Ten years of the Care Act 2014

[Introduction] 

Sherelle: Welcome to another Research in Practice podcast where we champion evidence-informed practice in children's, families and adult's services. And where we try to encourage critical thinking and reflection in prevalent issues for the sector.  

This podcast will be looking at ten years of the Care Act 2014. This is a landmark legislation which received royal assent in May 2014 and went live in April the next year. And it represents significant reform of care and support, intending to put people and their carers in control of their care for the first time. The act consolidates existing law relating to adults with care and support needs, it emphasises the improvement of wellbeing for adults who need care due to physical, mental impairment or illness, as well as meeting the support needs of their carers for the first time. It was intended to modernise 21st-century care and support. However, it was followed by an unprecedented ten years. Who could have predicted 5 prime ministers, dramatic downturns in the UK economy and, of course, the COVID-19 pandemic and subsequent national lockdowns. So, very unpredictable ten years behind us. No one could have foreseen any of that.

But today's a relatively brief conversation about what's going well with the Care Act, what's perhaps not going so well, what areas do we need to address to fully deliver on the original aspirations of that legislation. And, so, we have two amazing speakers with us. We have Phil Anderson who is the Strategic Director for External Affairs at the National Children's Bureau [NCB]. Before joining NCB, Phil had a variety of roles at the Department of Health and Social Care. Working in response to the swine flu pandemic, tackling childhood obesity, and reforming social care. He was an integral part of the team developing the Care Act of 2014, stewarding it through parliament. We also have Gerry Nosowska, director of Effective Practice, which was set up in 2013 so that her knowledge and experience could contribute to work improving social care for adults, families and their communities. She is a registered social worker in practice and management with the local authority social care services. Her specialism is social work with older people and she co-hosted the Helpful Social Work podcast. She is a member and former chair of the British Association of Social Workers, and a current Associate of us here at Research in Practice.  

[Different perspectives on how the Care Act was developed and received back in 2014] 

So, welcome to the two of you, thank you so much for joining us on this podcast. I'd like to, if I can, kick off with an introductory question, where were you and what were you doing this time ten years ago when the Care Act achieved its royal assent? And, what aspect of the sector are you representing? What perspective are you coming from? Or, should I say, what hat are you wearing as we go into this podcast? Let’s start with you, Gerry.

Gerry: Hi Sherelle, it's great to be here today. So, I'm coming from, primarily, a practice perspective. Also, to some extent, policy, because of my work with the Association of Social Workers. I'll try not to be too social work-y in talking about practice because we're only a small part of the workforce. I'm also of the age where my parents and parents of my friends and neighbours and many people around my community are at the point of drawing on social care so I bring a bit of that perspective. And, I've been really fortunate over the last few years to do quite a lot of work closely with experts by experience, I'm going to try and bring in evidence of the experience of people who are drawing on social care and carers, and keep that fairly central to what I'm saying.  

That question about where I was when the Care Act achieved royal assent, May 2014 does feel like a very long time ago. So, I'd just set up as an independent social worker at that stage, and become an associate for Research in Practice. I spent a lot of time in 2014 and 2015 travelling around the country and delivering workshops on implementing the Care Act. So, that's what I really remember from that time, is going along to local authorities and talking to practitioners and managers about the implementation. And, at that stage, we weren't doing things in that much of a co-productive way actually, so most of those workshops I was facilitating on my own. But, again, trying to, kind of, share the message of why the Care Act had come into place and where it had come from. And, that it had been… the Law Commission had really involved adults and carers in doing that. And, the positives around promoting wellbeing and, you know, the changes that we were looking at. And, what I remember from that time was an atmosphere of real cautious optimism, let's say. So, people were seeing the value of it and I think really hopeful about what would happen and could see the positive moves within the law. But, there was quite a lot of uncertainty and, you know, even then we were already several years into austerity. So, depending where you were in the country, that was biting more or less hard and it was really evident in the conversations, that there was that balance between aspiration and reality.  

Sherelle: Philip?  

Phil: Yes, thanks so much Sherelle. And it's great to be here, thank you very much for having me on. So, the specific question of where I was on the point of royal assent for the Care Act, I was actually in the secretary of state's office sipping lukewarm prosecco because there is a, sort of, reception when an act gets royal assent. So, as you touched on briefly, I was a Senior Manager at the Department of Health, as it was called then. Didn't even have social care in the name, which we might come back to at some point. Helping steward the Care Act through parliament. An interesting way that Gerry and I intersect is I also spent the summer of 2014 going around talking to local authorities about implementation of the Care Act, but specifically in the formal consultation on the statutory guidance behind the act. And I think that, sort of, speaks to the slightly different perspectives we can bring.  

