In this short report, we step back, take stock and synthesize the key insights that can be derived from the decades long journey of promoting social innovation in Europe, with a view to supporting policy-makers and organizational stakeholders that wish to engage directly in the implementation of social innovation initiatives in long-term care. We identify three core elements that make long-term care initiatives socially innovative and we propose a broad conceptualization of successful implementation. We argue that local innovators should shift focus away from ‘best practice’ initiatives and towards defining the ‘best fit for purpose’ initiative. Successful social innovation in long-term care is built through the process of identifying innovative ideas, adapting them to match the characteristics of local settings and creating a flexible policy framework that supports local implementation. Furthermore, we highlight the need to match investment in social innovation design and development with investment in scale-up and sustainability of social innovation approaches, in order to increase societal impact.