Home Care Day 19: Changing times for home care – a blog by our National Director, Karen Hedge


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