Domiciliary care is rooted in our communities. It takes place in our living rooms, our gardens, and on the streets where we grew up. It is by design and ambition people driven and person centred. Nourish Community is the exact same. Our system is built alongside care providers, with functionality that brings together the potential of digital with the vitality of human experience in home care, empowering providers to support their communities effectively and empathetically. Digital records, real time appointment notes, a comprehensive carer app, and many more features make up the core of Nourish Community, but it is our focus on lived experience, and the ability to measure and review such experiences, that makes our system the best at supporting person centred care in people’s homes. In this blog we’ll cover the host of benefits that come with embracing digital records and workforce management for your domiciliary service with Nourish Community.
The Person Centred Power of Going Digital
The most obvious benefit of going digital is the efficiency it can bring to a home care service. It is widely known how much time providers can save by digitising their processes. Nourish Community gives providers the tools to improve efficiency and crucially, increase their oversight into the workings of your service. By reporting people’s care digitally it is easier to review and improve upon it. Carers can share notes from their calls, coordinators can view trends over time and the people utilising the service can become involved in decision making. Knowledge is power, and with Nourish Community your team will have all the knowledge they need, in one place and on the go, to provide truly outstanding care.
Starting on the Right Foot with Implementation
Digital functionality is powerful, but it can be misdirected. It is crucial that your system is shaped to your service, supporting the unique way you provide care in your community. We provide all Nourish Community users with a dedicated point of contact to make sure you are getting everything you need from our system. With robust training and onboarding, your point of contact will learn about your service as you learn about our system, building an understanding and teamwork that will guide you through your digital journey with Nourish Community. So you have a smooth implementation and sound system.
Effective Functionality
Through our hands-on approach, we come to understand the intricacies of your service as you learn how to best apply our system, with the end result being an effective, caring and responsive approach to person centred care for those you support. We have a suite of features that can be tailored to the needs of your service. Our assessments ensure your care plans are comprehensive, and with our trends and reporting features you can simply review and adjust your ongoing care as desired.
Your Back Office Backbone
Nourish Community backs up its powerful point of care functionality with best in class admin features as well, giving you every tool you need to focus on providing outstanding care. Our scheduling and invoicing features simplify your administration and provide functionality for long term planning and consistently recurring schedules. Workforce management is supported with the ability to book training, time off and sickness, so you can create both ‘carer’ and ‘client’ profiles that are always developing (just like the people themselves).
Community Care in your Pocket
The Nourish Community Mobile App gives your carers all the tools they need to support your community. Timetables and travel destinations are included, along with appointment notes, electronic call monitoring, eMAR and more so your carers get to the right place, at the right time, with the right information! The app even works when there is no internet because we all know those pesky black spots can crop up!
Using Data to Support Outstanding Care
Data is a hot topic these days, abstract as the term can become. With Nourish Community we are focussed on making data tangible and applicable in real terms for home care providers. For example, our ‘recommend a carer’ feature draws upon information you have added into your system, and graded on a scale you can adjust, to find the best partnerships between carers and clients in your community. The data is all there, and we give you the tools to apply it effectively, using data points like travel time, carer skills or appointment history. Data is a powerful tool, one we have previously explored the benefits of. We are taking data and making it real for people who utilise care, people who provide care, and the communities who are shaped by it.
Care-centred community
Home care, domiciliary care, community care, whichever name it takes, the purpose is always the same, freedom. People who utilise care in their own homes want to be empowered, elevated by their service so they can continue to live their lives to the fullest. Nourish Community combines a digital system with a comprehensive data infrastructure and an internationally recognised user experience under that one defining goal. Empowerment, from our living rooms, gardens and communities, to wherever it needs to be.
Find out more about how we can empower your community here.
In the UK, the Care Workers Charity (CWC) provides support to carers throughout the year. In challenging times, they are often the lifeline that keeps carers afloat. The CWC also challenges misconceptions and helps shine a light on wonderful relationships, as well as many of the challenges that exist when providing care to others.
Our partnership with the Care Workers’ Charity enables us to support their efforts. So we look forward to every year’s Professional Care Workers Week, where we are able to participate, learn, and celebrate the wonderful world of care and the staff that make it happen.
