On the last day of the ADASS Spring Seminar and the mood turned distinctly international as we looked outside for some inside perspectives.

The first debate involved a live link to Australia with John Walsh and an enthusiastic "thumbs up" from the audience in Staffordshire helped signal the start of the session as sound was temporarily lost.

But with the link quickly and calmly restored, John provided a fascinating insight into the evolution of the National Disability Insurance Scheme being formally launched in Australia on 1st July. 

The emphasis upon investing in individuals to remain independent rather than taking a deficit model  approach was keenly noted, as was the success of bringing together individuals, carers, providers, business, the general public, and even cross party politicians to support the adoption of the far reaching proposals to include doubling the budget from 1% to 2% of GDP support the scheme.

This collaboration was no mean feat and demonstrated the commitment to the ideals of personalisation and asset based approaches echoed at the seminar.

For the second debate, we virtually travelled to Catalonia to hear from Ester Sarquella and their experience of integrating health and social care.  It was clear and also somewhat reassuring that as like the experience down under and here in England, there are many unknowns and many similar challenges and opportunities, which Ester cleverly summarised as being like "building a plane whilst flying!"

In summary Ester noted that culture change and leadership was key to making things happen and implored delegates to "think global, act local" which is a neat extension of our own "think local, act personal".

We then continued our international voyage and were presented with the very thoughtful and powerful example of integrated working in Bruges by Christian Fillet, President of the European Social Network (ESN).

Christian eloquently explained how he co-manages local hospitals and social care as one organisation within Bruges and the arrangements by which this integrated approach is equally accountable to the local population and the government, and importantly focused on people rather than structures. 

Christian went on to talk about the refugee crisis impacting upon Europe and the significance of social care's contribution to social cohesion rather than the alternative of social exclusion.

David Pearson (Chair of the international conversation sessions) thanked all the participants and  amusingly welcomed the offers to hold the next Spring Seminar in Australia, Belgium or Spain.

After a short break, the debate moved much closer to home and Cathy Kerr (Chair of the session) welcomed Elaine Torrance (President Social Work Scotland) and Neil Ayling (President ADSS Cymru) to speak to delegates about the position in Scotland and Wales.

Neil firstly described the similarities with the position in England concerning the challenges and opportunities facing social care, but highlighted the coming together of 3 major pieces of legislation to strengthen the health and wellbeing principles, setting out the duties upon councils and detail the regulatory framework contains to assure the approach.

Neil carried on to set out the importance of "good connections" across the system to make things happen and described a new public information system called DEWIS CMYRU which was designed to help individuals to navigate the health and social care system to find appropriate support and information. 

Elaine was up next and talked about how Social Work Scotland had evolved to become a professional leadership body, including both commissioners and providers, creating greater cohesion around resource and demand challenges (and opportunities) facing the sector.

Elaine explained the importance that Social Work Scotland was placing upon shifting organisation culture and the move to values based induction and joint workforce planning.

The Spring Seminar programme then moved to it's last plenary session and as Chair of this session, Margaret Willcox was pleased to welcome David Behan and Andrea Sutcliffe from the Care Quality Commission to talk to delegates about quality in social care.

Andrea started first and set out the challenge that "when care is good, it is very good: but when it is bad, it is horrid" and quoted that to date 3% of inspected social care services were rated as inadequate, 29% as "requiring improvement" , 67% as good, and 1% as outstanding.

Behind these inspections, CQC noted services were generally "caring" and that the dimensions of "safety" and "leadership" are key to quality services and support.

Andrea commented that the current recruitment crisis facing nursing homes for Registered Nurses was a major concern and whether the scale of operation had any bearing upon quality. In terms of outstanding services, Andrea commented that a clear distinction is the emphasis placed upon "giving people a life, not just a service".

David spoke about the wider CQC strategy and vision, commenting that the future is naturally uncertain in terms of how some services will look and feel, but that regulation does make a real and positive  difference to the experience of the individual.

David then went into crystal ball gazing mode and offered some suggestions on how to respond to the rapidly changing landscape and the commitment to quality services. David suggested that there was opportunity to tap into Healthwatch intelligence, there was opportunity to align with the work of Health Education England, commissioners could consider applying the CQC 5 domains within their contracts, and there was a growing importance of care associations and federations amongst smaller providers as the size of operations increased.

After 3 days of simulating discussion and sharing of ideas - and the welcoming of the new ADASS President Harold Bodmer, the Seminar was closed by the new Vice-President Margaret Willcox, who in her summing up painted a picture of integration being like a choir requiring the participation of many, with different talents to sing in harmony to one song.