There is huge interest in developing our social care capacity in our communities, so that people can receive healthcare services in the most appropriate setting and therefore help to alleviate the pressures on our acute system. Home care is an important plank in the HSE’s social care policy.

The difficulty is that many of our community services aren’t well developed and our home care service in particular, is facing a serious capacity problem.
Social care in Ireland needs to change and probably change radically, if the growing number of older persons and people with disabilities, are to be supported in their communities.

Is it possible that existing governance, ownership, and organisational arrangements that reflect the status quo, are dramatically limiting the potential for a more proactive a vibrant social care sector?

Are we stuck in delivering a very limited range of pre-determined options to people who have little meaningful power or influence over them?

At Home Care Direct, we believe that small local businesses and indeed individuals, can help improve the current health and social care system especially within home care, by delivering both important local social interaction and high quality formal services that are rooted within communities. Through this, good jobs in the local community are created and maintained.

We believe that the HSE commissioning system should be embracing and encouraging a wider ecosystem of home care providers including these small local business and should be embracing technology as an enabler of better home care provision.

To do this yes they will have to be brave and shoulder some extra risk. They will have to let go of some control and professional egos, moving away from inherited structures and genuinely trust people.

There are shining examples in the UK of new initiatives in social care which encourage and nurture small local businesses such as Community Catalysts( ) , Wellbeing Teams ( )and Power To Change ( ) . We are also seeing a significant move towards personal budgets there, which in themselves, open up the possibility of small local enterprises or individual carers working directly with older and disabled people.

The Home Care Direct model sets up local qualified carers to work for themselves in a legal and transparent manner, directly with families where appropriate. Our platform provides insurance to the levels required by the HSE while handling all the carer’s payments, invoicing, administration and tax returns. This allows carers to concentrate on delivering great care.

Our model removes where appropriate, the cost of an agency, ensuring more funds flow directly to carers which in turn makes caring a more attractive career. It also removes any need for a person with a disability or an older person to become an employer.

An online platform has the potential to deliver the following benefits to the HSE and the people receiving home care;

  • Development of a cohort of qualified local carers, properly rewarded, who feel real ownership of the work they are doing and as such are motivated to deliver great care.
  • Better continuity of care as carers work directly with families.
  • Caring becomes a more attractive career, as carers are earning significantly more and have more control over their careers.
  • Activation of new local people into caring. People who would have no interest in working for an agency for little above the minimum wage but would be interested in working for themselves setting their own charge rates.
  • The simple fact that families have increased choice, means there is increased pressure on agencies to price competitively and pay carers fairly or risk losing business to carers and families working directly.
  • Encourages agencies to work only where they are genuinely adding value.
  • Brings significant savings to the home care budget by removing agency margins where a full wrap around service is not needed and creating more competition.
  • Revitilisation of local communities and local economic benefits.

Commissioning is the key to promoting new home care initiatives such as the Home Care Direct platform and a movement towards putting more power into the hands of people and communities. The idea of the natural blossoming of community assets remains a pipe dream unless there is a strategic decision for commissioning to foster this. One of commissioning’s most important roles as we see it, is to promote bottom-up innovation, promoted by top-down support.

Without innovation and the harnessing of technology, we will find it increasingly difficult to deliver on people’s first preference of living at home and in their own communities for as long as possible. Increasing our ability to do this, has the prospect of delivering huge benefits to society as a whole.