This year we enjoyed many fantastic talks and activities. Monday was spent learning about the realities of social care, how it affects those around us, and how we can drive change and have an impact. It was an empowering day filled with insights, followed on Tuesday by a roundtable on the future of the social care workforce. During the morning roundtable, prominent leaders led discussions, followed by a roundtable led by carers themselves in the afternoon.
Wednesday offered a chance for reflection and self care in the form of a wellbeing seminar led by the Voices of Care podcast host Suhail Mirza and the Care Workers’ Charity’s always inspirational Karolina Gerlich.
Thursday was the day we had been waiting for the most. While we enjoyed taking part in the charity run the previous year, we (our knees) decided it would be better to focus on more sitting based fundraising activities this time.
What better way to enjoy sitting than with a cup of tea and some friends?
A great time was had by all sharing stories and munching on homemade snacks. In order to participate, several people made the trip into the office. This allowed us to catch up with old friends and relax. All for a worthy cause!
We also took it as an opportunity to practise some of our games before The Care Show in October. With the games getting a little competitive it was a great chance to test the rules and make sure everything was working before our trip to the NEC.
The posts of people heading out on the South Downs Trek came through on Friday morning, reminding us of last year’s endeavours, and the people who this week celebrates annually. Professional Care Workers Week is a great time to raise money, but also to take time to appreciate the incredible effort and passion carers contribute to our communities every day.
The government has released a ‘What Good Looks Like’ (WGLL) guide for Local Authorities and care providers in England. This guide builds on the ‘People at the Heart of Care’ white paper from 2021. The guidance is aimed at individuals who have responsibility for digital transformation. In both local authorities and care provider organisations. It provides an aspirational framework to help them shape the future of digital solutions in social care.
The paper is focused on England. But it offers good practice and practical advice relevant to care providers across the UK and Ireland. We’ve summarised its key points in a series of blogs. To help Nourish users and others in social care learn from the White Paper.
The new WGLL framework comprises 7 success measures divided into three categories. The three sections are Digitise, Connect and Transform.
“Effective use of digital technology, data and processes can support the delivery of outstanding quality and personalised care and support at the right place and at the right time.”
Ultimately, digitisation is about improving care. The pursuit of this goal lies at the heart of every improvement that digitisation can bring. By saving time and money through digitisation, you can reinvest it in the care your team provides. Improving outcomes for the people who draw upon your service.
Digital care management platforms, such as Nourish Care, can help you to improve your application of the data you are already gathering every day. By examining this data and applying the information it gives you to the continual development of your care. Empowering you to be dynamic, responsive and collaborative in your approach to care provision.
This can be through studying trends that were previously more difficult to recognise. Building case studies over time on specific clients to better personalise their care. Or sharing experiences from different carers with the whole team in easily accessible documents sent directly to each person. There are a wide range of ways to use digital tools to improve the standards of your care.
This benefit is not dependent on spending a lot of money on new technology or hardware. As habits, successes, and even mistakes are all held in the same system, it becomes much easier to track them, learn from them, and adapt your approach.
Of course, it is vital to know where you are starting from. Make sure you record your current practice before making any changes, otherwise you won’t have a record of the improvements you are making!
If you would like to learn more about how Nourish can help you improve your services you can read our case studies on how Quality Home Care made significant savings or how Priory Group improved their focus on outcomes for over 2,300 residents.
“Having good data to understand and plan for the needs of the population (whether at a community level or individual level) means that we can reduce inequalities and improve outcomes for all people.”
You can change the way you provide care by using data effectively. By monitoring your care, you can gain insights you wouldn’t otherwise get. To ensure effectiveness, it must be balanced with a human approach.
Data security is vital for ensuring the privacy of your team and the people who utilise your care. You must also keep in mind the ethics of data collection. The danger is that when people are reduced to numbers and data points, you start to see them that way.
Co-production offers an effective bulwark against these bad habits. By involving people in the process of shaping their care, and keeping them in control of their own data you empower both the people themselves, and the service they are a part of.
The same rings true for finding the right digital partner. When you work with a supplier who understands your goals, and works with you and your community, you can ensure that together you use data securely and ethically. We have previously discussed the importance of Safe Practise in the What Good Looks Like guide. When considering the health of people in social care both the security of the data and how you apply the information you have gathered are crucial to your success.
