As someone who works as a manager in the Care Industry and registered as a manager with the Care Quality Commission (CQC) I know first hand how Local Authorities are trying to balance the needs of a person accessing social care and the cuts that have been imposed on Local Authorities by Government.
Social Care has become a pawn in a political tennis match and usually by people who don’t have first hand experience of the care industry and yet all protest that they know better than the next person. I would recommend a study of CQC’s Sumary of Regulations, Outcomes and judgement framework which should hopefully give those who remain confused a little more understanding of what lies behind Social Care Provision.
Historically, older people were expected to get home help, go to a day centre, move into sheltered housing before then being placed in a home. To some extent, some people still believe that this should be the way we continue to support and care for our aging population. I completely disagree with that historic approach.
Care Provision should be bespoke and tailored to an individuals needs rather than the expected or historic approach. Many of an individuals needs can be met without extra financial resource if we plan creatively in conjunction with family members, health care professionals and most importantly the person that needs the care service.
I believe that Day Centres do serve a purpose in care provision but they shouldn’t always be the first option offered to an individual when there are alternatives that can provide better stimulation. Having worked in a Day Centre, I know that on occasions they can great for social interaction but I have seen first hand that they can also place older people in isolation – how many times have you seen images of Day Centres where older people are sat around the outside of the room, waiting for activities or a hot meal and reliant on care staff to help them interact with other users?. So what’s the alternative?
Well we could start by making sure we discover as much as possible about the individual requiring care. I’m not talking about what medication an individual is on or what time they like to take breakfast etc. I’m referring to their likes, dislikes and hobbies etc. For example, why would an individual who has been active all their life with a passion for cooking suddenly be stimulated when attending a Day Centre? An alternative option would be to meet his or passion for cooking which of course would be more stimulating to the individual. If we’re being clever, we could also identify other individuals who have the same passion and between them they could prepare a meal for each other and enjoy it together. This sort of option would also likely be less costly meaning that more funding could be directed to those that do get stimulated by attending services such as Day Centres.
I have to point out at this stage that I am not against Day Centres as for some people, they meet all of their needs and I have seen some really great examples of how services have started to offer a wider range of activities to the people accessing the service including yoga, Internet lessons and photography.
One thing we have to remember though is to ensure that we offer choice and one of the great ways in which we can do that is by educating people about Individual Budgets so that they have control and choice over the care service that they receive. A simple menu of services could be used to tailor make a care package and any funding left over could be used elsewhere. For example, ‘Bob’ might be assessed as needing a care package of 3 vists per day to enable independence as well as one day a week at a day centre. He might have been an avid Reading Football fan and has been lucky to be getting assistance from a male care worker that shares ‘Bob’s passion for football. One week, ‘Bob’s son visit for the week so Bob decides that he only needs personal care in the mornings and evenings rather than his usual full service as his Son will be assisting him. He also doesn’t require the Day Centre that week as he will be taken out. As Bob has control over his individual budget, he is able to roll over the money saved in that week. It could be used, for example, to enable his male care worker to be able to take him to a football match.
This approach won’t suit everyone though but I’m sure you can see the possibilities. Care Provision needs to be person centred and with the cuts that have been made, we need to start looking at innovative ways in which we can meet an individuals outcomes.
Those that work in the Care Industry will know exactly how cuts are affecting older people as well as other client groups. Some local authorities have only made minimal changes to social care provision whilst others have seemed to hit it rather harshly. I know in Berkshire, for example, some local authorities have closed day centres whilst others have asked for a slightly higher contribution from the individual who is accessing Day Services. There seems to be no rational behind some of the decisions that have been made by local authorities and I guess decisions will vary depending on the political party that has control over a local authority. The facts:
- We now have an aging population that require more care and support
- Local Authorities have had to make cuts to their budgets
It’s time to stop using Social Care as a Political Ping Pong Ball and look at the above facts so that we can all work together to create a solution that needs to be innovative, cost affective, that protects the vulnerable and meets the needs and outcomes of an individual requiring care services. Simple. Or is it? It’s a problem that requires a solution and Local Authorities should be engaging with Social Care Professionals and Service Users to solve this problem.
I’m not saying I have the answer but I hope that my blog piece demonstrates that there are alternatives to the traditional delivery of Social Care – alternatives that could reduce our Social Care Spend here in Reading so that it can be directed to those that need it most.