral part of the wider transformation of social services, for which the national recovery and resilience funds can become a crucial driver and resource. This includes strengthening and supporting services to generate ecosystems of care, in which support is designed alongside a continuum which includes home care, technology improvements at home, day care, emergency care, residential facilities and respite care.
This change implies developing kind and friendly support and residential services where people who choose to do so live with dignity, where their needs for care and support are covered in a person-centred manner adapted to their needs as well as their preferences. These are places where the outcome is to provide for people’s wellbeing, hence quality measurement is concerned with improvements in their lives.
To make it happen, we need to work jointly to change the current model of care within the wider transformation of social services, understanding care as a response to people’s needs but also to how they wish to live their lives. It is about putting the person, their home, and communities at the centre, so that the various services are modelled around the person. In short, it is about closing down the institutionalised model of care and opening up our services so that they support people to take greater control over their own lives and allow everyone to enjoy a good quality of life, so that they can contribute fully to our communities.
The transition from institutional to community and home-based care, powered by a well valued workforce, has been identified as a central component for building social services provision resilient enough to meet future needs at the recent European Social Services Conference. Indeed, social services across Europe share a common challenge – recruiting and sustaining their workforce to meet rising care and social services demands. This change and the wider strategic service transformation requires also strategic choices, particularly when it comes to investing in the workforce.
It is time for a paradigm shift in our models of care and social services so that they can respond better to people’s needs, and for this they should be meaningfully involved in the process. This shift requires transitioning from a paternalistic model of care to one that places both quality of care and quality of life at the core. National policies incentivised by EU funds need to promote an integrated and coordinated approach between services and sectors. There also needs to be an overhaul of working conditions for care and social services staff as they play the primary role in care delivery, and in building relationships with beneficiaries. In the end, no price can be placed on human dignity, compassion and meaning in a person’s life.