We have worked closely with both third party developers and County Councils to develop innovative applications of data in care through our Partnership Programme. The Nourish Partnership Programme (NPP) unites key best-in-class innovators like Camascope for eMAR, Radar for incident management and PainChek for pain management whilst keeping a finger on the pulse for emerging technologies that will have a big impact on the social care sector.
If you’d like to learn more about the power of data and how we work with providers to help them harness the power at their fingertips you can read our case studies. See how Abney & Baker utilised our Application Programming Interface to improve their service. You can also read about how going digital helped transform Hampshire County Council 16 adult social care services.
The government has released a ‘What Good Looks Like’ (WGLL) guide for Local Authorities and care providers in England. This guide builds on the ‘People at the Heart of Care’ white paper from 2021. The guidance is aimed at individuals who have responsibility for digital transformation. In both local authorities and care provider organisations. It provides an aspirational framework to help them shape the future of digital solutions in social care.
The paper is focused on England. But it offers good practice and practical advice relevant to care providers across the UK and Ireland. We’ve summarised its key points in a series of blogs. To help Nourish users and others in social care learn from the White Paper.
The new WGLL framework comprises 7 success measures divided into three categories. The three sections are Digitise, Connect and Transform.
This guidance builds on the NHS What Good Looks Like framework and can be applied alongside the What Good Looks Like guidance for nursing. The DHSC page also contains a range best practice guides for digital working, and further supportive resources here.
In our second blog we are focussing on the ‘Connect’ category.
“Supporting your workforce means developing a skilled, capable workforce who can confidently identify, recommend and use appropriate technology safely and effectively for people drawing on social care.”
When it comes to supporting your workforce, it’s about trusting them and empowering them to use the digital tools available to them and to those who use your services.
When supporting your workforce it is important to keep in mind that digital literacy is commonplace in today’s society. Almost everyone utilises some form of digital technology each day from Facebook, to Whatsapp, Fitbits, alarms and even banking. We live in a world of digital technology, to the extent we often overlook just how skilled we are with digital tools.
Care Roadshows invited us to take part in a series of panels on Balancing Technology and Human Connection. In Glasgow, Quality Compliance Systems Head of Social Care Content Lindsay Rees discussed the importance of understanding ‘Why’, and how the purpose of digitisation must be understood by all in your organisation.
In spring of last year, in response to Sajid Javid’s comments on digitisation in social care, we examined digital literacy in social care. Our analysis of the Ipsos Mori Polling revealed there is far greater understanding and use of digital tools in social care than was being openly discussed, especially in domiciliary care settings.
Time and again we have seen that the social care workforce is highly capable and adaptable to change. With support to learn new skills and clarity on the benefits of doing so, carers will excel in utilising digital tools in their provision of care.
You can read about the experience so many of our own team have working in care here. Experience that shapes the way we approach digital social care every day.
“A person-centred approach to the design and use of digital technologies can improve people’s quality of life and wellbeing and support independence.”
We believe that the Local Government Association said it best when they defined empowerment as ‘treating people as equal citizens’.
True empowerment comes from partnership, not dictation. Where people, services and systems work together to realise the ambitions we all share for better care. Our ability to understand each other and the challenges we face is much greater when we work together.
Care is based in community, and digitisation should be approached in the same way, as a communal undertaking. This means co-producing care with both the people who will be providing the care, and those who will be utilising it and co-producing your digitisation with partner who works alongside your team to build the most effective solution.
We specialise in working with care providers to create the best digital solution for your service, if you would like to learn more about this process you can see our case study with: Encompass Care or Winserve Care, or reach out to us directly.
The government has released a ‘What Good Looks Like’ (WGLL) guide for Local Authorities and care providers in England. This guide builds on the ‘People at the Heart of Care’ white paper from 2021. The guidance is aimed at individuals who have responsibility for digital transformation. In both local authorities and care provider organisations. It provides an aspirational framework to help them shape the future of digital solutions in social care.
The paper is focused on England. But it offers good practice and practical advice relevant to care providers across the UK and Ireland. We’ve summarised its key points in a series of blogs. To help Nourish users and others in social care learn from the White Paper.
