Reimagining home care

Featured article - 06 February 2017
By Helen Sanderson, CEO of Helen Sanderson Associates

Head-shot of the author, Helen Sanderson, CEO of Helen Sanderson Associates

We know that there are some significant problems in home care. This can be the case for the people who receive support or the people who provide it. We can see this from the 25% increase in complaints, that 25% of services require improvement or are inadequate, and that staff turnover can be as high as 40%.

Most solutions focus on trying to get more money into the system, or to get more out of the system by making it more efficient. Realistically, there are challenges with both of these approaches as many think that fundamentally the system is broken. We need to focus on well-being - the wellbeing of people supported and the well-being of people who provide support. We are trying this through Wellbeing teams. They are small, neighbourhood, self-managing teams working in partnership with Community Circles, designed around the wellbeing of people and colleagues.

Wellbeing for people

Wellbeing teams focus on outcomes, not hours, and start with a conversation, not an assessment. Co-production is at the heart of the way teams work, and people choose how and when they are supported and choose their own team too. Teams include Community Circle Connectors who work with friends, family, neighbours and volunteer facilitators to build a support circle around each person.

Wellbeing for colleagues

As Daniel Pink, in another You Tube film - Drive - says: "Ample research has shown that people working in self-organized teams are more satisfied than those working in traditional teams." Wellbeing teams are small, they meet weekly and share the roles that are traditionally taken by co-ordinators or managers. They are recruited through value-based recruitment - Wellbeing teams are finalists for a Skills for Care Accolade for best recruitment initiative - paid at or above living wage, and are supported by a coach.

How is it affordable?

Wellbeing teams are inspired by Buurtzorg, in the Netherlands, who have over 10,000 nurses in self-managing teams with excellent satisfaction rates for people and staff. They have low overhead costs of 8% against typical industry costs of 25%. Wellbeing Teams are affordable because the self-management structure reduces layers of hierarchy and routine processes are automated with bespoke IT. They are funded through personal budgets (as Individual Service Funds) and therefore can be used by people funded through Adult Social Care and self-funders.

Creativity and care are not words that you often hear together. I think that can change. Through self-management, teams have greater freedom to be creative - a change from the traditional ‘task-and-time’ approach.

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