HOW TO BUILD PUBLIC SUPPORT TO TRANSFORM SOCIAL CARE Summary of our public audience research Publishing information Published by In Control for #socialcarefuture, April 2021 In Control Partnerships, PO Box 17649, Solihull, B90 9LA www.in-control.org.uk / Charity registration number 1130761 This is an open-source publication. We would be grateful if those wishing to reproduce any part of it would reference the publication and include links to it. Illustration: Belinda Evans / Design: Henry Iles Contents Introduction The challenge The framing challenge Our story The current public story Methodology What we’ve learned Before people saw our new narrative Invoking shared values Using explanatory metaphors The tested metaphors A believable plan for change The tested narrative in full Our #socialcarefuture The impact of our new narrative In conclusion Further reading Acknowledgment INTRODUCTION This research summary provides an overview of research led by #SocialCareFuture in partnership with Equally Ours and conducted by Survation. The research explored how the English general public talks, thinks, and feels about social care and how, through a reframed narrative, we can help build public support to transform social care. This research lies behind guidance published by #SocialCareFuture, ‘How to build public support to transform social care – a practical guide for communicating about social care’. #SocialCareFuture is a growing movement, with a shared vision of a radically different future for what we today call ‘social care,’ where social care exists to support everyone to draw on formal and informal support and relationships to live the lives they want to lead, with meaning, purpose and connection with their community. As well as the way that social care is presently organised and funded, a significant obstacle to achieving our vision is the way social care is talked about, thought about, and the feelings that it generates among the public at large. We can only hope to move towards our vision by changing this narrative. Drawing on best practice in values-based framing, we wanted to explore how different framing could change people’s response. The research that we have conducted with strategic communications experts Equally Ours and public opinion researchers Survation has demonstrated that by reframing the way we talk about social care it is possible to build stronger public support for investment and reform. Moreover, it shows that shifting mindsets towards the vision and approach advocated by #SocialCareFuture provides a successful route for doing so. We have found that by reframing the way we talk about social care it is possible to build stronger public support for investment and reform. This report summarises what we have learned. Survation’s full research report for #SocialCareFuture, which has informed this work, can be found here In November 2019, #SocialCareFuture published ‘Talking about a brighter Social Care Future, which described the approach and best practice in values-based framing that we have been following, and brought together our research into the messaging of campaigners, the way print media talked about social care and existing evidence on public thinking about social care. We subsequently commissioned research during the 2019 General Election into how politicians and political parties talked about social care, and into how social care was discussed on Twitter. That research allowed us to map the gaps between our own vision of the future and the dominant discourse about social care that shapes how many people think and feel about it. During the Covid-19 pandemic we have only noticed these gaps widen and solidify, particularly as a result of the tragic situation facing many people who live, or lived in, residential care homes, and through relentless talk of ‘the vulnerable’, invoking highly paternalistic stereotypes which make it harder to build the case for people to have greater choice and control over their support. In summary, the current public story characterises social care as caring for rather than about people and as being kept alive rather than living a life of meaning, purpose and connection. Since mapping these gaps, our research has focused on how to bring the public closer to understanding and supporting our story. Working with Equally Ours and Survation, we developed and tested ways of talking about our vision and approach that could be shown to be capable of shifting attitudes and building understanding and support, adapting and refining this new narrative throughout the research process. This included testing a range of metaphors to explain the role of social care in people’s lives, and exploring the effect of invoking different values (security and belonging, freedom and control and community and interdependence) through the narrative. The research focused on the ‘conflicted’ public – that is, the roughly 40% of the public who tend to have conflicted views on a range of social issues and are open to persuasion if we communicate in the right way. The opinions of this group are of particular interest to political parties and indeed our research included focus groups in so-called ‘Red Wall’ former Labour areas of the north west of England as well as in the south and south east of England. As well as exploring current attitudes to and understanding of social care, the research tested different ways to communicate our vision and approach and the action needed to make it a reality, including who we believe is responsible for making it happen. The research took place between July and December 2020 and included: An online co-creation forum, involving 25 participants in a