The new WGLL framework comprises 7 success measures divided into three categories. The three sections are Digitise, Connect and Transform.
This guidance builds on the NHS What Good Looks Like framework. It can be applied alongside the What Good Looks Like guidance for nursing. The DHSC page also contains a range best practice guides for digital working, and further supportive resources here.
Our first blog focuses on the three measures contained in the ‘Digitise’ category.
“Your organisation’s leaders fully understand the benefits of digital technology and have the confidence and capability to drive forward digital transformation, sharing and learning from best practice.”
Digitisation is a long journey that starts with a simple decision. The decision to take a step forward into the unfamiliar in pursuit of improving the quality of care you provide and the quality of life for your teams that provide it.
In an ideal world, we would fully understand everything we do before we do it. But that’s not how the world works. Ambition and empathy are the essential starting blocks. The ambition to take on the process of digitisation and the empathy to ensure it is always rooted in the human experiences of the people providing and receiving care. Thereafter, it’s time to find the right digital partner for your organisation.
Our goal is to match our expertise with yours. So that we can produce the best results for your service and the people involved. We know each care provider is as unique as the community they support. Our team is here to ensure your unique community benefits from digitisation.
‘Digital Transformation’ is not a term we are wholly comfortable with at Nourish. We prefer to think of it as digital support, or digital augmentation. We’re here to help improve your service. By working with you to match our expertise in technology with your expertise in providing care. So, we can apply best practices from both perspectives. Producing effective digital solutions while always keeping the human connections at the heart of care.
To learn more about how we work with care providers you can read these case studies: Westmorland Care, Smart Care Homes & Care 4 U 2 Day.
“Your organisation has modern and secure digital infrastructure, and staff have reliable access to comprehensive and up-to-date digital records.”
A good start is half the journey in life, and ‘ensuring smart foundations’ is all about putting your business in a position to succeed from the get go. This means finding a digital partner that understands and appreciates the context of your care. There are a huge variety of factors to consider; geography, infrastructure, digital literacy and many more. Before offering solutions, a good digital partner will work with you to ensure they also understand these factors.
You may begin digitising with a robust knowledge of best security practise, and the reliability of local internet connections. You may not. It is important to work with your team and digital partner to understand what you want to accomplish, and how you plan to get there.
We are happy to talk to prospecting care providers about their experience and concerns regarding digitisation. In case you need more information about security, cloud based storage, or any other aspect of this process, we are happy to help. (Even if you don’t join us in the end)
If you’d like to learn more about digitising with Nourish and our onboarding process you can read these case studies: Leicestershire County Care Ltd, Your Care and Support & Nexus Care Services
“Good data and cyber security means organisations can safely use and share information which can improve care and support for people.”
There is always going to be a risk when centralising information. As data becomes more commonly used across social care the opportunity for it to be mishandled or even abused naturally increases as well.
Education, empathy and proactivity are crucial to ensure your team is confident enough in the system they are using to maintain safe practice as well as being confident enough in their team and leadership to share any breaches they think might have occurred.
When choosing a digital partner, make sure you ask about their approach to data protection and cyber security. An expert digital platform should be able to explain how their system fits into your service simply and securely. The less you know, the more questions you need to ask.
There are also some fantastic resources online like the DSPT toolkit from Digital Care Hub, which WGLL points to directly on their outline.
If you’d like to know more about the importance of cyber security and our approach at Nourish you can read here.
Or if you are new to digital security feel free to contact us for a chat about the buzzwords, the meaning behind them and how they relate to care provision.
Many of our team members have had first-hand experience working on the frontline, we’ve walked in your shoes, faced the challenges you face, and celebrated the victories of providing good care. This wealth of experience has shaped the Nourish Care platform into what it is today and gives us unparalleled insight into the sector and allows us to deliver a digital care records platform that truly makes a difference.
The care experience in the Nourish team ranges from carers and activity coordinators to registered nurses and registered managers. The importance of having care experience is essential throughout our team and has shaped our team with the introduction of roles such as Clinical Lead and Safety Officer. We also have team members with nursing and care experience including Quality Assurance. In addition, our Customer Success teams truly put the impact and outcomes for people supported by care at the forefront of everything we do.
