business clinic let’s be clear that no Government of any political persuasion can escape tough financial constraints – that is just the reality. The numbers of over 85s is to more than double by 2035 and the ratio of working age people to older people will change from around four working age to every older person to around two working age people to every one older person. This has profound consequences and we need to be creative with what we have.’
Pressure on the system The Government’s Innovation Challenge is admirable but it won’t ease the immediate pressure on the system, and given it isn’t likely to report until the autumn, it won’t be fastmoving action. Although some organisations are able to cope with increased demand, disability charity Leonard Cheshire Disability has declared that it is putting an end ‘to bidding for future contracts providing 15 minute homecare visits for disabled people… exactly three weeks after the Government called for an end to care workers being limited to 15 minute care slots.’ Leonard Cheshire Disability is the UK’s largest voluntary sector provider of social care services to disabled people. With over 7,000 staff, it supports over 4,600 disabled people either in their own homes or in residential services. Announcing the charity’s policy change in a
speech to the National Disabilities Conference in London, Chief Executive Clare Pelham told delegates, ‘As pressure on council budgets grows, the time allowed for care visits is decreasing…we know that 15 minutes is insufficient time to give disabled people high quality personal care and support. To put it clearly – it’s not care if the support worker does not have time to take their coat off. Let alone have a proper conversation. ‘Care workers are telling us that they cannot properly support disabled people to get up, to bathe, get dressed and to have breakfast in 15 minutes. This is not care. It is boxticking. The situation has become critical. This is why we are going to stop bidding for 15 minute homecare contracts, unless the person specifically requests a short visit, for example to receive an injection.’
Extreme cases Ms Pelham went on to explain just how restrictive some contracts have become. ‘In the most extreme cases we have seen a tender for visits of only 10 minutes. This is entirely unacceptable. ‘We understand the pressures on council spending. But there comes a time when it is right to draw the line. And to say so. We urge the Government to act now and use the Care Bill which is currently in Parliament to
actually stop inappropriate and indecent care visits from being commissioned.’
The rest of the sector Although Leonard Cheshire has withdrawn from bidding for these contracts, many private homecare providers are able to deliver acceptable care under local authority contracts and turn a profit. Many are able to make good investment in staffing, technology and processes to streamline the ability to deliver care quickly and efficiently. However, there has also been a rise in zero-hours contracts in the care sector, which according to the Office of National Statistics, have risen to over 300,000 from previously estimated figure of 200,000. Are these contracts and the flexibility they provide employers and employees helping to reduce costs? cmm
Over to the experts... Many could say that Leonard Cheshire’s approach is admirable and in the best interests of those it supports. But is it good business sense if these contracts are all that local authorities are commissioning? Will others follow suit and refuse to bid for 15 minute contracts to force a resolution to the problem? How do you solve a problem like homecare?
Their stance is exemplary Paul Tarsey Group Managing Director Bluebird Care All credit to Leonard Cheshire Disability for showing the courage in the 21st century that Group Captain Cheshire himself displayed to win his Victoria Cross in 1944. It is strange how so many care providers are happy to put themselves in the firing line whilst at the same time complaining about the risks to people who use their services. The reality is that, if a provider accepts an instruction to provide care (even at an utterly unrealistic price and with myriad tasks stacked into a 15 or 30 minute visit) from a local authority, they are immediately complicit in any shortfall in service or quality. For providers to say ‘it is not our fault’ is clearly, legally at least, naive. In stating that they will not provide an inferior service, even though refusal to do so may impact on their operational strength, Leonard Cheshire Disability’s stance is exemplary. Too many providers seem to believe that they will not be held responsible if things go
wrong and that they will simply blame the local authority and their funding regime. Until more providers take a stance like Leonard Cheshire Disability the practice will go on. The funding of care is, of course, a much bigger issue than simply the provision of 15 minute visits. Local authorities are being set up to fail and are in an impossible situation. It seems that no central government, of any political persuasion, will take the unpalatable decisions which would undoubtedly cost votes and, with the ratio of 3.2 people of working age to every person over 65 getting tighter and tighter every day, the current financial architecture is probably untenable anyway. So, how do we solve a problem like homecare? We have to start with the very biggest of issues and push the whole care, health and pensions questions to the very top of the political agenda, rather than tinkering with 15 minute visits. cmm september 2013 | 27
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