By Debbie le Quesne

Archive for November 2014

Joseph Rowntree Foundation: Indeed, worthy reading

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I have plenty of regard for Geoff Hodgson, editor of the Caring Times. He appears to have a balanced overview of the care sector and, more importantly for me, is in touch with the realities of life.

I’m also equally impressed by the many findings of the Joseph Rowntree Foundation and its recent report on social care. Geoff blogged that the document was worthy of an enthusiastic response. Indeed it is.

In particular, there’s a section on what should be a bedrock of principles for all care whether providers, regulators, local or central government or the NHS.

Written by JRF’s director of care services John Kennedy, the report (simply titled John Kennedy’s Care Home Enquiry), used social media to harvest the broadest possible comments.

Let me quote Geoff: “By far the most emphatic of the findings in the report is that care workers are undervalued, undertrained and underpaid, echoing the sentiment of Baroness Kingsmill in her report earlier this year.” Err . . . yes!

As Geoff adds, reading such reports do taken a determined efforts but among the dross there is pure gold to be found and this is one such gem.

At the risk of repeating the ‘important stuff’ raised by Geoff and being pilloried by my peers for doing so, I find myself almost agreeing with the report’s author that “regulation should be more than inspection . . . it should look at pay and working conditions, staffing levels, mission, commissioning practices and transparency of tariffs, in order to improve the quality of care.“

But before I’m stoned, what better way would there be to expose the government shortcomings on funding?

The report offers other nuggets too and asks its readers to consider the following principles – and I quote:

  1. Be appreciative of the million and a half people who work in our social care sector. They are your friends, relatives and neighbours. They care for us and our own. Judge them by the reality of humanity not by an idealised, unattainable expectation.
  2. Be proportionate about risk. Share the risks, don’t just try and pass it on.

Much of this report is about right attitudes, culture and better futures. Below is a snippet or two lifted from Kennedy’s work and you may even wish to read it (I do hope so).

For care homes:

  • Providing care is not the same as making widgets: it comes with a wider social responsibility of national importance. If your business model is driven solely by profit, you shouldn’t be in the business. The vision, values and attitudes required to run a care home start in the board room and proprietor’s office. Your business has a significant social and community impact. Take responsibility.
  • Be active in your representative organisations. It is time to step up and help create a vision for the 21st century care home. Stop being passive. Care homes will only get better if you are part of creating the solutions.
  • Be open, honest and transparent. Be candid about your strengths and your failings. Resist defensiveness.

For government:

  • Declare the care sector a ‘sector of primary national strategic importance’ for the country, the economy and ourselves.
  • Recognise that social care on the cheap is very expensive. The opportunity cost of low investment in our social care system is simply pushing higher cost onto the NHS. It is also inhibiting our national economic potential by failing to effectively support a modern labour force.
  • Regulate the market, don’t just inspect. We need to take a ‘whole system’ approach. We need proper regulation of the market as a whole. Regulation should encompass pay and working conditions; staffing levels, commissioning practices and transparent tariffs. These are the factors that directly impact on quality of care. Only with firm foundations can the care sector deliver. Regulate the market to compete on quality. Regulate for success not failure.
  • Care managers need a professional body. Managers should be registered and have a licence to practise. The body should set professional standards, have disciplinary powers and provide a voice at a national policy level.
  • To give assurance and to raise the status of the profession, care workers should be registered and have a licence to practise.
  • Introduce a single assessment instrument to provide real data on quality indicators, dependency profile and resource needs. Understand the care home sector. This would give valuable data in measuring quality. It would also provide a national statistical database to inform strategic planning for health and social care.

For the system: regulators, local authorities, the NHS:

  • Ensure that your requirements support the ‘mission’ of the care home. Be mindful that whatever extra you ask them to do takes time away from relationships and people. Find out about your local social care providers. Engage with the care sector in partnership.
  • Rationalise the ‘paperwork’ burden on care. Work together to ensure a proportionate bureaucracy that supports ‘people time’ not ‘office time’. It is people who make the difference in the end, not paper.
  • Share what is good. You need to be more ‘in the game’ – don’t just point out what is wrong; engage in finding solutions too. Listen. Share your experience.
  • Be collaborative and involve the care sector at the inception stage of new requirements and initiatives – not just a consultation at the end of the process. Care homes have a lot of experience to share.
  • Ensure there is someone on your boards with direct experience of working in and running care homes.