Fairness is good care: why equality and equity matter in adult social care

ADASS President Phil Holmes reflects on a recent webinar which concluded equity is not a ‘nice to have’ or political debate, but a legal duty and fundamental to delivering good adult social care.

ADASS, the Equality and Human Rights Commission (EHRC) and the Care Quality Commission (CQC) recently came together for a webinar to explore equality, equity and inclusion in adult social care. Alongside colleagues from Solihull and Camden councils, we reflected on what good practice looks like, what regulators are seeing across the country, and why this agenda matters to adult social care leaders now.

Equality is good practice, not just compliance

The EHRC began by highlighting the importance of the Public Sector Equality Duty, reminding us that public bodies must actively consider how decisions affect different groups of people and ensure they are eliminating discrimination, advancing equality of opportunity, and promoting good relations.

A recurring theme throughout the webinar was that equality impact assessments should not become tick-box exercises. Their strongest use is when embedded in programmes and used to make decisions, understand risk and identify opportunities to improve services.

The learning from recent EHRC legal challenges was clear – councils are more vulnerable when they cannot demonstrate how they considered equality impacts, and how they gathered and treated evidence in making their decisions. Those that gather robust evidence, engage communities and keep clear records throughout are in a much stronger position.

What we are learning from assurance

CQC shared emerging learning from local authority assessments, where equity has been one of the weakest-performing areas nationally.

Many councils demonstrate strong intentions through strategies and action plans. However, the challenge is often showing how those intentions have improved outcomes for people.

The strongest-performing councils share some common characteristics. They understand their communities well, collect and use meaningful data, engage with voluntary and community organisations, involve people with lived experience in decision-making, and measure whether their actions are making a difference.

Importantly, equality is not treated as a standalone programme. It is embedded into commissioning, workforce development, service improvement and governance.

The message was clear: intent matters, but impact matters more.

Learning from local government

We then heard from two local authorities who were rated as outstanding by CQC in relation to equity in experience and outcomes: Solihull and Camden.

Solihull demonstrated the importance of understanding changing communities and working directly with people who may not traditionally engage with council services. Their work with faith groups, carers, people with learning disabilities, people with sight loss and newer communities showed how co-production can improve both services and people’s experience of support. In particular, they talked through a sizable population of people from Hong Kong who now reside in Solihull, and how the council is responding to their needs.

Camden highlighted what happens when equality is embedded strategically, council-wide. Their approach links workforce development, anti-racism work, community engagement, commissioning and co-production into a coherent set of actions designed to improve outcomes for residents. They have worked this into a shareable toolkit.

Despite their different approaches, both councils arrived at the same conclusion: services are better when they are shaped with the people who use them.

Why is this important now?

This webinar was convened because these are challenging times for equality and equity.  As adult social care leaders we recognise that equality and equity are foundational to our adult social care systems and values. Yet this is not evident to everyone we work with. These values are contentious, often misunderstood and today are often being caricatured in arguments about ‘wokeism’.   

For adult social care leaders, equality and equity cannot be defined by political theatre.  Adult social care exists to help people live the lives they want to lead. To do that well, councils and care providers must understand the different experiences, needs and aspirations of people who draw on care and support.  

Good social care services don’t shy away from diversity. They recognise that people come from different backgrounds, cultures and communities, have different life experiences, and may face different barriers to accessing support. Understanding your community isn’t about privileging one group over another or putting people into boxes.  It’s about working alongside people as individuals and members of families and communities, helping them to shape care and support around what matters most to them. 

At the same time, we recognise that councils are operating in an increasingly challenging environment. Care needs continue to rise, finances remain under pressure and public debate about equality and inclusion has become polarised – often marked by hostility and suspicion. There are many within councils who are templated to see equality duties as an additional requirement or a competing priority, when set against the massive challenges of day-to-day delivery. In reality, equalities duties are fundamental to delivering effective, lawful and person-centred care. 

Failing to understand and respond to people’s differing needs can have real consequences. People may disengage from services, support may arrive too late, needs may escalate and councils may face higher costs as a result. Investing in early engagement, accessible services and inclusive approaches is not only the right thing to do, it is often the most effective and sustainable approach. 

What next for equity and adult social care?

The Government’s ambitions for a National Care Service are rooted in fairness. Whatever shape future reform takes, it’s likely there will be increasing focus on reducing inequalities and ensuring people receive high-quality support regardless of where they live.

As local leaders, we must continue to engage with the diversity of our communities, share power with people who draw on services and carers, and design support around what matters to them. We must move beyond intentions and demonstrate impact. We must be able to show that our decisions are fair, evidence-based and improving outcomes.

Most importantly, we must recognise that equality, diversity, inclusion and equity are not separate from adult social care. They are central to it.

As I said in my closing remarks, “It doesn’t matter about politics. These are legal requirements, but they also make good business sense. You cannot do adult social care well without doing equality, diversity, inclusion and equity well.”

At a time of significant change and reform, that principle feels more important than ever. By working together across local government, regulators, providers and communities, we can continue to build services that are inclusive, responsive and fair, delivering better outcomes for everyone.

To see the presentation delivered during the webinar, please visit: https://www.adass.org.uk/resource/equity-webinar/