Straight Talk

In the light of the Burstow Commission’s Key to Care report, Trevor Brocklebank argues that good care costs money – and it needs time.

Trevor Brocklebank, Chief Executive, Home Instead Senior Care

I welcomed the publication at the end of last year of the Burstow Commission report, Key to Care which looks at the future of the homecare workforce.

While it did not make happy reading – generating shock national headlines about a crisis in elderly care – it pinpointed a key issue that those of us in the sector are only too aware of. How do you train and motivate a high quality homecare workforce when the system they work in is under immense budget strain?

We are all very aware that there is no silver bullet. Ingrid Koehler, Senior Policy Researcher at the Local Government Information Unit who authored the report, highlights the ‘complexity and interdependency of problems’ and that is, of course, the nub of the issue.

The care system is currently experiencing a perfect storm. While the ageing population is growing at an exponential rate, along with increased expectations for more personalised care, providers are frustrated by a system which is currently focused on time and task care plans and low hourly rates. Local authorities, the main commissioners of care, are themselves frustrated by shrinking budgets and rising demand. And in the middle of all that sits the care worker.

In the vast majority of cases they are good people, keen to provide good care, but how can they if the local authority who commissioned their employer has driven the hourly rates down to such an extent that the only way to make it pay is by scheduling short-duration calls?

As with many things it comes down to budgets. The Secretary of State for Health, Jeremy Hunt MP, has told Parliament that he wants Britain to become the best place in the world in which to grow old. But while the Government is putting extra money into the NHS (an extra £2 billion announced in December), budgets for social care continue to be under threat as the vast majority of this care is organised by local councils who are having to reduce the amount they spend on care. In many local authority areas, there is also a lack of knowledge about the wider care provider landscape, with potentially affordable and beneficial providers simply not ‘on the radar’. The new Care Act should change this, giving councils a new responsibility to better understand the whole social care ‘market’, not just what they commission.

Ultimately, for me the solution lies in the integration of our health and social care systems and there is no doubt that we simply need to move more money into social care as the current budgets are unsustainable. Investing more in better social care will reduce costs for the wider health service, by enabling more elderly people to live independent lives at home and preventing them entering the more costly health system.

At Home Instead, our solution has been to pursue our own distinct model of care. We operate outside the arena of volume contracts with local authorities as we believe they can drive down the quality of care and prevent carers from providing a quality service.

We respect and value our frontline CAREGivers, who enjoy above average terms and conditions and specialist training.  Most of all, we give them the time to care and to build lasting relationships with their clients. This has meant making brave business decisions, for example, refusing contracts that specify 15-minute slots of care, but it has paid off. Our business is succeeding and our CAREGivers enjoy working for us; many describe joining Home Instead as a ‘relief’.

In concluding, I would echo Paul Burstow’s important comment in the Key to Care report. We must ensure that pressure on budgets does not mean that good care providers are driven out and those who profit from exploiting their workers thrive.

It’s time to invest in good quality care.

Do you agree with Trevor? What are your thoughts? Add to the debate in the comments below. Subscription required.

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