Latest blog from our CEO – Redressing the balance: the potential of homecare

In just over a week Scottish Care will be hosting our annual Care at Home Conference, Exhibition and Awards. It is shaping up to be a great day of debate, a very full exhibition and a real opportunity to celebrate the best of homecare across Scotland in the evening. The title of the event as a whole is Redressing the balance: the potential of homecare.’ To some extent it is a bit disquieting and disappointing that we are still talking about re-dressing the balance of care in Scotland. After all we have had a policy direction of enabling independent living and support in our communities and homely settings for over two decades – and yet we are still talking about re-dressing the balance from acute to community, from health and clinical dominated concepts to social care practice, from time and task commissioning to relationship, trust-based approaches. To redress the balance means to achieve ‘an even distribution of weight to ensure equilibrium within a system.’ It is that care equilibrium that is significantly missing from our current approaches to health and social care in Scotland. That’s what we are after in social care – namely the gain of truly integrated services and supports which we are meant to achieve. At the heart of the debate and all the policy and political priorities in terms of re-dressing the balance is the need to move the focus from reactive response to need on to one which is truly preventative in nature. This is the massive and largely untapped potential of homecare within the whole health and social care system and economy. For what we are seeing in practice on the ground across Scotland is yet more sophisticated approaches to reacting after the horse has bolted. Our eligibility criteria which determine the level at which social care supports and services can be accessed have now reached critical in most parts of the country; and resources for innovation and new models of care are depleted and drained as we seek to keep the ship of care from grounding on the rocks of reality. As a sector with some of the best independent care and support, providers and frontline workers alike are straining under the stress of ever-growing demands being met from ever-tightening funding. It is the care economics of insanity not to recognise that we need to prevent people from accessing the expensive and unhealthy acute system in the first place rather than to seek to respond to their needs once they have been in it. Let us stop people from going to hospital after their latest bout of mental distress and illness; let us prevent unplanned admissions as a result of an unnecessary fall or incident; let us ensure that malnutrition and poor diet, unaddressed lifestyle factors and loneliness are not the vehicles for the inevitable journey into the acute system. But to achieve all that we have to change not just the rhetoric but the reality to properly resource our social care sector in order to enable real prevention to happen. It is not rocket science so why decades after policy initiatives are we still talking and not doing? There is a real opportunity for us to be brave and dynamic, innovative and creative in working together at local level, commissioners, planners and providers in developing models of preventative care which are up to the mark. We can do so much better than we are at present in developing models and approaches which prevent an individual from either early or unnecessary access to enhanced care, hospitalisation or sharper personal physical decline and deterioration. We can do so much better in working together to re-balance care so that we focus on approaches which enable independent living for a longer period of time and which focus on maintaining a higher quality of life and wellbeing. Our obsessive functionalist approach to social care is not only degrading and demeaning of worker and recipient alike, it is a public health hazard and threat. Let us work together to re-balance care by achieving the potential of care at home and housing support, by maximising autonomy and control. Join us on 17th May and get involved in the debate! Dr Donald Macaskill, CEO Scottish Care @DrDMacaskill