A Qualitative Inventory of the Key Drivers of Social Innovation in Social Support and Long-Term Care (QUALIND)
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WP8 Deliverable 8.3 A qualitative inventory of the key drivers of social innovation in social support and long-term care (QUALIND) Katharine Schulmann and Kai Leichsenring with contributions by Georgia Casanova, Vasilica Ciucă, Mihaela Ghența, Rita Gouveia, Giovanni Lamura, Aniela Matei, Luise Mladen, Gerhard Naegele, Ian Oja, Gerli Paat-Ahi, Speranța Pîrciog, Monika Reichert, Sandra Schulze, Zsuzsa Széman, Mária A. Tróbert Final Report Vienna, December 2015 Funded by the European Commission’s Seventh Framework Programme FP7-SSH-2012-1/No 320333 www.mopact.group.sheF.ac.uk MOPACT WP8_QUALIND Report Key drivers of social innovation in social support and long-term care Contents 1 Introduction 3 1.1 Social innovation and long-term care 3 1.2 ObJectives and structure oF the report 4 1.2.1 ObJectives 4 1.2.2 Structure 5 2 Identifying key factors in the development of eFFective social innovation practices 6 2.1 Methodology 6 2.2 From the literature: drivers enabling social innovation 6 2.3 From the literature: barriers to social innovation 8 2.4 Case study analysis of the barriers & drivers of social innovation initiatives in long- term care 10 2.5 Overview oF key barriers & drivers 12 3 Findings From Focus groups and interviews with stakeholders 13 3.1 Methodology 13 3.1.1 Organisation and participant recruitment 13 3.1.2 Structure oF the Focus groups and interviews 14 3.1.3 Analysis of data 15 3.2 Comparison of priority areas For innovation in LTC by country and care regime 15 3.3 Thematic clustering oF priority areas For innovation in LTC 17 3.3.1 Supporting & empowering users & inFormal carers 18 3.3.2 ShiFting the ‘ageing’ paradigm 20 3.3.3 Expansion oF services 21 3.3.4 Community-based care 26 3.3.5 LTC Workforce 27 3.3.6 Integration and coordination of care 28 3.3.7 Financing and governance 33 3.3.8 Sustainability 35 4 Conclusions and policy recommendations 37 4.1 Drawing conclusions From the Focus groups and expert interviews 37 4.2 Policy recommendations 38 5 ReFerences 44 6 Annex I: Focus group participants and expert interviewees by country 47 6.1 Austria 47 6.2 Germany 48 6.3 Estonia 51 6.4 Hungary 52 6.5 Italy 53 6.6 Portugal 55 6.7 Romania 56 7 Annex II: MoPAct Focus Groups ‘Social Innovation and Long-term Care’ – Design 58 8 Annex III: Priority areas For social innovation in LTC and social support, by country 62 2 MOPACT WP8_QUALIND Report Key drivers of social innovation in social support and long-term care 1 Introduction 1.1 Social innovation and long-term care There is a clear need For change and innovation in long-term care policy and practice in Europe. This need arises From a combination of Factors, including but not limited to the rising share of the population occupied by older persons (European Commission’s Ageing Report, 2012), a diminishing pool of available informal carers, and constraints on public sector Financing, all of which raise concerns that current service options and coverage are inadequate in meeting the demand For high quality care in many countries. While the convergence oF these realities poses a distinct challenge for policy-makers and providers, it can also be viewed as an opportunity to innovate, to change the status quo For the better by improving and expanding long-term care services, financing and delivery. In this context, long-term care and social support are notably appropriate areas to search for ‘social innovation’, needs and potentials For change. Following a detailed investigation oF these issues and examples oF good practice in selected EU Member States (Schulmann & Leichsenring, 2014)1 the present report sets out to Focus more speciFically on drivers and potentials of social innovation in emerging long-term care systems. Scholars locate the origins oF the term ‘social innovation’ in Europe amidst the social upheaval oF the 1960s. Since then, however, a large body oF literature has developed around the concept with multiple and disparate interpretations and applications oF social innovation (Moulaert et al., 2013). This report adheres to the definition developed by the European Commission in collaboration with the Young Foundation. According to this definition, social innovation is defined as new and progressive ideas that meet social needs by building new relationships or new Forms of collabora- tion (European Commission, 2011). Defined as such, social innovations can occur and take hold organically as a reaction to shortage and political deadlock, e.g. the widespread phenomenon oF live-in care assistants in Austria and Germany in which migrants From neighbouring countries are employed, largely inFormally, to care For older persons living at home. There are however growing attempts on the part of policy-makers in many countries to Formalise the concept and the process in the hopes that socially innovative practices may be activated to address specific policy challenges, e.g. by funding ‘social innovation’ programmes and by establishing ‘innovation hubs’ or ‘incubators’. Such efForts are also supported