I'm a, sort of, recovering policy wonk, if you like. I'd spent all of my career up to that point in the civil service but left quite shortly after that and have worked in charities a bit closer to people with lived experience since. So, I'm hoping to bring a slightly more rounded perspective back into the… kind of, Whitehall policy-making atmosphere at the time. But I would say, cautious optimism probably reflects what we felt as well. That, you know, things were tough but that we did have a… not just a cross-party consensus but, actually, a Care Act was developed with quite a collaborative process. Certainly, for the time, certainly for Whitehall with the… kind of, wider stakeholders. And it really felt like we'd at least got the same vision, like implementing this can be an uphill battle. But we're really starting in a good place but, as you've talked about Sherelle, nobody could have predicted the ten years that would follow and everything that's happened. So, really looking forward to getting into that with Gerry.  

[The major shift in the focus and narrative in delivering Social Care; from risk management towards a more strengths-based approach, with a more intentional focus on co-producing better outcomes] 

Sherelle: The Care Act was meant to be a significant reform of care and support, and this was the first time people and their carers were put in control of their care. Is this how you experienced it from your point of view? Was this how the service was experiencing the Care Act? Was it seen as an amazing reform? And, how would you say it was received? 

Gerry: Well, it was received positively I think. I want to start with the positives. Having this law is really vital. Having a good law is really vital, that's where rights start. And having it with wellbeing and involvement at the heart of it and this real emphasis on strengthening the rights that people have, the parity for carers, and I think one of the most significant things was putting safeguarding onto a statutory footing. All of that is really, really positive. It also did dramatically simplify adult social care law, which I'd been working with as a social worker and it wasn't easy. And I think from a social work perspective, and this would apply across practice, I hope, putting the focus back onto rights-based work and person-centred work and partnership was really in line with our ethics. We moved away from, kind of, a feeling of a more administrative role that a lot of people did really experience.  

However, the data, the evidence, does show that the promise of the Care Act hasn't yet been realised. And again, I'd use 'yet' rather than say it's not possible. And that's particularly the case for people who are most marginalised. There are still a lot of people who aren't getting their rights. If you look at, for example, the Association of Directors of Adult Social Services or the King's Fund or CQC, Care Quality Commission, you can see these issues around realising prevention, people waiting for care or for assessments, people not getting advocacy. Lack of, kind of, advice and guidance, particularly for self-funders. And still some issues, you know, big issues around safeguarding and quality of care. So, I think the experience is mixed. And, the big thing for me is that the emphasis, in what we're trying to do in adult social care, that has really changed. If you put yourself back ten, 15 years ago, you know, there are some really big shifts and one of them is the development of involvement and the growth of involvement and, ideally, co-production. And really focussing on being person-centred and involving people effectively.   

There's been, I think, a real shift from protection and risk as a focus. So, thinking back to the old eligibility criteria where we were putting in services to prevent risk, and that real focus on deficits. I think there's been a shift through to wellbeing, much more focussed on strengths and positive risk enablement and honestly, the eligibility criteria focussing on wellbeing, that was a really big signal to me as a practitioner and hopefully to people receiving support. I also think having, just, a good clear law has helped to refocus practice and user-led, kind of, work around legal literacy. Because it's much more possible to, kind of, fight for your rights and be rights-based if you can understand clearly which law you're using and how it works. And, not trying to navigate between things from the '70s and 1948 and, you know, all over the place. So that, I think, has helped.   

Overall, I would say my experience has been a real shift in my mindset and what I advocate and campaign for to those things of co-production and rights-based work and using the law for that. And I think a big shift in how much allyship and joint work I've been doing. And I don't think that that's… I think that is connected. That's not separate from the change in the law. I think that has really helped us. So, yes, we've got a long way to go but it's definitely been a shift. 

Sherelle: Phil?  

