In Lancashire last October, five day centres serving older people went under review: Byron View, the Derby Centre in Ormskirk, Milbanke Day Centre in Kirkham, Teal Close in Thornton Cleveleys, and Vale View in Lancaster. Lancashire County Council has called it a strategic review alongside attempts to save £50 million in adult social care costs over the next two years.

The consultation closed mid-December amid fierce opposition, with a decision now expected in Spring. This is not a new process. Councils have reviewed care provision for decades under various guises including personalisation, transformation, and reprovision. What seems familiar is the framing of withdrawal as ‘improvement’.

Consider the impact. Post-closure, someone's daughter says her mother's days no longer have structure. Once the morning carer has come and gone, she won't see another human face until dusk, her unsettled pacing labelled "sun-downing". The daughter feels like she is losing her mother.

Then there is the man who used to go three times a week. He loses the people and rituals that gave his life meaning. He asks continuously when he's going back. One morning, he walks out looking for his friends. The police find him on the main road, asking strangers for directions.

When the police bring him home, he doesn't understand the fuss. What the man was looking for was the day centre. The multi-agency response initiates risk management and safeguarding procedures. But this follows a script that has nothing to do with his reality. By the following evening, he's asking again.

Meanwhile, his visiting carer tells me that, fearing he'll lash out, he just knocks, listens to check he is still alive, then leaves. This is not ‘best practice’. But perhaps it shows the limits of what care has become. The carer marks the visit as 'complete' and the human encounter is already lost.

Councils call this ‘reprovision’. But this term bears little resemblance to what follows. The man becomes agitated and withdraws. Carers can see what's lost but are so overwhelmed by the immediate crisis, they rarely have time to stop and reflect. Social workers focus on risks, while the GP or psychiatrist seem limited to reviewing and prescribing medication.

The man is now in acute crisis. Or was he simply searching for something real that had disappeared? When you lose something that gave life meaning, isn't that grief? His care plan has become a series of thirty-minute visits for washing, feeding, and medication. All needs met.

Grief in care

In twenty years in social care, I've seen it stripped of the one thing that makes it actually work: its emotional bond. The word care itself comes from the Old English caru, meaning sorrow, anxiety, and grief. In Danish, sorg means grief, while omsorg means care. Whether due to risk culture, managerialism or fragmentation of services, if care has lost its capacity to be with someone through loss, we don't really have care fit for purpose.

The language we use often hints at this but rarely names it outright. "Social isolation," "loss of independence," and "reduced meaningful activity" take us so far. But the 'improvement' agenda tends to frame anything merely sustaining people as stagnation, even in the face of documented evidence, and treats them as fair game for closure.

Research already shows the consequences when older people lose access to day centres and the structured social contact they provide. Day centres not only help sustain those who attend but are equally vital to carers and care networks. When withdrawn, outcomes include loss of valued connections, increased anxiety, and lower quality of life.

The risk and responsibility of maintaining standards amid collapsing provision falls on individual carers and care providers. But what makes the situation particularly toxic is that it is systemic by design. The system produces the ruptures, rarely acknowledges them as losses in practice at all, then in a final act of indignity, calls it progress.

So what can people do? This is where the law is supposed to offer protection. The Care Act 2014 requires councils to promote wellbeing. Starting with needs assessment, the idea was to build holistic care and support around the person. Commissioning frameworks reverse this: budget allocation first, then fit people to available resources. Funding panels won’t budge until crisis forces a rethink.

CASCAIDr, a Community Interest Company specialising in adult social care law, uses wellbeing duties to address this. Courts don't reliably side with people, though the threat of a ruling can be enough to force local authorities to justify their decisions in these terms. This is one way to narrow the gap between Care Act duties and commissioning practice. 

Such protections, if enforced, can prevent some of the devastation that follows. But commissioning frameworks in their current form remain intact. And to compound matters, serious problems accessing Legal Aid mean that carers are left carrying an impossible burden.

Grief as engagement and prevention

Experience shows that attunement to grief is essential for effective care. It is hard to gain someone’s trust unless there is a capacity and a willingness to sit with what a person is actually going through. In care, this could be for numerous reasons: dementia, bereavement, ageing, or loss of capacity. But the grief that follows when the continuity of relationships is designed out is also real.

If we can give it the attention it needs, as a human response to loss rather than just an individual symptom to manage, it can become a space where genuine prevention becomes possible. As therapist Francis Weller notes, grief is a threshold emotion. Once accessed, it becomes a powerful point of engagement. 

Of course, none of this will reverse cuts or restore day centres. But it does offer a counter-narrative to the latest round of public consultations, and perhaps a language for those who sense something's wrong. At the very least it could restore care to something recognisable.

Until then we can expect the gap between Care Act duties, commissioning frameworks, and lived loss to keep showing up in incident reports and carer exhaustion. That isn’t justice. But it might slow the process long enough for us to see who it is grinding down.

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