Taking Care Of The Care Home System

The care home system is facing one of its biggest crises to date, with growing costs triggered by regulatory changes and employee pay legislation, increased insolvencies leading to less choice for consumers, and recruitment and retention challenges. Despite soaring demand for social care, more nurses are leaving than joining for the first time in the industry’s history and expensive HR campaigns are failing to justify their costs as the health service still remains understaffed. These issues have led to a branding crisis for the industry which is fuelling people’s anxiety and uncertainty. Social care is a reality we all must deal with, if not for our elderly relatives, then for ourselves a few decades down the line.

Taking a closer look at this situation, this could be regarded as the anatomy of an organisation which isn’t facilitating a context for collaboration and is going out of its way to seclude the parties involved. To address this complex issue all stakeholders in the industry should come together to simplify its understanding and start building ideas on how to develop a culture of compassionate care. This nurturing process requires inclusivity; listening to all impacted by the situation, be they elderly people and their relatives, care home providers, practitioners, the Government, the media and so on.

To shed some light on this, we took the plunge to hold in-depth conversations with the representatives of the social care arena and singled out seven pain points to which we wouldn’t have had access otherwise.

Pain points
– Funding

Funding seems to be perceived as the cornerstone to improving aged social care.

From an employee’s point of view, the Government or private companies don’t fund apprenticeships or training for workers on zero-hour contracts and very few people are willing to pay for training out of their own pocket.

From a patient’s point of view, due to the postcode lottery, which is leaving elderly people facing significant bills based on where they live, some fear that their home can be taken away to compensate for the cost.

– Quality and quantity of care workers

Universally there is appreciation and concern that a lack of staff due to poor pay and perception of the role is a significant issue for both the short and long term.

At the same time, the country’s aging population base is widely recognised as a driving factor which will impact care services in the coming years. Professionals in the sector are also aware that a declining youth population will reduce the potential pool of workers as there are some who take these roles as a first job, alongside older care workers, who have come to the job later in life or stay-at-home mothers who decide to get back into the workforce. The uncertainty could also be fuelled by Brexit, as care homes rely heavily on migrant labour as well.

While everyone’s in agreement on the points above, views on the quality of staff vary based on personal experience. Those within the industry are typically more critical of the quality of staff given their (lack of) experience and training. On the other hand, recipients of care and their relatives are generally more concerned about staff turning up on time, shorter visits than the scheduled time and the lack of consistency in staff. The industry professionals support these opinions as they are aware that staff are under significant pressure and therefore having to work longer hours and reduce client contact time. Having enough time for their clients is also a key concern for the care workers.

– Taking a personalised, user-centric approach

With so many issues and options, how do we know what’s right for our elderly relatives? User choice should be at the heart of the system as currently services are provided based on what’s available rather than what’s suitable for the user.

Additional findings point to the fact that the lack of choice available and limited awareness about what options exist are a key concern for stakeholders and people in management positions within the industry.

When it comes to accessing the support required, the aged and their relatives are often struggling to secure care quickly and are confused by the process due to long assessment times, being passed from pillar to post by local authorities, not knowing what services they’re eligible for etc. The reduction of hours from 50 funded care hours per client to 20 resulted in some people turning from accredited agencies to other options to be able to afford the care needed. This is the point when families start to evaluate the situation actively and consider their options. This then acts as a catalyst to consider residential care options.

– Better support for the community of carers

Although caring comes with plenty of emotional stress, the paid carers we spoke to acknowledge that their satisfaction lies in helping people and making them happy. They don’t feel, however, that they have much support or praise from the public sector.

For live-in carers, it’s also a personal matter as their work and life is often lonely and involves living out of a suitcase. It takes an effort to benefit from their scheduled two-hour breaks and their social lives and mental health tend to suffer because of that.

Unpaid carers, on the other hand, are concerned about the lack of respite and support on public and bank holidays.

