Homecare Day 20 – National Director Blog

Homecare Day is a place for celebration and we need look no further than the incredible stories from our social care workforce in pandemic response.

I heard a fitting metaphor for the current experience as being referred to as a natural disaster. After an earthquake or hurricane, you can’t instantly build new and better, you must first clear away the rubble and heal the cracks.

This is a story told by the voices of women and men I have spoken to over these last months of pandemic response.

I want you to take a deep breath before you read this, use their words to paint the picture. This is the story of the forgotten social care workforce.

“I’m worried I am spreading the virus, how would I know” “I don’t think you get tested unless you’re a celebrity”

“Other healthcare professionals look like stormtroopers I’m struggling to get paper masks, it’s like we’re not important”

“We’re only getting paid per planned for the first 24 hrs, how do I support and keep my staff? Their hours are now all over the place”

“Oh yes there is guidance, but it’s everywhere, there is nothing good enough that is specifically for us. If only they asked us”

“I come home from work and my kids run to give me a hug but I have to hold back. I have to strip off, put the clothes in the machine and shower before I can hug them safely. They’re too little to understand. It’s breaks my heart every day”

“I think she would just love to see everyone, she’s been on a downer hasn’t been eating or anything. Today she’s broken down and cried the whole time I’ve been here. How do I leave her like that?”

This is the hidden story of the pain, loss and isolation of an entire workforce, a workforce that must be increasingly recognised for their skills and expertise, for their loyalty and for their humanity.

And all of this sits in a pre -existing landscape of challenge and power imbalance: undermining procurement contracts which hinder fair work practice and restrict innovation. A crowded landscape of data and technology where limited vision and investment on a national scale risks limiting the potential of social care. And, a move away from the preventative model of care and support as we see a rising eligibility criteria and much later access to care and support to a point of crisis.

Many of our workfore have experienced trauma and grief. We hear a lot of conversations about resilience, but that is simply not sustainable. People are exhausted. Personally, and as a sector need to acknowledge our pain, embrace our emotions, support and be supported to work our way through. We need to focus on what we were able to do, how we are able to support each other. That is how we progress, that is how we heal.

Without recognising and challenging this landscape, we will not be able to rebuild.

Yet, in many ways, pandemic response has brought us closer together. With people who access care and support and with our colleagues. But it goes beyond. A rather interesting reflection is that one of the lowest reported challenges reported in the recent CI report on homecare is the relationship between providers and HSCPS. Indeed in some parts of Scotland, there has been a real feeling that integration has extended to include the totality of the social care sector.

The theory of Disruptive innovation “Creates a new market and value network which overtakes the existing market… It is where innovation and a change in value-base disrupts complex systems.”[1] We saw this for instance with the invention of the Model T Ford motorcar and the home computer.

It is not so much that our vision is different, but that pandemic response has been the opportunity to see that shift from the fringes to the mainstream. A glimmer of understanding of the critical role of social care. Where choice and control is available to everyone as it should be in the human rights based delivery model that we aspire to.

Social care is our route to staying in our communities, but it also supports and enables us to connect and if not bound by time and task can be used to introduce many kinds of support which will reduce decline, enabling us to contribute to and be part of our societies for longer.

We thought that the Self-Directed Support Act and the Integration Act would pave the way for new models of care, but all along there has been missing a shared vision and focus and understanding of the potential of the sector as a whole. We have, consciously or not, been constrained by traditional boundaries and a habit of thinking that improvement means putting more things in place instead of thinking about what needs to be removed.

The impact of coronavirus has been to reduce our focus solely on a combined effort towards pandemic response. In some places, that has cut through silos and issues of power to build relationships. An experience which offers the best use of the resources that we have available to us and looks to implement them in the context of human rights. It is now critical to harness that before we remember how things used to be:

  • We have seen partner organisations come together to support each other in infection prevention control and in training provision and access to staffing.
  • Market disrupting activities such as consortium purchasing to tackle the over inflated costs of PPE, including working with local distilleries across Scotland to divert production from (sorry folks), gin, to hand sanitizer and tackling HMRC to downgrade the tax to make this viable.
  • The development of and the introduction of Near Me to allow for remote consultation with healthcare professionals.
  • Many other technological advancements in terms of connectivity such as an arts programme produced and developed by organisations such as luminate.
  • Working with Glasgow university on a project to use mobile of 5G vans to allow for training in PPE using virtual reality.
  • And critically, grown out of a highlighted understanding that data is a weakness across the sector, different ways of collecting and sharing data, alongside a desire to trial a shift towards citizen owned data.

I spoke earlier about trauma and how to navigate through and we can apply the same method here. Now is our opportunity to make real and substantial change. We must all take some time to reflect not only on our roles in pandemic response, but also what helped to get us through. Write it down, keep it with you to draw on that strength going forward. Celebrate your tenacity, strength and dedication.

But I would also ask you to apply this process across the health and social care sector, write down what has worked for you personally, for your organisation and for the system. Talk about that, share it, tweet it, raise it as part of homecare celebration day. We have learned so much in 2020 yet there is still more to learn. Disruptive innovation gives our workforce the opportunity to take us there.


Karen Hedge

National Director, Scottish Care


[1] https://en.wikipedia.org/wiki/Disruptive_innovation