Nourish founder and CEO, Nuno Almeida spent time working in care services before the idea of Nourish had been formed. He saw care teams struggling to find time to fit their handwritten notes into their already tremendously busy day and how sometimes issues that needed to be reported slipped the net because there was no opportunity to record those concerns in the moment. He saw how many notes needed to be written to record every care interaction and to prepare for the always-looming CQC inspection.
Nourish began with the mission to give those receiving care a voice and input on the care they receive and to give the team supporting them time to deliver truly person-centred care.
“I volunteered with a care home and I was just a Portuguese chap that had a good enough English, able to come on in and help us with baking competitions on a Wednesday for example. When I started spending time in care homes, it became very obvious that care workers were writing a hell of a lot of notes. It is clear that carers genuinely have caring as a vocation but aren’t always confident writing notes and this can really remove motivation or joy out of the job they do. That’s where the idea of Nourish came from.” Nuno Almeida, Nourish founder and CEO.
There are things you learn while working in care that can only come from that environment. From small details like how much it costs to use agency carers and how the shifts run, to more significant issues such as statistics around falls and how knowing essential information about a person receiving care immediately can change how a person experiences care. The Nourish team started out their careers in the sector in a variety of different care services and job roles which means as a team we have great coverage of the sector. We can and regularly use our experiences to enhance our abilities at Nourish.
“I have only ever worked in Care and cannot imagine working in another field. I worked as both a care coordinator and a registered manager. Both job roles gave me an insight into the pain points that care providers experience in their day to day and how digital platforms can support you in providing person-centred, safe, quality care. I draw upon my experience providing care everyday when supporting my users as a Customer Success Manager, whether that’s training them on how to fully utilise the rostering and scheduling or supporting managers to run reports from the system in line with their compliance. If you have worked in care you will know the feeling of joy you get at the end of the day knowing you have made a difference in someone’s life, I still get that feeling now knowing I am helping my customers provide an impactful, safe and person-centred service.” – Jessica Atkinson, 10 years’ experience in care, Customer Success Manager at Nourish.
We know the importance of the little things. We know the difference between feeding someone lunch and assisting someone to eat their lunch. We know the difference between giving someone a choice regarding the care they receive and assigning care based on an assumption. We know the importance of personalising care notes over the same text being copy and pasted. We know because we have experienced it first-hand.
“Each time I deliver a Nourish training session, people will want to know how a certain feature relates to their sector specifically. By being able to personally draw on a large number of previous experiences across a multitude of care and support sectors, this helps the people being trained to use Nourish more effectively as I ‘get’ what they are needing. This creates a mutual trust pretty quickly and those being trained know that they will get what they need to put Nourish into action in their services.” Jason Hengler, 29 years experience in care, Trainer and Project Manager at Nourish.
Working in the health and social care sector is a skill that regularly goes underappreciated. The narrative surrounding the sector is often negative and the selfless hard work that goes on largely goes ignored. Many of our team have worked in care and know that it is so much more than its reputation. Health and social care is a rewarding career with a clear career path that relies on emotional intelligence, the ability to build relationships and spot signs of change. Our experience in care has given us the ability to communicate effectively with and about the people you support and first-hand experience in the feeling that comes with delivering great person-centred care.
Nourish exists to ensure that care teams are given the opportunity to provide the best care they can by reducing administrative burdens, enhancing communication across the whole team and giving carers back time to spend on person-centred care.
“As a Community Team Manager previously, my journey has been a blend of compassion and adaptation to the digital age. Transferable skills and experiences have enabled me to have a deep understanding and empathy to the needs of my customers and this has ensured that I am able to suit their needs as a Customer Success Manager in a more effective and speedy manner. Working for Nourish has allowed me to tap into my experience within the home care environment. As I have experience as a care coordinator, a carer and a manager, I am able to adapt and tailor my training sessions and support to ensure that the content is relevant for the individual.” Katie Loader, 5 years’ experience in care, Key Customer Success Manager at Nourish.
Because so many of us have worked in care, we know that each service is truly unique in its approach and working ways and that is why Nourish is unique and a leader in the digital social care sector. Nourish is customisable and can be tailored to your care service’s needs entirely to ensure your care service retains what is unique about it.
