Home Care is in the news a lot because of rising waiting lists for home care packages and because of increasing delayed discharges from hospitals. There is a feeling we need to invest more in our home care services, spend more on our providers both public and private and indeed bring in regulation to oversee the provision of services, so that those services can be measured and evaluated.
But let’s step back and ask ourselves, what exactly is home care? For me, it’s a service invented by the State to replace what communities used to do for themselves, look after each other. It’s a service that compensates for the breakdown of our communities.
Over the last 70 years or so, our communities have gradually broken down and this breakdown has probably accelerated in the last 30 years.
I think the main reason for the breakdown has been a rise in individualistic thinking and needs, at the expense of a more communal approach and focus on community needs. A movement from the primacy of the collective to the individualistic.
As our communities have broken down, this has necessitated that Government step in more and more to provide services and look after the weaker and less fortunate in our society.
The question then is, should we be looking for more Government designed systems with top down intervention and provision, that tends to commodify home care, or might it be better that we actually try and support and encourage communities to do things for themselves, rekindling that community spirit?
At Home Care Direct we are about empowering local people in local communities, to contribute to the health of their communities. We believe the less layers there are in the provision of home care, the better. We believe home care can be over complicated at times and this can result in the exclusion of great local people bringing their capabilities and willingness to bear.
If that community self-help ethos within social care is to be rekindled, one important lever in doing so, is how we commission home care services and how they are regulated. If commissioners stick to imposed outside solutions, through form filling tenders, that can be measured and controlled, then communities will always find it difficult to help themselves and just come to expect solutions to come from the outside.
If commissioners worry less about overly managing risk and focusing on what might go wrong, rather than what might go right, then that could be a first step towards encouraging local solutions. A first step towards recognising not one solution fits all.
Any regulation brought in, also needs to ensure it doesn't suffocate or dampen, local desires to self help and contribute.
We believe great home care is delivered by motivated and willing local people being supported to organise themselves, rather than by rigid, centralised, imposed services, often devoid of the human touch.