How is home care changing…
The pace of change is fast, yet the principles of care and compassion are age old. Whilst practical methodologies have changed in how we might support someone, the way we want to feel when we are cared for has not. Care, which is grounded in dignity and compassion, which supports us to be independent and to have choice and control, to be part of and contribute to our communities for as long as we might wish, and which makes us feel safe and connected.
We are now in a place where idea to execution can take only a matter of weeks, making it all the more important to ground progress in human rights. There is much conversation about the role of technology in social care – increasingly more of us use wearables, tech is becoming much less intrusive, but the development of products has often been in isolation from the sector, or solution- focussed rather than innovative. Earlier this year, Scottish Care launched A Human Rights Charter for Digital and Technology (https://scottishcare.org/wp-content/uploads/2019/10/Tech-charter.pdf), developed in collaboration with people who access care and support, care providers, academics, software and hardware producers and others. By signing up to the charter, organisations commit to founding their developments in human rights, and with this in mind technology is developed which can help to create the conditions or that positive care experience. The development of the charter came from Dr Donald Macaskill’s report ‘Tech Rights’ which can be found here.
For the last 2 years, Scottish Care has been working with the European School of Innovation and Design at GSA on what the future of care should look like. You see it is important as Megatrends drive change, that to ensure these principles remain as key drivers, we are not only ready, but are part of leading change to come (https://futurehealthandwellbeing.org/future-of-care-at-home).
What was initially seen as a 20-year vision is already coming to being (I said the pace of change is fast). Out of the research came 3 new roles for home care. They have a particular focus on connectivity and feeling connected, which chimes with the human rights approach outlined in the aforementioned ‘Tech Rights’ report. Much of this is about freeing up care staff to simply ‘be human’, and with that the potential to optimise their wide-ranging skills in care and support.
We have since ran workshops with providers and regulators and many others to test out the applicability of the roles and as a result, some organisations have made changes to practice. The roles were designed to stimulate conversation and inspire the sector towards meeting requirements of the future, yet we are now seeing components of the roles in action.
Some care organisations have begun to monitor vital signs which is leading to a reduction in unplanned hospital admissions or GP visits. Some have invested in digital software and staff who will analyse the data contained within to inform care plans for the future. The opportunity to introduce e-MAR in care at home has reduced mistakes as well as medicines wastage.
The regulators are getting behind the trends with the SSSC developing open badges in the use of technology, and the Care Inspectorate looking to upskill their own staff to be able to inspect in a technological age of care.
Technology is being used to support people to live more independently, where an alert system or other can offer security that care, and support will be there when needed. This is not just about in emergency situations, although this is obviously important and can form part of the home care support offer, but this is about longer term data analysis which in identifying trends sooner allows us to intervene sooner.
The challenge with this is the multiple systems which we all use – I am frustrated when my laptop and phone don’t speak because one is Apple and one is Android, but imagine if you have several systems, all collecting data. The solution is not to make them interoperable, nor to have one tech provider owning the market, but instead to have a cloud-based system where citizens hold their own data, and which they get to choose who has access to it. Better still, imagine if this data was held across a person’s care journey and could be accessed across health and social care. Scottish Care is working with organisations to pilot this technology in 2020 and of course will be developed with the Tech Charter at its foundation, because there are many ethical questions to be answered in this context.
But megatrends do not point solely to technological advances. There is much talk of collaboration and whilst laudable, it is merely being promoted as a systemic diversion rather than a real solution. The change required in social care remains as it always has done, by focussing on the individual and how they can lead in their care and support. The future is about creating the conditions to achieve that, and collaboration may be one aspect, but what is truly required is the realisation of integration in the widest sense. Every week I read the Economist, there is a call for a change to capitalism – what is needed in home care is a route to address the power imbalances tied up in tender process and contracting, shifting the importance to achieving person-led care and support with systems which support all who are involved in making it happen. Another example of such a shift is the increasing number of employee-owned organisations in social care – widening the offer which people who access care and support have available to them.