“Having been involved in a family run care home from a young age gave me a respect and understanding for the sector like no other. Knowing the pressures, the pain points and the sheer variation of the day to day really helps when thinking ‘is this new feature in the platform going to work in practice‘. The team will often hear me repeating the same thing ‘benefit vs burden’ and that comes from understanding the sector. Here at Nourish, we don’t just create a product, we genuinely aim to improve the lives of the manager, the carer and most of all the person receiving support.” Dan Hollingworth, 10 years experience in care, Product Owner at Nourish.
“My experience of working in care homes helps me to understand the daily struggles carers face; that everything is documented correctly, that everyone has had their care delivered properly, that medication has been administered at the correct times, that tasks have been completed, all within a particular timescale for multiple clients with different needs. I try to use that experience every day to make sure we deliver a quality product to alleviate the stresses that come with being a carer so they can offer great support for their clients.” Curtis Cridland, 5 years experience in care, Senior Quality Assurance Engineer at Nourish.
Find out more about how Nourish can enhance the care you provide by booking a personalised demo with our team.
Technology is an innovative and interruptive force felt across the world, its application as varied as its interpretation. These interpretations have presented themselves across health and social care, in pursuit of better patient outcomes, productivity and connectivity. Noble aims, but a focus on results can cause us to lose sight of the journey. An especially concerning effect for us in the world of social care. A world where the journey matters far more than the destination.
Lorcán Murray, our Marketing Manager, participated in an industry panel discussion at Care Roadshows Glasgow. Focussed on the importance of balancing technology and human connection. The panel consisted of Quality Compliance Systems Head of Social Care Content Lindsay Rees, Scottish Care’s Technology and Digital Innovation Lead Nicola Cooper, Abbey Court’s Care Home Manager Brian Murray and Activist Peter Hope. A verified buffet of experience and perspectives from which we have drawn these five informative morsels.
Scottish Care has been working hard to support social care in Scotland and help guide its development and effectiveness. A key part of their support for people engaging with technology in care has been the development of their Care Technologist role. A Care Technologist is someone who helps people trial new technology in their care, and find out what solutions would be the most effective for them. This provides the user with an opportunity to test technology and provide feedback on its effectiveness. An endeavour that firmly roots technology in human experience. Providing a resource for the continued improvement of technological initiatives in social care.
Peter Hope had himself experienced the benefits of working with a Care Technologist when introducing new technology into his life. He also made a point of detailing the value of involving people in each step of the process. The difference between offering someone a cup of tea, and going with them to the kitchen to make it together. Self actualisation is at the heart of care, where dignity is experienced and shared in equal measure for all participants. By involving people throughout the process we, in the words of Scottish Care’s CEO Dr Macaskill, “make room for dignity to flourish,” and avoid the trapping of technological advancement purely for the sake of efficiency.
When people bring technology into their care, or really introduce measures of any kind, it is always with the aim of improving their service. However, a common mistake is waiting for these improvements to show up on the ‘eye test’. Establishing the standard of your service before you introduce new technology is crucial, as it establishes a baseline for you to measure your new initiatives against. Otherwise, you can spend far too long trying to work out the specifics of the success and the shortcomings of the changes you implement.
Where you begin your change is as important as the change itself. While decisions are traditionally made at the top of a company, they will never be successful when said success is determined by their ability to trickle down through your company’s processes and positions. Whether it is new monitoring equipment or management software, it must be implemented from the bottom up to ensure it reaches every part of your service and those who rely upon it.
Finally, and most crucially, the power of Why? With new technology so frequently the focus is on more tangible questions; How do we use this system? Where do we apply it? Who is in charge of it? Throughout the onboarding process of any new technology the most fundamental question that everyone in your company and using your service must know the answer to is: Why?
When people know the purpose of their efforts, when people understand the ambition of the new initiatives that are taking root in vital areas of their lives, it is far easier to implement, understand and benefit from technology. Too often we are told simply how, what, when and where. Ensure everyone involved in your service understands why new technology is being brought in, and your chances of success increase significantly, while your ability to get lost down rabbit holes and in the weeds is considerably reduced. When you know why you started something, you also know when to stop an unsuccessful initiative.