Phil: Yes. I'd agree with all that. I mean, I've spoken with hundreds of people about the Care Act. Mostly around the time we're talking about but since as well, and I have yet to find a single person who defends the legal framework we had before that. You know, I think everybody buys the fundamental Law Commission insight that we needed a new modern framework. In preparing for this I was just reviewing the consultation on the statutory guidance that I mentioned before and, kind of, reminding myself what the main currents of debate were. And I think, with everything that's happened since, it's easy to forget how seismic the so-called Dilnot funding reforms, which at that point we were, sort of, definitely implementing until we weren't. And a lot of the conversation was around how much will it cost to do a funding assessment and decide how much someone should pay and, you know, is all of that resourced properly? And that took up a lot of the oxygen around some of the more thoughtful practice, kind of, innovations that we were trying to introduce. So it's really pleasing to hear Gerry say that some of that, kind of, did get through to practice.   

And then, the other thing that was a big, big topic was the new rights for so-called informal carers. Although we just called them carers. And, you know, local authorities were, I think, rightly saying 'The funding you're allocating to this doesn't touch the sides of what it would actually take to fully implement, you know, proper wellbeing-based assessment for every informal carer.' And, I would be interested in Gerry's perspective on this. For what seems to have happened is that, true, the funding network did touch the sides and, actually, the Care Act achieved a, sort of, increased focus on carers from what I've heard. But the sort of… the vision of thinking about caring in the same breath as the person cared for and a, sort of, joined up assessment and, most importantly, proper support coming in behind an assessment of a carer I think is, to use Gerry's helpful phrase, hasn't happened yet.  

Gerry: Yes, I absolutely agree with that. I think, I mean, not just the data on who's getting assessments, whether the carers are getting them, but also the experience of, you know, how carers talk about their experience and the numbers of carers who don't even release that they're entitled to an assessment still. I think we are a long way from realising that parity. And it puts practice in a really difficult position of wanting to advocate for carers but also knowing that we need carers to be doing… to be willing and able in order to keep the whole thing working. And I think that that's a really difficult tension. And the way to break that is by having true carer's rights and true advocacy for that and making everything fit that. But there's a big issue around funding for that, absolutely. Absolutely recognise that. I would really want us not to get disheartened by that though. Because I think that's, you know, this is a wealthy enough country that if we actually believed that people should have the right to thrive and carers should have the choice of how willing and how able they are and, you know, what else is in their lives, we could actually make that work. So, to my mind, it's not about there not being a way, it's about there not yet being a real will. 

[Rethinking the Care Act that require some rethinking in today's context] 

Sherelle: Ten years on, the climate has changed. We have a new-ish government in place and we know we're dealing with a very different climate. Are there aspects of the Care Act that you think we would need to revisit or reframe in order to move forward? Philip. 

Phil: Thanks. Yes, I mean, in getting into this, I think it's worth just stepping back and saying we'll probably talk about things that didn't go as planned, they weren't implemented as planned, and I think it's really important to be clear. This is not a blame game, and it's certainly not to suggest that any local authority in the country, any social worker, had a realistic chance of completely implementing the vision of the Care Act. We just have not created the conditions for that to be possible as a country, as successive governments. So, I think people may have seen the Local Government Association did a survey on the Care Act ten years on and 80% of respondents said the Care Act remains fit for purpose. And so the LGA are very much saying, 'Don't dispense with the act and start again, but we have never created the right conditions for the legislation's intent to be achieved.' And I absolutely agree with that. The place to start is obviously funding.  

I think it's really interesting to reflect back on 2014 and how the Dilnot proposals were actually meant to be a, kind of, sea change in public awareness about social care generally. And there was actually a public awareness campaign planned around social care, and I think this isn't a political point, parties of all political stripes find it a lot easier to cut things people don't understand, or under-fund things people don't understand. And very few people understand adult social care and that system until they rely on it. And part of what did for the Dilnot reforms was… the vision was that social care would be understood enough that insurance companies could create insurance products against social care and that through having that cap would stimulate a market. But the companies came back and said, 'We can't sell this because nobody understands that they need it. And we can't change that on our own.' So, the way that, kind of, practice could almost have driven public awareness which could, in turn, have made it much harder to under-fund, was actually quite an important but unspoken part of the vision for how the Care Act would change things over time, and that's definitely not job done.  

