Kevin Lewis, Founder and Chief Executive of Caremark, wanted to create a service to help get social care out of the crisis being faced and to provide better support to the people affected by loneliness and isolation.
There is a national shift to move away from time and task-based commissioning in the home care sector and PatchCare is aiming to offer an alternative solution.
How does it work?
The idea behind PatchCare is to provide all of the benefits of a care home in a person’s own home. Areas are divided into small geographical ‘patches’, with no more than ten people per patch who require services. Two care workers are allocated to each patch and provide visits based on the people’s needs. This might be helping them to get out of bed and get washed and dressed or supporting them at mealtimes, for example.
Having two dedicated care workers for a small area means that clients can receive more visits over the course of a day as needs arise, rather than scheduling visits with limits on the time a care worker can spend with people.
Some tasks are planned – e.g., a morning routine might be planned between the two care workers, based on when clients prefer to get up, eat breakfast and get dressed – but as care workers have a small distance to cover, they can easily travel from one person to the next and back again. Care workers can be contacted via a mobile app, which they can also use to communicate with each other.
Care workers also arrange outings and social events for their patch, so that the people using the service can leave their homes to meet with others. This might be a shopping trip or an outing to a local tearoom.
Care workers are paid on a salaried basis, rather than by the hour, and always know when they are working, with set shift patterns. The clients also know who to expect at which points of the day, as the PatchCare system means that consistency of care workers remains. All travel time and waiting time is also included in the care worker’s salary.
To test the system, Kevin implemented a pilot in West Sussex, which began in April 2018. This was initially funded by the local authority for six months but has been extended to complete in March 2019.
The Caremark head office team were involved in setting up the trial, which was run by the managing directors of Caremark Mid-Sussex and Crawley, with the support of their existing team. Two occupational therapists employed by West Sussex council were also involved in monitoring the clients.
The pilot has been extremely successful so far, with positive impacts on the people who use the service. Sue Hills, Managing Director of Caremark Mid-Sussex and Crawley said, ‘Whilst most people will see the obvious long-term financial benefits for the local authority and NHS, our team focused on the fantastic improvement of wellbeing for our clients. To hear at the start of the trial that some of our clients had little or no will to continue living, and to then see the transformation to them enjoying life, it is heart-lifting.’
The original idea behind the social aspect of the PatchCare system was to find a central location as a hub for all the gatherings. The team considered using a vehicle similar to a mobile library, to be shared between several different patches, but it was decided that the cost was in excess of what could be afforded. However, the team has found that using local community venues such as a garden centre has been successful. Some clients have also hosted in their own homes.
PatchCare also has the difficulty of charging people even when they are not at home, for example if they are in hospital. The clients must still be charged in order to cover the cost of the salary of the care workers supporting them. However, the care workers do still visit the clients when they are in hospital, which allows for an improved experience, with the workers able to inform hospital staff of any specific requirements and supporting the client to leave hospital sooner.
This also negates the difficulty of clients ‘losing’ care workers that they have become familiar with. They can maintain existing relationships as care workers won’t be allocated to a different person while the client isn’t receiving support.
The trial has seen benefits for clients, care workers, the local authority and NHS services. The people using the service are receiving more responsive support, without limits on the amount of time they are allocated. Loneliness and isolation are also being reduced through the service, and clients have been seen to deteriorate less quickly, and regain skills in some cases.
Care workers have regular shift patterns and a guaranteed salary, making it easier to recruit staff. The ability to form lasting connections with the clients has also created a more rewarding role for the care workers, helping with retention.
For authorities and the NHS, the hope is that this service will result in fewer calls to 999, as clients will be able to contact their PatchCare care worker. The service could also be more cost effective than traditional models of care, and help to reduce hospitalisation and delayed discharges.
Caremark has over 100 offices across the UK and aims to have PatchCare implemented in all of them by the end of 2019.