These are our five key takeaways from our time on the panel in Glasgow. A thoroughly enjoyable and informative experience, and one we look forward to undertaking again at Care Roadshows Liverpool on the 25th of May.
Social Care is going through one of its most challenging periods in history. Everyday frontline workers put themselves at risk to help support the most vulnerable amongst us. Care agencies are doing everything they can to support their staff. However with increasingly vulnerable service users, limited funding and PPE supply chain frustrations, it is a Herculean task.
The COVID-19 crisis has made the public far more aware of social care’s structural issues. And yet, these are issues over which the United Kingdom Home Care Association (UKHCA) has been hounding the government for years. As the sector’s cornerstone of information and representation, the UKHCA fights a daily battle to support social care’s critical providers. We spoke with Dr Jane Townson, CEO of UKHCA, to find out more about social care’s access to funding and PPE during the current pandemic.
The UKHCA has been a longstanding bulwark of the care agencies that constitute its membership. Right now the organisation’s primary focus is securing funding and PPE for social care during COVID-19. Dr Jane Townson explains:
“(The Government’s) £1.6 billion is supposed to be to strengthen care for vulnerable people. Some of that has got to be used for homelessness, but the bulk of it should be for frontline social care services. How much of it has actually made its way to any social care providers yet? Virtually none. And that’s what we’re spending most of our time trying to sort out.”
Things have become particularly tough for an industry that was already running on empty. A National Living Wage increase of 6.25% kicked in on April 1st. Yet according to reports from UKHCA members, 60% of local authorities are yet to reflect that increase in the rates they pay to providers for delivering care. On top of that, the arrival of COVID-19 has further exacerbated social care’s lack of funding.
“The amount local authorities pay for homecare is not enough in general,” Townson says. “Many companies are struggling with extremely low margins. One CEO was telling me this morning that he’s calculated that the cost of PPE alone is an extra £2.50 per hour of care delivered at the moment. In his case the sick pay is coming out at £1.16 per hour extra. And his absence rates aren’t as high as they are in other companies. That’s already £3.66 an hour more than normal, never mind the increase in the National Living Wage.
“The UKHCA calculates the UK minimum price of homecare. We calculated from the first of April that the minimum price would be £20.69 an hour. We captured some data from our members on the week of the 23rd of March. The average fee rate was coming out at £17 pounds. So they are already £4 beneath where they need to be just to be compliant with National Living Wage. Never mind talking about extra cost on top.”
UKHCA has been working closely with the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS) to try and address the most pressing issues.
“At the beginning of March, we emailed them and said: ‘Would you be willing to do some joint guidance for local authorities on how to support providers during COVID-19?’ They agreed and some guidance was issued on the 13th of March. That went to all local authorities…which mostly ignored it”, Dr Townson said.
The guidance focussed on three key areas. First, a fee uplift to cover the increase in the national living wage. Secondly, to start paying providers on planned commission work, rather than in arrears as standard. Thirdly, to provide a temporary uplift to cover the additional costs that have arisen due to COVID-19. These would include: PPE, sick pay, as well as remote working and travel costs where relevant.
Trying to get Local Authorities to pay attention to their guidance has proven difficult for UKHCA.
“Local Authorities have been given the money – it’s sitting in their bank accounts,” Townson says. “But they don’t want to send it out to providers for reasons best known to themselves. We’ve been putting a lot of pressure on LGA and ADASS to try and get them to force their members to do what’s right. But they say they’re a member organisation: all they can do is give them strong guidance. They (LGA and ADASS) said they want the opportunity to work with their members first. They’ve said, ‘give us a list of the ones that aren’t behaving’. The Minister for Care is also very actively engaged with this issue.
“So the plan is: raising concerns with ADASS and LGA about the councils that are doing nothing. If that doesn’t work, go to the Minister for Care in the Department of Health to personally phone them up. Then if that doesn’t work we go to the media to name and shame them. We have already given notice on everybody that the timescale for that process isn’t going to be a long time. It’s already the 9th of April. If the National Living Wage went up on the first of April, what possible excuse is there for them not addressing that?”
That may seem like a drastic plan, but it could be exactly what is called for in our drastic circumstances. And Townson certainly sees the urgency:
“The provider market could collapse quite quickly because it can’t sustain these kinds of additional costs and be able to meet payroll. Especially with the fee rises they’re paying. No money means insolvency, and then (issues like) PPE become irrelevant because everyone’s business has collapsed. This really, really needs to be sorted.”
