How older people interact with the social care system and market

Social care is in urgent need of reform. We need a care system that provides consistently high quality care regardless of an individual’s health condition, their ability to pay or their postcode.

To better understand the way in which people engage with the social care system we have looked in depth at the experiences of 29 consumers of social care in the home. We interviewed older people across four cohorts, ranging from: those who did not receive care at home but who were finding it increasingly difficult to cope; through to those receiving local authority funded care at home; and those living in age-specific accommodation both with and without care.

We found people were unsure of their rights and struggling to navigate the system, often stumbling across information through word of mouth. For the individual consumer, there is little distinction between healthcare needs and social care needs, with one inevitably driving the other.

In our previous policy report Beyond social care: Keeping later life positive we called on the Government to design proposals in the long-awaited social care green paper which will work with the grain of consumer behaviour. Most consumers will not voluntarily plan or make provision for their future care unless and until they are approaching the time of need - which is often a crisis point. Behavioural research suggests that this will remain the case even if people are better informed about how the social care system works, the choices they may face and the costs they may incur. 

A further study carried out on behalf of Which? to look into this in more depth can be found psyarxiv.com.

So it is important that the design of the social care system reflects this and can respond quickly and effectively at times of crisis.

And it’s no surprise that, even though people overwhelmingly want to stay living at home more or less independently for as long as possible, they often resist installing aids and adaptations because these are often considered unattractive and stigmatising.

Nevertheless, our consumer research also indicates some opportunities. While people are clearly reluctant to plan for their potential care needs, there are indications that some could be motivated to prepare for a good quality later life. But for this to work there must be options available that promote the positive concept of choice and active living: Better designed, innovative products and services which support people to live independently and are attractive and enjoyable to use; and more ‘lifetime’ and adaptable housing. And consumers need support that is quick and effective, that integrates their health and social care needs, and is easy to navigate.