A few weeks ago I joined Sam Bennett and Clenton Farquharson at an event jointly held by TLAP, University of Birmingham, ADASS and the LGA to examine commissioning for better outcomes in adult social care.
As Clenton and colleagues will tell you, commissioners need to ensure that the services and support they are investing in serve the whole local population, in all its diversity. But planning and understanding what people who find traditional, mainstream social care and mental health services inaccessible or unsupportive can be a challenge.
However, a research review I carried out with the University of Birmingham as part of a wider research project on community-based micro providers in adult social care, sheds light on some of the issues. The review looked at the types of specialist, community-based support and networks developed by BME communities, refugees and asylum seekers and people from faith communities.
The research shows that there is a tradition of compensatory self-organisation, the use or informal networks and use of social capital for all the groups in response to experiences of marginalisation from mainstream services. Local specialist and community support organisations and networks can offer cultural intelligence, opportunities for self-help/mutual support, a collective voice, social and emotional support as well as integrated and holistic understandings of support.
Local specialist and community-based support can make an important contribution to a wider range of choices and better outcomes for people who feel larger, mainstream services are not suitable or accessible. However, these bigger generic services should not abdicate responsibility for providing culturally responsive, accessible support to these small organisations. There are potential opportunities for shared learning and development between the two. Specialist and community-based organisations can help seldom heard people engage with mainstream services and help reduce stigma, particularly for mental health.
Commissioners need to map, understand, recognise and nurture these local organisations and networks in ways that do not stifle their unique nature. Such organisations need investment in terms of funding but also capacity building and skills development for sustainability. Processes (including those for commissioning and funding) and regulation need to be proportionate and accessible for small community-based support providers. There is a potential wealth of local activity and intelligence on the margins of mainstream social care and mental health that commissioners can invest in. One of the first steps is to make space to engage with and support marginalised people’s resources and knowledge of how to make lives better.
