The recent publication of the Department of Health’s Consultation on how to improve the home care sector while welcome, was also somewhat underwhelming. The big idea is a movement towards a regulated home care sector underpinned by a statutory home care “Fair Deal Scheme”. However, this is projected only to happen in 3 years’ time.
The other main message coming out was a consensus that to meet demand, funding will have to incorporate some form of means testing or co-payments.
Other messages well aired already were about further training and other step-down models of care.
What the report failed to address in a comprehensive manner was the scale of capacity crisis the sector is presently facing and the simple fact that caring is not recognised as a valued career or as a potential economic driver in local communities.
Many of the solutions put forward to promote a more important role for home care within our health sector revolve around increased funding and little else.
However, if home care is to play is its full role within our health sector, the government must change the way home care and the task of supporting our older and disabled population is viewed. Rather than being a burden on the exchequer, home care should be viewed as a key driver of economic well being in our society. An economic force capable of creating jobs and spending in every part of our country.
If we want to maximise the efficiency with which funds are spent, we need to move away from a commissioning system that promotes a small number of large corporate providers driven by shareholder returns, to supporting an ecosystem of small local providers imbedded in and with intimate knowledge of their local communities and who are focussed on prevention.
Small scale home care generally means better quality and more personal care and support. It often means dedicated staff fairly paid. There is a focus on continuity of care, sadly lacking with many agencies, where social relationships can be built and the independence of those receiving care is prioritised.
An ecosystem of this nature, has the potential to revitalise local communities in both an economic and social sense.
By activating and facilitating local people to participate in social care, we will also go a long way to addressing the severe capacity crisis the home care sector is facing because of caring not being an attractive career.
There are some interesting movements in the UK promoting a more local vision of social care like the Community Catalysts initiative which works across more than 40 areas of the UK to try to make sure that people who need care and support to live their lives, can get that help in ways, times and places that suit them, with real choice of attractive local options. The aim is to help local people use their energies and talents to deliver services and supports. These community enterprises and ventures provide much more choice for people needing care and support.
The HSE should be using their market shaping powers to promote a similar wider canopy of providers here, that moves beyond approved corporate providers with their limitations around cost and quality.
Local communities helping themselves is a powerful tool that needs to be harnessed if we are to meet the social care needs of our society.