Founder, Care Campaign for the Vulnerable (CCFTV)
The appointment of Baroness Louise Casey to lead the government’s independent review into adult social care has brought renewed attention to a system that many families already know is under immense pressure.
Her early comments describing social care as fragmented, confusing for families, and struggling under workforce pressures will resonate deeply with those of us who work closely with people navigating the care system every day.
At Care Campaign for the Vulnerable (CCFTV), I support families across the country who are trying to make sense of a complex system at moments of great emotional stress. When someone you love needs care, families often assume that once a decision has been made, support will fall into place. The reality can be very different.
What Baroness Casey has highlighted so far is something families have known for many years: social care and health services still operate in ways that can feel disconnected. The line between the NHS and social care is often unclear, and when that happens, families can feel caught between organisations while their loved one’s needs continue to grow.
However, while the challenges of the system are well recognised, it is important that the national conversation around reform also reflects the dedication and compassion of the people who work in care every day.
One of the most striking aspects of visiting care homes across the country is the commitment shown by staff. Many carers are working under enormous pressure, managing complex needs while balancing regulatory expectations, staffing shortages and the emotional demands of supporting vulnerable people.
What often stands out most are the leaders who have come through the care system themselves. Many care home managers began their careers as carers on the floor. They understand the pressures, the responsibility and the human side of care because they have lived it.
That lived experience matters.
In my work at CCFTV, I have often found that the most effective leaders in care are those who understand that mistakes and challenges can occur in any human environment. What defines strong leadership is not simply preventing problems, but how organisations respond when things do go wrong. Transparency, learning and accountability are the foundations of safe care.
Over the past decade, I have sat down with many senior leaders during difficult moments – following safeguarding concerns, serious incidents or complex family situations. What I have often seen is not indifference, but genuine empathy. People who understand the enormity of what it means to care for someone’s mother, father, husband or wife.
The care sector is made up of human beings supporting other human beings at some of the most vulnerable moments of life.
That is why reform must be thoughtful and balanced.
While national reviews rightly examine funding structures, workforce challenges and system design, they must also recognise the emotional and relational nature of care. Good care cannot be measured purely in spreadsheets or policies. It is found in culture, leadership and values.
One area where the conversation must continue to evolve is transparency.
Families today expect to be partners in care. They want openness, communication and reassurance that their loved ones are safe. Over the years, CCFTV has worked constructively with the sector to champion independent, choice-led safety monitoring in care homes. This approach recognises that families should have the right – with appropriate safeguards and consent – to introduce monitoring where it provides reassurance and protection for residents.
Importantly, this is not about suspicion or surveillance. It is about partnership and transparency. When implemented responsibly, safety monitoring can protect residents, support staff, and provide clarity when concerns arise. In many cases, providers themselves have recognised the benefits of this approach as part of a broader culture of openness.
The future of social care must also recognise the growing impact of dementia.
With increasing numbers of people living longer with complex cognitive conditions, care homes are supporting residents with higher levels of need than ever before. Dementia care requires specialist training, patience and understanding. The workforce delivering this care deserves recognition and support equal to the responsibility they carry.
Baroness Casey’s review provides an opportunity to bring together the voices of policymakers, providers, staff and families to shape a more coherent future for adult social care.
But it is important that reform does not happen solely at policy level.
The lived experience of families must be central to the conversation.
For many of us, our journey into understanding the care system begins not as professionals but as sons and daughters. That was certainly the case for me. My own experience supporting my mother through dementia and navigating care shaped my understanding of the system in ways that statistics alone never could.
It is that perspective – the perspective of families – that must remain part of the national dialogue.