It's also true that no one local authority or even clustered local authorities can really tackle the scale of the workforce issues we've got in adult social care. We will always be fighting with one hand tied behind our back without a proper ambitious workforce strategy, I think. I don't think that's a controversial point to make. I would also say, and it would be really interesting to get Gerry's reflections on that, that practice does move on in ten years. Or, some people might legitimately argue the Care Act should have been looking forward a bit more on some practice points. For example, I certainly think that we should have put the transition cut-off at 25 rather than 18. Or, at least up to 25. And I think that would be much more aligned with how young people's lives actually develop. I think that would have really been helpful for care-experienced young people. And I know that there are some local authorities, which we might be able to come onto talk about a bit more, who are actually starting to do this. Or are using the… sort of, preventions you gave in the Care Act to say 'Under that clause, we actually will think about a more gradual transition.' But I'd really like to see that become followed practice. And then on the prevention duty, I do think if I had my time again I'd definitely press for that to be stronger. You know, it doesn't happen without funding, but a general duty just doesn't have a lot of teeth relative to how transformational that can be when you get it right. So, I would love to see a stronger prevention duty with proper funding behind it. It's just two examples of where I think the actual legislation could be perhaps improved, but I do think the fundamental point is the context point. 

Gerry: Those are two really interesting examples of potential strengthening of rights actually, and it's just made me think of another potential place which us around advocacy because that does feel very underused. I know it's very underused, but maybe a more general right to advocacy rather than just for specific bits of the Care Act operation would help with that. Yes, that's really interesting. I think I would agree with you Phil that the main thing is living up to the Care Act. So, the recent project that I was involved in around social work with older people the experts by experience they were saying that they don't want to fear later life, they want to be kind of hopeful. And so having that aspiration and making that possible is the kind of fundamental. I mean I think the things that I think are holding it back are pretty similar to what you were saying - there is a resource issue absolutely and particularly around carers' rights and quality and diverse care. Because without that support to carers and that support to adults being available the rest of it is really hard to make it work. 

Workforce development and support absolutely and kind of hanging onto our really good practitioners and care workers, and I think integration with the NHS where social carer is properly valued. It was interesting that you reminded me that as part of health and social care, it hasn't been in existence for all that long and, yes, that still feels very symbolic rather than real, so we've got a lot to do with that. And I think to make the change that we need it's about as many people as possible in our society understanding what social care is and recognising how central it is to our lives. That's something that in my professional and also my personal life I bang on about a lot because yes, if people really grasped that then it would be a priority in society. You know, we could all need social care and that's not just about growing up with that need for support, lots and lots of people, myself probably included will require some kind of support later on. And having that understanding and that recognition I think would help us.   

I do see a bit more political awareness and more discussion about that, so the last election, you know, there was more discussion about social care than there had been in previous elections. The Liberal Democrats had it as a central part of what they were talking about and they've now 70 MPs in parliament for whom this was a really big deal. So, that kind of shift I think can help us, but yes, recognition, speaking up for rights and not letting the Care Act get watered down. Making sure that when we're advocating for good social care we're doing it as a right, not as a wish because it's in the Care Act already. And yes, really focusing on the fundamental, that the purpose of social care is for everyone to have a good life and there's a real equity issue in that. But coming back to what experts by experience say they're asking for recognition of everyone's individuality, everyone's right to have the kind of life they'd like to live and that recognition that it is people's lives. And I think going back full circle to what Phil was finishing up with about thinking about how the law is fit for purpose in the future, lives are changing aren't they?  

We've got a much better understanding of what holds people back and we'll keep growing that understanding, we'll keep needing to work with people to kind of push for those changes. And, you know, no one's ever done social care in 2024, like, December 2024 before, no one's done it in 2025 yet, we don't know how that's going to look. So, yes, we do have to kind of keep an open mind to what the future requires. 

Phil: I think the point about the NHS is really powerful, I think there's been a conversation for a while about, sort of, the political power of the NHS, towards kind of adult social care. I think we all agree we want to make a positive case for the difference that social care can make for people living the lives they want to live, but when you talk to a health secretary it's all about 'How does this save hospitals and bed blockers.' That horrible phrase and so forth. And I think there are some very mixed views in some of the evidence I was looking at from local government about how ICBs [Integrated Care Boards] are not driving true integration and whether it's more cosmetic. But, sort of, adult social care having its own voice, but having its own story to tell about how it can and should partner with the NHS is really, really powerful. I was actually originally coming back in just because I forgot one point which is, we really wanted to call it the Care and Support Act which conceptually would have made much more sense but Jeremy Hunt wouldn't let us. So, that's one thing I definitely take a direct marker out if I had my time again.  