– Supporting independent living for longer

Everyone agrees that independent living is desirable, as it facilitates interaction with the family and the community and also provides the comfort of familiar surroundings, particularly for people suffering from dementia. While the benefits of independent living are appreciated in principal, there is little awareness that living at home prolongs life, contributes to mental health and is more cost effective than residential care.

– Public education about the social care needs of the over 65s

The general public don’t like to think about their future (it’s just too scary) so largely ignore issues facing the care industry or the elderly unless they’re impacted directly by it. Although there’s general knowledge around the social care challenge due to funding and population growth, very few are aware of the specific issues and their complexities or the initiatives and activities aimed at promoting and supporting adult social care.

Another key element is the social care workers’ portrayal by the media, which reflects a poor quality of care and low standards, which comes with a detrimental impact. To readdress the imbalance, a voice should be given to industry ambassadors. This will also alleviate the unnecessary anxiety around this issue, leading to a more open dialogue.

Learning pills

The key to bringing everyone together is effective communication between families, relatives, carers and health care workers to ensure quality services are offered and to enable collaboration to help each other and elevate stress for both the workers and the families.

From an infrastructure point of view, a structural and organisational reform is welcomed to enable a single point of contact to co-ordinate services (including the council, hospital, GP, telehealth, charities, private providers and community groups). There has been limited success to date in integrating the services as everyone has taken siloed pathways.

Once the context is laid out by sourcing points of view from all parties and this signals a need for change, that’s when you know that collaboration is required to define actions and set a clear common vision so that anyone can operate individually under its guiding force. The care system as a whole is very traditional, which slows down the adaptation process; finding a way to innovate could make a great difference.

Years of generating ideas in collaboration with our clients have taught us that innovation requires inspiration from other industries, where views are diametrically opposed. So we had a look at another area which has the power to support people and the world but in which things have been developing exponentially over the past century – the technology sector.

Although for many blockchain might be a concept solely applicable to the science world, this is an excellent example of what can be achieved when a community gets together to solve a problem. Blockchain’s transformative potential could revolutionise the way our economy and society works – putting trust back at the heart of our exchanges. It implies replacing the power of the institutions we’ve been relying on for centuries with the power of everyone to facilitate opportunity and access. This operates through decentralised mechanisms which have no gatekeepers or hierarchy, but rely on many people coming together under a shared vision to address the issues of the whole system. Recent stats show that nine out of ten agree blockchain is likely to disrupt the banking and financial industry. In savings alone, relying on this new business model, could save banks an estimated $8-12 billion annually. The care industry can benefit from analysing how this network works as its success relies on allowing anyone with an idea to come up with solutions based on everyone’s opinions. As the care home system is currently fractured, it needs its members to be open to ideas and collaboration.

The industry could also take leaf from Walter Isaacson’s book ‘The Innovators’, in which the author suggests that innovation requires teamwork and complexity rather than individual genius. He illustrates this by looking into open-source, self-managing products such as Linux, the most utilised operating system in computing today, representing a $25 billion ecosystem in 2008. This powerful force, utilised in areas such as consumer devices and stock exchanges, has been developed collaboratively by enthusiasts and companies alike that believe in its worth. So much so that Linux is now the single most expensive project the world has undertaken, although everything has been implemented for free. The Linux Foundation has also looked into the economic value of collaboration and estimates that 500 companies in just the last few years have generated $5 billion in economic value through collaborative projects. This equates to work which would have taken 1,356 developers more than 30 years to replicate.

Isaacson also points out in his book that the best type of leadership has complementary styles and requires a wide range of specialties. (Collective Impact frameworks could be a topic for another day.)

While there is no standard treatment to address all the issues the care industry faces, a collaborative approach could benefit the system by putting all the pieces together as a whole and inviting a larger conversation with all the stakeholders involved. This challenge should be viewed as a great opportunity to drive change in order to improve lives; to make lives better we need to come together and act as one body.
1 https://expandedramblings.com/index.php/blockchain-statistics/
2 www.linuxfoundation.org/infographic/estimating-the-total-development-cost-of-linux-foundations-collaborative-projects/