Personalisation: Commissioning home care for older people

If older people are to be properly supported at home, practitioners need to provide social and health care services that meet the person'’s own understanding of their complex social and health care needs. [5] Flexible, personalised care is particularly important for older people who do not have family and friends living nearby to give them such help. [6]

The best home care takes a personalised approach that:

• focuses on the person using service
• provides quality of life
• meets assessed needs
• meets the quality standards for both services and care staff [2]
• supports unpaid carers.

People who use services should be involved in their care in the following ways:

• They should be given the information they need to make their own choices about their care.
• Care plans should be created with the service user and should meet their individual needs and respect their rights, privacy and dignity.
• There should be detailed and up-to-date documents on what services are available locally.
• Agencies should have a guide to their services that gives information on their aims and objectives.
• Care workers should be given the flexibility to vary the care they provide on a day-to-day basis, depending on the needs of the user.

Also, the particular needs of the following groups of users should be taken into account:

• people who live in rural areas
• people from black and minority ethnic groups
• people from the lesbian, gay, bisexual and transgender (LGBT) community [15]
• people who misuse substances
• people with learning difficulties
• refugees and asylum seekers.

The ability to personalise care varies a lot between service providers and local authorities. Issues around the following all have an impact:

• contracting
• funding
• staffing
• monitoring
• the attitudes of individual care managers.

Some service providers are willing to allow flexibility in care plans and cater to users’ individual preferences. But others stick rigidly to the care plan and focus only on users’ essential needs. This may be because local commissioning or social work practice forces a more rigid approach, and may need every variation in care delivery or timing to be approved.

The values and policies of those buying care services have an important influence on how flexible and personalised the service offered by providers is. [6]