Sherelle: Where have you seen some really forward thinking? 

Gerry: We've seen a real shift, I think, in practice and there are some big things that weren't discussed in the same way ten years ago, things like reablement and, you know, strength-based practice, making safeguarding personal. These are all things that have grown massively over the time frame that we're talking about and are absolutely about enabling people, empowering people, to make choices and have control of their lives and be as much in charge as possible of what happens. So, I think those kinds of general shifts, you know, we can look at and think, 'Okay, we're doing some things really, really well here'. You know, there was a massive opportunity in the Care Act for people to have a personal budget and to understand that and to use direct payments and have much more control over the resource that they were entitled to, to do the things that they want to do in their life. And some of that you really do see happening, although obviously, clearly, yet nothing like enough. 

But one of the projects I was involved in recently, which was the social work with older people research project, that was an observational research project looking at how social workers were working with people across the… sort of, six-month period in two different local authorities, and there was really good practice. There is really good practice out there, people are doing really good things, and when good adult social care happens you see the impact on people's well-being. You know, if they get good advice and reassurance, if they get helpful information and if they get timely support where there's a properly person-centred assessment, where the care and support is tailored and empowering. And above all where the persons voice is central in what's happening and I think social care is good at doing that. And that's the real offer that we've got to the health service, for example, is having that relation approach and upholding people's wishes and voice in the midst of what's happening. So, that's really great on a kind of individual basis and I think there's also a really helpful campaign kind of movement within social care which is Social Care Future.   

And I know research and practice have recently done an evidence review about what a positive social care future could look like. But the vision that's been produced from that, you know, really makes sense of what social care is and what it's trying to be and what it can be for people. That it's about people living in the place they call home with the people and things they love in communities where we're looking out for one another and doing things that matter to us. And that re-framing of social care is what we need and it's possible because that's movement that comes from people with lived experience. So, again I think that's a really positive example of where opening up the space to hear from people more and more and let people lead on what they want social care to be is going to make the difference we need in the future. 

Sherelle: Phil, do you chime with that?  

Phil: Definitely. I'm a huge fan of the Social Care Future work and I think it's an interesting contrast to what we called co-production from within Whitehall in 2014 which was, sort of, 'We'll do some stuff with lawyers and then we'll talk to, kind of, charity policy teams about it to what real co-production looks like.' And I think, you know, I'm not here as a defender of the care per se, but I think the legal framework we've got does give us an opportunity to respond to it. But it definitely encourages some deep thinking about the context we need around that legal framework to respond to what people are telling us. I think I maybe stole my thunder a little bit with the previous answer. Because my point about changing the transition cliff edge and about harder prevention duties are both based on what I've heard about really good practice where people are struggling, going further. What I always found really inspiring back in the old days and now is you talk to people who need and care support and they say 'My social worker just gets me, they get what I need, they get what my life is about, what's going to matter.'   

And with the best will in the world, you don't hear that with nurses and doctors because that's just not how the health system works. And I think that, sort of, relation value is hugely important and such a big part of a positive story about social care and the difference it can make. I've also heard some really interesting things about support for carers and the partnership with the voluntary sector. So, the, sort of, classic local model authority is maybe you outsource the care assessments to the local carers to the enter and that vaguely joins up but not properly. But actually kind of moving beyond that to a richer partnership between local authorities and the voluntary sector. And that leading to a richer view of how families fit together, how carers and people with care and support needs fit together is I think exciting. But I think it is a real uphill battle where some brilliant professionals are trying to drag things beyond the minimum and they're not even getting funding for the minimum, so we do need to, sort of, approach that in that context really.  

[Realising the potential of the Care Act] 

Sherelle: How do we utilise the strengths of all these different partners in moving forward and addressing some of the needs you've mentioned? 

Phil: I mean you might expect me to say this with my background, I think it's ultimately it's national government that has the biggest levers to pull to make a difference. But I think that will only happen if we have the, sort of, other groups you mentioned as a unified chorus with a unified vision, and that's why some of the Social Care Future work is so exciting it's because I think we are on our way to that. But, you know, we've talked about funding - that is a huge part of the equation. We've talked about workforce recruitment and retention, we've talked about the inability to invest in prevention because of budget pressure. You know, I think these are issues that will have different specific solutions locally but have national enablers that just aren't there at the minute. So, the more, you know, we can be clear to the government that there's actually a lot of consensus between practitioners and the people they're trying to serve about what a good vision really looks like the easier it is. And the more we can get adult social care into the public discourse and, you know, I mentioned Ed Davey in the Liberal Democrats as an important part of that. 

