82534 Sitra Bulletin No.1 2014_Layout 1 14/01/2014 14:53 Page 4
A caring future With Supporting People contracts drying up and worries over welfare reform, organisations are looking to social care as another source of funding. Sitra’s Adam Knight-Markiegi looks at what it means to move from housing support into personal care. We all know the demographics: we have an ageing population, with more retired people for every worker, people living longer but with more years in ill-health. The number of people aged 85 or more will double by 2026, while those with dementia will double in a generation. This all means that the need for personal care is rising too. Sitra delivered workshops for Riverside ECHG to help them prepare to expand their care services. Mark Nightall, their Director of Business Growth & Strategy, said: “Through our nationwide sheltered housing service … we are alive to demographic changes and increasing numbers of older and frailer tenants.” Although budgets in care are falling, there was still some £7.8 billion spent on day and domiciliary care for adults in 2011-12.1 More and more of this funding is being channelled through personal budgets, so opening up the market to new care agencies.
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2014 No.1
Users and services To enter social care, housing support providers have two main options: domiciliary care or a care home. Domiciliary care, often called ‘homecare’, may well extend the services you already offer. It is organised similarly to floating support and you may have a potential market among your existing clients. While running a care home is akin to intensive accommodation-based support. On average, each person receives seven hours of homecare a week. Just over half of council-funded visits lasted 30 minutes, while 16% lasted just 15 minutes, according to research2 by trade body UKHCA, although there have been recent calls for the 15 minute visit to be phased out. This shows how short most visits are. These will be shorter than many floating support visits, so a constraint to plan for. Hourly rates are becoming increasingly problematic in housing support services. Even lower levels are punishingly common in domiciliary care. The UKHCA
reckons the average hourly rate paid by councils to independent homecare providers was £13 in 2009. So again a limitation. Sitra also delivered a workshop for a housing association in the North West last year. A year on and things have moved forward. They’re looking at taking on a home that is not up to scratch or has “got into financial difficulties”, says their director of support. They’ve also had a feasibility study carried out by a university business school. But what else do you need to consider when setting up a care service?
Register and regulate The Care Quality Commission (CQC) regulates social care (and health services). You must register a service and manager with them before you start. This will be for a specified ‘regulated activity’ such as ‘personal care’ or ‘accommodation with personal care’. In the aftermath of Winterbourne
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