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

 

#homecareday19

“It is a privilege to be welcomed into someone’s home and to work with them in their daily lives”

Working in home care is not for the faint hearted, however, for the amazing individuals that do work in home care it is, even with the challenges, a particularly rewarding career.  It is a privilege to be welcomed into someone’s home and to work with them in their daily lives experiencing all their different highs and lows.  The relationship between care and support workers and those they provide services to can be something extremely emotional to behold.

I personally have many stories and great memories from working in home care both as a care and support worker and as a manager.  I started working as a care worker at the age of 24 and it made me into the person I am today.  I learnt so much from the people I supported from practical skills to seeing different perspectives and learning some good old-fashioned wisdom.

When I started as a new care worker, even with comprehensive training, it can be an overwhelming experience going into people’s homes and assisting them with their complex needs.  Learning how to assist an individual to move in a training session is quite different from assisting an actual person with various health concerns and mobility issues.  I was very fortunate to receive great support from wonderful supervisors who were able to demonstrate the job and mentor new staff members with little or no previous care experience.  Care and support workers who had worked in care for many years and had that innate and natural ability to build relationships with people in challenging situations and to make a difference to their lives.  These experienced workers provide reassurance and comfort at distressing times in a person’s life and are invaluable when showing new workers that important aspect of the role.  Many practical skills are transferable and can be taught but having compassion and empathy for others in distress and understanding their needs is at the heart of the job the social care workforce does.

I will never forget the supervisor who received a round of applause upon completing roughly five minutes of the Great Scottish Run in order to get from one side of the road to the other.  The crowd watching the run responded with joy and laughter when the supervisor set off at a jog in pace of the runners to weave her way through the crowd.

This is a lighthearted example but there are so many more of staff going above and beyond to help and care for the service users they support.  This often means taking time out of their own lives and personal time to stay with someone who is unwell or has fallen.  Home care workers rearrange their own commitments and responsibilities to ensure that the individual has a familiar face and someone there to provide comfort while they are waiting on an ambulance and are in pain or unwell.

I had the absolute privilege to accompany staff during the extreme adverse weather we experienced when the “Beast from the East” came to Glasgow.  Staff were walking though knee-deep snow and found the solution of wearing poly bags over their socks and inside their boots to try to keep their feet warm and dry.  On an occasion where people were being advised to stay at home and protect themselves, care and support staff, among others, were out walking through the snow and blizzards to get to people in their homes and give them the care and support they needed.

Within all types of social care valuable relationships are made but it is so inspiring especially as a manager of a home care service when you find that match between care and support worker and service user that is life changing for that individual.  I have seen first-hand the difference that special person can make especially when people have experienced mental health problems and periods of stress and aguish caused by a change in life circumstances.  To see someone flourish under the right support after a time that they thought they would never get back to the person they had been is so rewarding for all involved.

I loved my job as a home care manager going out and meeting some fantastic individuals and hearing stories of their lives and personal experiences.  I met an elderly lady who had worked at the age of 16 during the war on a forty-foot crane and had walked along the gantry whistling with her hands in her pockets.  People are full of surprises from all walks of life and have so much to offer to the younger generations.  This is an important aspect of social care and we must realise that these relationships can go both ways and benefit both the care worker and service user.  Staff often express their pleasure in some of the things that they learn from the people they support, and you can see this empowers the service user too when sharing their life skills with others.

Amongst the current challenges it is important to remember the positive aspects of this sector and the good times that happen too.  I will leave you with a story that I feel encompasses home care: I was talking with a provider who told me that during the torrential rain we had back in September they had been calling their staff working out and about in the community to see how they were getting on.  When the manager of the service had spoken with one staff member they had responded that they were absolutely fine: they had been soaked to the skin while getting to their first call, however, they were now getting dry and were nice and warm in the service users home having a cup of tea together and planning the day ahead.  That to me gives a true example of the sharing of lives and experiences and the wonderful benefits that home care can bring to both the workforce and those they care and support.

Caroline Deane

Workforce Policy & Practice Lead, Scottish Care

#homecareday19