And that is new to have a political leader and political party make sure social care is such a central part of their platform and it's exciting. The more space we give government to, sort of, come into and the more we take some of the really unhelpful politics out of things, you know, we all remember the Dementia Tax and so forth. And, you know, this has been very helpfully politicised as an issue and it is I think partly because it's poorly understood. So, it's easy to take a little bit of something and call it the Dementia Tax or so forth because, you know, there's not really much of a sense check on that in the general voting public. So, a lot to do, but there definitely are some green shoots to build on. 

Gerry: Yes, I think we're at a pivotal point and it's been disheartening hasn't it every year getting more surveys that say, 'It's at breaking point, it's under pressure.' And trying to find new language to describe really the same thing. I think this is a moment of opportunity though, and the reason I think that is because we have got people with lived experience in a position of strong advocacy which is what we've really needed at the centre of things. And the ally-ship across the sector is so much better and stronger than it has been from practice, from research, from political leaders and employers. So, that does put us in a position as adult social care to speak up for this future. I think the two missing bits are government action and the public push for that. I think you need both of those and again the reason I think that we've got a possibility or an opportunity now is because the discussion about social care is huge in public forms, very often without people realising what they're talking about is social care. 

But if they're talking about people struggling to live at home or they're talking about people being stuck in hospitals, they're talking about issues with employment or young people transitioning into adult life without much opportunity. They're talking about social care they just don't necessarily know it yet. So, the more that we can make the case for social care being at the heart of all of those things that we want for our communities and our families the better. And everyone's got a, sort of, stake in that, so I think, you know, when you're talking to your friends, when you're talking to your family that's the case to be made. And reminding people that they are already concerned about social care they just haven't realised. And there isn't anyone who's really privileged enough to not need social care to be good. If you're incredibly wealthy but you can't get hold of a care worker in your area because there are none, because there's no market because we haven't invested then you're hit with it as well. So, this isn't something where anything but a whole society approach will work. So, yes, I do think there's an opportunity. 

Sherelle: What are your hopes for the next ten years of the Care Act? 

Phil: Yes, I feel like Gerry's nailed it already in terms of what a positive vision could look like. You know, I think it seems clear we don't need to rip up the Care Act and start again, we can build on it. There might well be some refinements to the legislation, but it's really the context where I think we're pinning our hopes. And it's absolutely right that many people care about social care without having that particular label on it, and I totally agree that is a real source of hope. But what I'd really love to see is that vision, which I'd say is battered but not broken, you know, I think there still is that basic consensus across different groups on what we want social care to be about. If I had to summarise it in a word I'd love for it not to matter where you live across England, you'd get the same standard of care. And that standard of care being what the Care Act originally envisaged, which is a look at what well-being means to you and a look at how the state can make that happen, which is fundamentally what the contract between any citizen and the government should be. 

Gerry: Yes, and for me I want us to live up to the spirit of the Care Act, I do want that contextual change, the funding reform, the public conversation that kind of demands investment and support and funding for social care. I also want the day-to-day to be as good as it can be, so for social care to really focus in on its kind of best bits. And, you know, again the social work with older people research showed me really clearly what people value from social care which is the relationship and that relational encounter. They can have the reassurance that you can get from that and the way that their rights can be upheld. And so hanging to doing that, seeing that as what practice can offer and then as a sector advocating for that, those encounters to be, you know, really good and working with allies, with experts by experience to call for that. That at the kind of centre of what we're doing because all of the money, the recognition and the understanding and the support, all the system change that needs to happen is all about enabling those really positive encounters. 

Between practitioners and people who draw on care and support when it's needed and not as a, you know, a favour or a lucky chance depending on where you happen to be, but as a right. And the words that really stick with me are from experts by experience involved in our good decision-making work and research and practice, and talking about, 'Well, where are we at and what decisions should we be making, and what are we trying to do in adult social care?' And them saying, 'Be an agent of improvement, don't go through the motions.' And that's what I'd like everyone to think about, 'What's our agency for improvement? Let's not settle for what we've got.' It's a good start, but it's definitely not the finish line. 

Sherelle: Thank you so much for your time today.