It is clear that the independent care sector is at the forefront of developments for the future. Of course it is, it is a sector of innovators and entrepreneurs and it has the capacity to adapt quickly, with the support of skilled and dedicated staff who come to work because they care. Home care also bucks the business trend by having proportionally more women in leadership roles and as business owners. Scottish Care is working with Women’s Enterprise to promote the sector as such and to explore further why that may be and how other organisations can learn from this, culminating in a Cross-Party Group at Scottish Parliament.
It might be Home Care Celebration Day, but it is not the only day that we should be celebrating home care. It is not only a part of our future but leading the way. As one of very few job roles which sees no threat by automation, it is integral to our future. To deliver care is to care and we should be proud of that.
Thank you
Karen Hedge
National Director, Scottish Care
Before the event he wrote the following blog to challenge some of the stereotypes and negative attitudes which still exist around age. Madonna – The champion of age. Over the years the controversial singer Madonna has spoken about the flak that she had to take because of “using sexuality as part of my creativity” and with being labelled a “sexual provocateur” amongst the politest of critiques. She is now facing a new battle and in an interview in British Voguepublished on 10th May has argued that she is now fighting ageism in the music industry and that she is “being punished” for hitting 60. She told Voguemagazine: “People have always been trying to silence me for one reason or another, whether it’s that I’m not pretty enough, I don’t sing well enough, I’m not talented enough, I’m not married enough, and now it’s that I’m not young enough. All too many people will share Madonna’s angst about ageism and I for one look forward to her battling against it. Ageism is so endemic that it has become part and parcel of the wallpaper of our realities – so subtle, so pervasive that it is not even noticed; it is just accepted as a given, as a state of unalterable being. It’s almost the same position that racism was in the 1950s and early 1960s – so unconsciously accepted as a social norm in the UK that it went unnoticed – except by its victims. It is in the language we use, the stereotypes we accept, the rhetoric we hear. What do a ticking time bomb, a silver tsunami and a population apocalypse all have in common? No, they aren’t the latest plotline from an episode of Line of Dutybut rather they are phrases used to describe the fact that we are living longer. They are highly negative descriptions of a reality that most of us would or should want to celebrate – we are dying older and healthier than at any time in Scottish history. So why the negativity? Why is it that so much of our cultural and political discourse about old age paints such a dark and depressing picture of decline? Old age is something which should be valued, but alarmist attitudes fail to recognise the benefits and potential of older age and feed into the myth that getting old is about losing something rather than gaining something new and potentially positive. Old age is seen as a challenge rather than an opportunity. Everywhere you look there are negative stereotypes which perpetuate the myth that older people are incapable and dependent, have nothing to contribute but rather are a burden and a drain on society. We see this in many of the current debates about social care and health which count up the costs an ageing population results in but fail to recognise that over 90% of care delivered in this country comes from the hands of people who are themselves old thus saving the taxpayer countless millions. In Scotland I am sure we would like to believe that we treat all peoples as equal, regardless of colour, creed, disability, sexual orientation and we have indeed made great strides in addressing discrimination and hate. But have we made the same progress against negative stereotyping and discrimination which is based on age? I think not – why is it that a child in receipt of residential care will have nearly double the amount of public resource allocated to their care than an older person of 90 in a care home? Why is it that countless individuals talk about not even getting the chance of an interview if they are over 60 and are seeking employment? Why is it that at the age of 65 people who are accessing social care support move from being an adult onto being an ‘older person’ and in some areas such as mental health services they tell us they suddenly find the level of their support diminishes? Do we feel it is adequate that for thousands of older people seeking social care support that you can only now be eligible if your need is ‘critical’, that our social care services are critically under-funded? We need to take off the heather-tinted glasses and face up to the reality that Scotland is as ageist a nation as many others in the world but rather than just recognise this we need to act . Yes, the Scottish Government has just published a great summative strategy, but … Scotland has a real opportunity to do things much better. Embedding human rights at the heart of economic, social and political systems is a start. However, regardless of good policy intention and political priorities unless we address the pervasive cult of youth in our society, we will continue to acquiesce with ageist discrimination. So, with Madonna I will continue to fight against the ageist discrimination that fails to value contribution, for me that means fighting for Scotland to have an Older People’s Commissioner and for a Convention of the Rights of Age. What does it mean for you? How can we together create a country which is the best place in which to grow old and in which value and contribution is recognised regardless of chronology? In the words of Madonna:
