‘If all you have is a hammer, everything looks like a nail’

I’m constantly impressed by the passion and creativity of frontline teams in social care. Whatever their role, staff want to understand everyone’s unique situation and strive to boost their independence. This might be by connecting them to things happening in their local communities, helping them to regain the ability to do the things that they’re passionate about, or finding tools and equipment to empower them to live more independently.

However, too often people are prescribed home care services to meet every possible need. Rather than using a strengths-based approach to assess what is needed to boost people’s independence, services are often promoted up front. As our recent report Five Fast-Forwards for Social Care highlighted, between 50-70% of support provided by the adult social care system could actually be prevented, reduced or delayed.

Home support services are vital to those that need them, but supporting someone to retain or regain the skills to live independently gives them much more freedom to live the life that they want to live. So why do motivated, engaged staff provide services to people whose needs could be met in a better way?

One problem is the ‘law of the instrument’, which says ‘if all you have is a hammer, everything looks like a nail’. It applies here in at least two ways:

• Local authorities make it easy for social workers to put services in place, and hard to apply more creative solutions. Procurement processes favour services, which can be structured, priced and standardised. If a service is the only thing on offer, and is usually good enough, it becomes the default.
• Behavioural science tells us people are influenced by ‘norms’. If everyone else with a nail has been given a hammer, we will demand a hammer too. Overuse of familiar services drives demand for more services – because it’s the only type of support that people can see.

How do we change this?

To get the best outcomes, councils must give their staff the freedom to relate to people as individuals so they can build the support that will best suit them. Continuing financial challenges in the sector encourage service leaders to narrow-frame the problem, and focus on what they can control – the price and quality of a limited menu of services.

Adult social care is a complex system. This complexity is driven by people who act in unpredictable ways and can’t always be fitted into service boxes. Our unique EDGEWORK approach embraces that complexity in multiple ways. It enables senior leaders to reframe their ambition and start to influence the things they can’t control; frontline teams to focus on people’s strengths and assets; and middle managers to develop the tools that can evidence the benefits of different ways of working.

Traditionally, consultants have offered tools that focus on structure and process. Such solutions might provide a tighter control over your service offer, but can’t help improve outcomes in the long term. We see the world differently; to find out more, please get in touch.