Home Care Day 18: The Future of Home Care – from an integration perspective

The Future of Home Care

As I write this thousands of people across Scotland are receiving care and support in the comfort of their homes. For many this is a life line and the reason they can remain at home, in their communities, surrounded by a life time of memories.

On hearing the knock at the door in the morning and seeing the smiling face of the Home Carer when entering their home, the person receiving the support will not be aware of the challenges facing all those involved in service delivery.

The economic situation, procurement and commissioning processes, the crippling recruitment and retention issues, the complexities of regulation and registration and the ever increasing demand for services are a daily feature in the lives of every care at home provider in Scotland. Yet, despite this they continue to operate and endeavour to develop, improve, adapt, innovate and influence. It is this spirit that gives me hope that one day, the most frail and vulnerable of our population will receive the care and support they deserve by an empowered, valued and recognised workforce.

Is it unreasonable to expect people to receive care and support at a time and in a manner they choose? I doubt there is anyone who would argue against outcomes focused care delivery and instead support the current time and task approach to service delivery. So why is it that we, one of the most progressive countries with regard social care, see care being purchased in blocks of time and delivered by support workers under intense pressure to quickly complete a task before moving onto their next client?

Admittedly transforming current procurement and commissioning services is far from an easy task, and is by no means the only of element involved in shaping care at home service so it is fit for the future. However there is increasing evidence that current models inhibit innovation.

In “Messages on the Future of Domiciliary Care” Dr Jane Townson noted that her experience showed that there is little thought from commissioners as to how they might contribute to creating the conditions in which providers are encouraged to research and innovate for new and best practice. If, for example, contracts are only 3 years long and, at the end of it, you the provider might be “booted out”, why would a provider invest thousands of pounds in innovation.

I have regular contact with care at home providers, as do all my colleagues in the Partners for Integration and Improvement team. We are always impressed with their passion and commitment to improving the lives of those they support. Despite the challenges of working in a sector often described as being in “crisis”, their innovative approach and entrepreneurial spirit shines through.

By harnessing this spirit and energy, by exploring and utilising the opportunities technology brings, by changing systems and processes, by the true cost of care being allocated to social care and rewarding and recognising our workforce, then only then will we see a care at home service fit for the future.

This is when we will see person led, human rights based care and a care at home system we can truly be proud of.

Margaret McKeith

National Lead, Partners for Integration and Improvement, Scottish Care


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