Home Care Day: Community enterprise in care at home

Julie Fraser, Care at Home Development Officer for North and West Highland, shares lessons from a new approach to commissioning and delivering home care in the Highlands


  • Community Led Care at Home Provision
  • Local care workers employed on flexible contracts to deliver local care
  • Co-ordinated from within the locality
  • Communities identify their own needs and models of provision
  • Tailored to each locality incorporating existing innovation
  • Traditional Care at Home has historically struggled to provide consistent service in some areas of the Highlands


Why? And How?

  • Smaller, more sparse population; geography; and recruitment in more remote areas have traditionally been difficult to overcome
  • Communities are best placed to understand their own needs and to understand how traditional hurdles can be overcome
  • Local, community led services are more sustainable, flexible and can offer more personalisation
  • Communities need to be consulted and engaged with to explore the issues with provision and potential solutions
  • Often there are existing Community Groups or Charities who may wish to explore developing further services to meet the community need
  • Interested individuals can come together to form a committee
  • Local workers are then recruited to work flexibly
  • Local Co-ordinator manages the staff team and the care provision


Communities can be supported in various ways to achieve this:

  • A partnership with an existing Care Provider can support the Community Enterprise, taking regulatory, financial and management responsibility
  • A Community Group can be supported to become a small, community led care provider in its own right
  • A Charity can be supported to develop additional services
  • A Social Enterprise Model can be used where profit goes back into the community to further develop innovative services


Resources available to support Communities include:

  • A Complete Start Up Information Pack – includes all relevant legal information as well as business management support
  • Scottish Care Development Officers – roles to support development
  • Independent Providers- some existing independent Care at Home providers are supporting the development of organic community led services, they offer business support as well as help with recruitment
  • Community Learning Exchange Fund – this new fund has been introduced by NHS Highland to allow communities to visit other Community Enterprise Care at Home models in order to share learning, experience and good practice
  • Training is accessible through partnership collaboration


Benefits to the Service User and Community:

  • Locally led care- communities are empowered to design their own
  • Locally based workforce- rural communities are retaining skilled jobs in their own areas
  • Localised care provision- service users confident in consistent care provided at a high quality from local people
  • Flexible, reactive, local service which is person centred and community led


Benefits to the NHS:

  • Community Enterprise Care at Home is successful and sustainable
  • Community Led Care at Home meets the needs of local areas in a way that a larger model could not
  • Community led Care at Home allows refocus of NHS in-house service
  • Greater collaboration between NHS and all external providers has led to closer working relations, stronger communication and ultimately a more streamlined process for Service Users


What have we learned already?

  • Not one size fits all- each community is unique and care services must fit the unique needs and assets of each community
  • Collaborative working and strong partnership relations are key
  • NHS support the start up of Community Enterprise Models by identifying hours of work in each area and work in partnership to ensure that the transfer of work is carried out smoothly
  • Communities are keen, knowledgeable and able


Next Steps

  • Partnership working and honest collaboration with the NHS is key to the process and to future sustainability of community led services. The process of setting up or registering a new service takes time so we cannot expect instant results- but what we have found is that when it works, it works well.
  • Many areas of Highland could benefit from community led models of care and we have an opportunity at present for communities to be empowered to design and develop services.
  • We would encourage communities and existing providers to really explore the benefits of such models of community led care – particularly in the more remote and rural areas of Highland where traditional service is difficult to sustain. We have the resources to help ensure that quality care services can be accessible and available across Highland.


For more information about the Community Enterprise Care at Home model, click here: https://www.scottishcare.org/wp-content/uploads/2017/10/Community-Enterprise-CAH.pdf 

Julie Fraser

Care at Home Development Officer, North and West Highland

Partners for Integration and Improvement

Scottish Care



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