PPE shortages have been reported from the majority of care agencies. A BBC poll from last week found 80% of the 500 care agencies they surveyed are running out of supplies. In response, the Government is implementing some solutions.
The initial step was a letter sent to providers last week from the Department of Health. It outlined four companies who had been instructed to exclusively supply social care. The demand, of course, quickly went off the scale.
“The inevitable happened,” Townson explains, “their lines got jammed. They couldn’t reply to emails and phone calls. Anyway, they’ve hardly got enough supplies as it is. So they have apparently been rationing what they give to care providers to 300 masks each. But they are also insisting on minimum orders so people are having to spend money on other stuff that they don’t need just to get the 300 face masks, so that’s not very good.”
The government is also preparing a parallel supply chain to the standard NHS supply chain to meet the urgent requirements of social care. The NHS Supply Chain set up this joint effort between them, the Ministry of Defence, Unipart Logistics and supported by Clipper Logistics. It will be for both acute and community hospital trusts and mental health and ambulance trusts. On top of that, it is also meant to service social care.
“The supply chain isn’t up and running yet,” Townson says. “We learnt on Tuesday that they’re going to requisition all of the PPE that’s currently in the ‘business-as-usual’ supply chain with the business-as-usual suppliers. So all of the PPE suppliers that normally supply homecare companies are going to find they have no stock because it’s all been requisitioned.”
Far from being a logistical solution, Townson sees a logistical nightmare:
“I have no idea how that’s going to work: 18,000 care agencies all trying to register for an account, ordering stuff and then getting it delivered. I just don’t know how that can be done, we’ll see, but that’s what they’re doing.”
The third step the Government has taken in response to PPE shortages is an emergency drop to local resilience forums. This will be a route by which providers can access PPE. However, UKHCA has been told that this will be ‘very much emergency stock’. Which, of course, raises the question of what is an emergency, and how much stock does it warrant releasing?
“They said: ‘Oh yeah it’s going to be like, nine and a half million face masks, and 8 million aprons’,” Towson recalls. “Well, that is only going to last 2-3 days!”
There is no completely accurate data available on the number of people receiving private care. Based on available information, the UKHCA estimates there are 1,000,000 people receiving care at normal times. These people would normally receive between 1-4 visits a day. Providing care to people at this rate would quickly exhaust the 7.8 million pieces of PPE the government has already provided, leading either to equipment re-use (and the possibility of viral transfer), or to care workers delivering care whilst unprotected themselves.
It’s clear, however, that despite logistical difficulties and financial irregularities, these are challenging times for all involved. While Dr Townson is critical of the support Local Authorities have provided up to this point, she appreciates their position.
“If you think about it Local Authorities have a lot to do generally. They are worried about things like food, homelessness, schools, isolation. There are a lot of things they’re responsible for.
“I don’t think it’s that they’re not working hard, I just don’t think that they’re focussed on social care. We have heard some good stories. In Carmarthenshire, they have offered an inflationary uplift for providers. They’re also paying on commissioned care from a particular date in March. Additionally for every hour of care delivered they’re paying a pound an hour extra to help cover the extra costs. Some of them are doing the right thing, but at the moment the vast majority of them are not.”
UKHCA has grown accustomed to fighting the Government for change on behalf of social care providers. But what was once a more private crusade has become a very public battle. Dr Townson believes that this will raise public awareness of how vital social care is to our social fabric:
“I think people are waking up to realising what’s going on,” she says.
COVID-19 has brought to the fore issues that those within social care have been anticipating for years. Voices for change have long been loud, but little been heard. The new attention that social care is set to receive is welcome, although there are very real fears that the sector will continue to remain ‘the Cinderella service’
Though as Dr Townson points out:
“At least Cinderella had an apron.”
eRostering (also written e-Rostering) is a term, popularised by the NHS, to describe the use of electronic rostering or rota scheduling systems for care. The scope of such an e-Rostering system encompasses management information about shift patterns, annual leave, sickness absence, staff skill mix, appointment/task details and locations of both appointments and each member of staff at any one time.
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