week-long deliberative exercise to explore understanding of and underlying assumptions about social care – and the language used and values expressed when talking about it – and to begin exploring potential new ideas and messages, Four two-hour online focus groups, comprising people from the south, south east and north west of England, to explore and refine our emerging narrative, a national (England) online survey with 3023 members of the public to explore the efficacy of our proposed new story at shifting how the public thinks and feels about social care. Participants responded to a series of questions before, during and after being presented with different articulations of our proposed narrative to gauge the impact of these on associations with, and understanding of, social care. WHAT WE’VE LEARNED The research has given us confidence that a reframed story of social care can command stronger public understanding and support for investment and reform. Moreover, it has demonstrated that the vision and approach advocated by #socialcarefuture provides a persuasive and powerful way to do so. Before people saw our new narrative, people’s default thinking about social care matches the dominant narrative that we mapped in our previous report, ‘Talking about a brighter social care future’, on campaign messaging and media discourse. Prior to being exposed to our new narrative, people tended to think of social care as being about looking after vulnerable people who cannot look after themselves, and they characterised social care as broken and in crisis. This mirrors evidence of the dominant public discourse around social care and the messaging of campaigners. Many didn’t identify social care as being part of their lives and a positive part of communities. It appears a big leap for people to imagine that social care benefits everyone and could have positive benefits for wider society – the ‘us’ is presently narrow. But even before we exposed people to our new narrative there was some cause for optimism about our ability to build support for change. When presented with a list of potential government priorities and asked to choose their top three priorities, social care was considered to be important, second only to the NHS, while 60% agreed with the statement, ‘I support greater government investment in social care’. Dominant ideas about what constitutes a ‘good society’ and the values expressed among the ‘conflicted’ public provide opportunities to promote #socialcarefuture’s vision and approach. Among our participants, dignity for all, equality and fairness and interdependence were commonly mentioned as underpinning the kind of society we all want. When thinking about social care specifically, they expressed ideas around empowerment, support and lifting each other up. People very much supported the idea that social care should be about caring about and supporting one another. In our quantitative research, 61% of people already agreed that social care is about people ‘having the support they need to live how, where and with whom they choose’. INVOKING SHARED VALUES Exploring the role of different values, we found that invoking security and belonging, freedom and control, and community and interdependence helps to shift thinking and build support for change when talking about social care. But how they are used is important, as they perform different roles. Security and belonging speak to what many consider the foundations of good social care but used alone they don’t shift people’s thinking in line with #socialcarefuture’s vision of what social care should achieve and how it should function, centred as it is on individual freedom and control and the role of relationships and community in enabling this. Similarly, while using individual freedom and control alone can help shift the focus from people being cared for, this neglects our interdependence and doesn’t help broaden the sense of ‘us’. Our headline vision has therefore been designed to create bridges between these values and it is through doing so that we have achieved a mindset shift. ‘We all want to live in the place we call home, with the people and things that we love, in communities where we look out for one another, doing what matters to us.’ USING EXPLANATORY METAPHORS People strongly supported our headline vision, but needed to better understand the role of social care in helping to achieve it. In the early stages of the research, the headline vision ‘we all want to live in the place we call home…’ enjoyed strong support from our participants, but some struggled to make sense of the role social care could play in supporting it. To help explain it, we shared some metaphors, developed in a workshop with #socialcarefuture members in February 2020, in the qualitative focus groups, and developed and tested the most successful ones in the quantitative survey. THE TESTED METAPHORS We developed and tested the most successful ones in the quantitative survey as follows: Weaving the web When organised well, social care weaves a web of relationships and support in our local communities to allow people to do what matters to them, whatever their age or stage in life Nurturing the ecosystem When organised well, social care is about nurturing an ecosystem of relationships and support in our local communities to allow people to do what matters to them, whatever their age or stage of life. The glue that binds When organised well, social care is the glue that binds together relationships and support in our local communities to allow people to do what matters to them, whatever their age or stage of life. Vehicle When organised well, social care provides people with