The media has been alive with news and debate on the subject of local councils commissioning care to vulnerable elderly people on the basis of 15 minute time slots.
First into the recent debate was the Leonard Cheshire charity. They published a report which highlighted that in England, 60% of local councils commission the delivery of care in these very short windows. Their report is calling for an end to this method of commissioning with an increase to allow people to take more time with the people they are caring for.
On the other side of the argument sits the Association of Directors of Adult Social Services (ADASS). Their president Sandie Keene suggests that “It is totally wrong to believe that all tasks need more than 15 minutes to carry out”. She feels that there are some tasks such as popping in to check that everything is OK and offering to make a drink or help with administering medication can be done satisfactorily in a quarter of an hour.
This discussion has led to examples given in the media of Care staff leaving clients with mugs of hot drinks because they cannot afford the time to sit with the person while they drink it and stories of clients having to choose between having a wash or a meal because the schedule does not allow for both.
For my twopenneth worth I feel that a number of people, Sandie Keene included, are completely missing the point of providing care to someone in their own home. Invariably, providing care will include at some point having to undertake certain specified tasks on behalf of the person they are looking after. However, a program for caring for someone should never be purely based on undertaking tasks for someone.
We are looking after people not robots. These people have good days and not so good ones; their emotional health and wellbeing is as important as their physical care. For this reason I will not enter in to local authority block contracts. I believe that they drive down the quality of care by forcing care companies to deliver short duration calls.
At Home Instead we have a minimum call duration of one hour as this enables our CAREGivers time to deliver person-centred care which focuses on the needs and dignity of the individual.
I firmly believe that our social and health care systems need to evolve to provide person-centred care that is both age and stage appropriate and which support healthy ageing and which takes a holistic approach to meeting people’s needs.
Yes there are obviously budget constraints. However, instead of adopting a one size fits all approach, our local authorities and providers should be working together with those in need of support and their families so that home care providers have the freedom to innovate and use budgets flexibly.
Philip Keohane is a regular contributor to Xn Magazine