by one of the key objectives of the European Union’s Europe 2020 Strategy, namely to ensure “that innovative ideas can be turned into new products and services that create growth, quality Jobs and help address European and global societal challenges” (European Commission, 2010: 12). However, while new approaches to support social innovation have been activated in areas such as city development, new technologies, youth and employment, to name a Few, no such dynamic development can be observed at First sight in the area oF active ageing and long-term care. In order to take advantage oF the opportunities oFFered by social innovation in the areas oF long- term care and social support for older people, it is therefore important to understand the key factors involved in the development, implementation, diffusion and sustainability of new 1 This previous deliverable For the MoPAct project entitled ‘Social support and long-term care in EU care regimes: framework conditions and initiatives of social innovation in an active ageing perspective’ is available online at: http://mopact.group.sheF.ac.uk/wp-content/uploads/2013/10/Social-support-overview-report.pdF 3 MOPACT WP8_QUALIND Report Key drivers of social innovation in social support and long-term care developments in this area and investigate on their potential to promote social innovation. Drawing on findings from desk research and qualitative data From interviews and Focus groups with stakeholders in selected countries, this report endeavours to identify these key Factors and in how far they function as barriers and drivers of social innovation. Based on relevant stakeholders’ proposals, a range of policy recommendations For the successFul take-up of innovative programmes have been developed and will conclude this report. According to a framework developed by the Young Foundation in the UK, the process of social innovation is divided among the following phases: prompts, proposals, prototypes, sustaining, scaling, and systemic change (The Young Foundation, 2012). Although the development oF innovations does not necessarily adhere to a linear model, this process-based model is useFul as a starting point For describing the stages of social innovation From recognition and acknowledgement of a societal challenge or need, to germination of new ideas and solutions, and ultimately to achieving systemic change in the area oF the innovation. Applying the Findings From the desk research and qualitative data to this model reveals that, in the area of long-term care and social support For older adults, while there does not appear to be a shortage oF prompts or proposals For innovation, or even oF prototypes (understood as the pilot phase oF an initiative) addressing long- term care needs, the main barriers to social innovation present themselves in the later stages of the process, namely when it comes to issues of sustainability, scaling up, and mainstreaming oF innovative projects. Figure 1 Model of the six phases of the social innovation process Systemic Prompts Proposals Prototypes Sustaining Scaling change Source: adapted from tHe Young Foundation (2012). As a result of the considerable policy attention afForded to social innovation in the last decade at the EU level, a substantial body oF research has accumulated addressing its conceptual and practical underpinnings, though sources speciFic to long-term care remain limited. While policy-makers and researchers seem to more or less agree on a conceptualisation of social innovation, the interviews and Focus groups revealed a stark disconnect between their understanding and that of service providers and practitioners operating on the ground. The Following chapters will address these and other key issues emerging From the qualitative study in detail. 1.2 Objectives and structure of the report 1.2.1 ObJectives The goals of the Europe 2020 Strategy, in particular in relation to extending employment and reducing poverty and social exclusion, are the main points of departure For the research presented in this report, with a narrowed Focus on promoting social innovation in long-term care to meet the societal challenges posed by Europe’s ageing populations. Previous research carried out within the framework of the MoPAct ProJect with respect to ‘Social support and long-term care’ involved a comparative analysis oF the level oF long-term care need in select European countries, and oF 4 MOPACT WP8_QUALIND Report Key drivers of social innovation in social support and long-term care available policies and services within the long-term care sector (and health and social care sectors), as well as in-depth case study analysis of social innovation initiatives in each of the partner countries (Schulmann & Leichsenring, 2014). The research carried out in the context oF this report builds on these previous tasks, with the following two main objectives: 1) to identify the principal drivers of and barriers to social innovation in the areas of long-term care provision and social support at the meso- and macro-levels; and 2) to propose recommendations For policy-makers on how to efFectively harness the opportu- nities oFFered by social innovation.