the vehicle that allows them to do what matters to them, whatever their age or stage of life. Tool When organised well, social care provides people with the tools that allow them to do what matters to them, whatever their age or stage of life. The survey participants were divided into five groups, and each group was exposed to one metaphor each throughout the survey. They were initially presented with the metaphor as a standalone message as above and then asked to indicate their degree of agreement or disagreement with the same statements that they had responded to prior to seeing the metaphor to explore what effect the metaphor had on their understanding and views. They were then presented with the full narrative statement, which included the metaphor they had previously seen, and asked to indicate their degree of agreement or disagreement with the statements once more. Following exposure to the first three metaphors (web, ecosystem and glue) as standalone statements, participants began to express views about social care that were more closely aligned to #socialcarefuture’s vision, such as ‘social care is about people having the support to live how, where and with whom they choose’, ‘social care draws together relationships and support’ and, crucially, that ‘living how we choose to live is dependent on the strength of the relationships that we have’. The ‘vehicle’ and ‘tool’ metaphors did not, as standalone statements, achieve a significant shift in the views that participants expressed. However, following exposure to the full narrative, the shift in views and understanding expressed by those participants that only saw the ‘vehicle’ and ‘tool’ metaphors was roughly equivalent to the shift among those exposed to the other metaphors. This suggests that ‘vehicle’ and ‘tool’ can be useful when used in a wider context, but on their own are unlikely to shift understanding and views. A believable plan for change Crucially, people needed to feel that the vision was credible and achievable. In the early qualitative stages of the research, while people supported our vision for social care, they were sceptical that it was achievable in practice. To address this, we built some concrete real-life examples of existing good practice into the narrative. In the final narrative we use Community Circles, Personal Assistance and Local Area Coordination. During the research we also used Wellbeing Teams, Shared Lives and Personal Budgets. 'There are already places that are thinking about and organising social care differently to achieve this. For example, by supporting facilitators who bring family, friends and neighbours together to support someone to do what matters to them, strengthening the relationships of everyone involved. Personal assistants, employed by people to provide practical support so someone can lead their life their way. And organisations that connect people with opportunities to use their skills and talents, which improves their well-being and benefits the local community.' Care needs to be taken in the examples used and the way that they are explained. For example, while people strongly supported the principle of people having choice and control over their lives, when introduced to the idea of people receiving a personal budget to purchase their own care, independently of the whole narrative, focus shifted to questions of abuse, both by and of people with the budget, and whether they could be trusted to use the money well. The lesson here is to lead our messages by talking about purpose, principles and results before talking about mechanisms and processes. We also included and tested two different ways to describe who is responsible for organising, funding and delivering social care. This was in part to allay concerns that approaches drawing on informal support removed government responsibility for change: ’We believe that this can and should be happening everywhere and for everyone. For that to happen, the government must make good social care a priority and begin investing more in it. And more local councils need urgently to start working alongside and supporting local people and organisations to bring these ideas to life by organising and funding social care differently.’ Or ‘The government must make good social care a priority and begin investing more in it. And more local councils need to think differently about how they organise and fund social care, learning from and investing in these new and more effective ways of doing things now.’ These two statements were included as variables, with sub-groups only exposed to one or the other of them in our narrative statement. The research found no statistically significant differences in the results, suggesting both can be used with equal effect. THE TESTED NARRATIVE IN FULL The following is a version of the tested narrative in full, using the ‘weave the web’ metaphor. 'We all want to live in the place we call home, with the people and things we love, doing what matters to us in communities where we look out for one another If we or someone we care about has a disability or health condition during our life, we might need some support to do these things. That’s the role of social care. When organised well, social care helps to weave the web of relationships and support in our local communities that we can draw on to live our lives in the way that we want to, with meaning, purpose and connection, whatever our age or stage of life. There are already places that are thinking about and organising social care differently to achieve this. For example, by supporting facilitators who bring family, friends and neighbours together to support someone to do what matters to them, strengthening the relationships of everyone involved. Personal assistants, employed by people to provide practical support so someone can lead their life their way. And organisations that connect people with opportunities to use their skills and talents, which improves their well-being and benefits the local community. We believe that this can and should be happening everywhere and for everyone. For that to happen, the government must make good social care a priority and begin investing more in it. And more local councils need urgently to start working alongside and supporting local people and organisations to bring these ideas to life by organising and funding social care differently.' What impact did our new narrative have on how the public think and feel about social care? The narrative increases support for investment and reform of social care and fosters optimism about the future. Following exposure to the narrative people: Saw social care as more important: people accorded even greater priority to social care above other areas of government policy. Considered social care to be more worthy of investment: people demonstrated stronger support for more investment in social care from central government (rising from 60% pre-exposure to 67% after. Felt social care to be more relevant and valuable: more people regarded social care as important to themselves and to those close to them (rising from 44% pre-exposure to 54% after) and a benefit to both those who need support and the wider community (rising from 58% pre.exposure to 68% after). Felt more optimistic about the future: people believed that it’s possible to start organising social care in a better and more sustainable way now (rising from 52% pre-exposure to 63% after). Had a greater sense of the possibility for change: The proportion of people believing that national and local government and communities can successfully work together to sort out social care grew from 57% pre-exposure to 65% after. The narrative helps to shift assumptions and mindsets about what social care should be and do. Following exposure to the narrative people: Shifted their associations from paternalism to empowerment: people were significantly less likely to associate social care with paternalistic ideas such as vulnerability and compassion (declining from 50% to 27% and from 52% to 36%, respectively) and more likely to associate it with words such as independence, community and relationships (increasing from 19% to 33%, 35% to 41% and 12% to 31%, respectively). Support the principle of people having control over their lives: more people agree that ‘social care is about people having the support to live how, where and with whom they choose to’ (increasing from 61% pre-exposure to 70% post). Believe that strong relationships are the key to being able to lead the lives we want to lead: people are more likely to agree that ‘living how we choose to live is dependent on the strength of the relationships that we have’ (49% pre-exposure to 60% post). Understand social care to be about bringing together a range of support, formal and informal: people are more likely to agree that ‘social care draws together relationships and support’ (from 51% pre.exposure to 65% post). Of course, we have to present these findings with some caveats. They report how people responded in the context of research where they were being asked to focus on social care. To harness their potential in the real world would require scale, reach, message discipline across different communicators, the right spokespeople, and creative, engaging communications. It would also require ongoing evaluation and refinement. Nevertheless, the research demonstrates significant potential to build understanding and win support for change by telling this evidence-based articulation of the vision that #SocialCareFuture’s members have created together. ENDNOTES Further reading How to build public support to transform social care – a practical guide for communicating about social care How to build public support to transform social care – full research report by Survation Talking about social care – easyread report Talking about a brighter social care future – how social care is talked and thought about today Talking about a brighter social care future – easyread report Acknowledgments Thank you to Kathryn Quinton and Alice Jennings at Equally Ours for their invaluable partnership in delivering this project, to Jane Carn, Madhur Mehra and Harry Mason at Survation for their research into public thinking, to our Working Group (Wendy Mitchell, Philly Hare, Clenton Farquharson, Sian Lockwood, Karyn Kirkpatrick, Bryony Shannon, Wendy Lowder and Jordan Smith) for their support, expertise and wise counsel, to all who have come together via #socialcarefuture gatherings on and offline to co-create this narrative, to Dr Pen Mendonca for helping us to visualise our vision and approach, to Henry Iles and Alicia Wood for their design work on this and previous reports and to those who have contributed to the costs of carrying out this work, including Keyring, Nesta, Power to Change, Dimensions, Macintyre, Seeability, Macmillan Cancer Support, Choice Support, Alzheimer’s Society, Certitude, United Response, Together Trust, Options, Think Local Act Personal, In Control, Local Government Association, Voluntary Organisations Disability Group and Camphill Village Trust. In memory of our friend, colleague and storyteller, John Popham @socfuture #socialcarefuture #oursocialcare www.socialcarefuture.blog Published by In Control Partnerships, PO Box 17649, Solihull, B90 9LA www.in-control.org.uk / Charity registration number 1130761