“Flying care visits” hit the news on Monday with a report that 60% of councils commission care packages of 15 minutes and in one instance a local authority reported that 84% of the care arranged was in 15 minute calls.
Media coverage, while often referencing squeezed Government funding, often also suggested by implication that care workers and care agencies were complicit in this situation. I want to clarify here that it is the Local Authorities who commission and mandate the care that is to be delivered. The public officials making these unpopular decisions about care are paid through our taxes, and the public needs to make their dissatisfaction with this felt, lest we risk a growing cultural acceptance that this norm of tightly timed, too-short care visiting is acceptable. It is not.
At Halcyon Home Care we don’t accept 15 minute personal care call commissions. We don’t believe “flying care visits” are reasonable, practical or fair to staff or customers. Above all else, we believe that each care package should be personal and tailored to the needs of the individual, and cannot be purchased in the same way as other types of council ‘bulk’ purchases. There is little in the way of standardised needs or similarities in the home environment of the care recipient, both of which affect the time and the way we approach designing a care package.
The problem is often a complete mismatch of expectation versus reality. For example, it is wholly unreasonable to expect the following in a 15 minute visit: To arrive at a property, read the notes from the previous visit (no carer can assume everything is the same since their last visit), say hello, how are you etc., help someone physically get up and out of bed, possibly to shuffle with a frame to the bathroom, assist with a full strip-down wash (a bath being completely out of the question on a 15 minute care package), to get dressed, tidy the bedcovers, assist downstairs , then write up notes so that emergency services/doctor/next carer can see what the situation was at the time of the visit … and yes, I haven’t even included any provision for making breakfast!
For many involved in care, the real scandal is not actually in the pressure to complete the tasks in 15 minutes but the way the care has to be delivered under such constraints. For many recipients of care the tasks are certainly important but it is the way they are treated that has the most impact on their well-being. Being rushed and harassed along rather than respected as an individual and treated according to their specific needs is not a dignified or satisfactory experience.
I understand the Local Authorities are under pressure to deliver services under considerable cost pressures. As they mainly commission care services on a time-served basis, this leaves them with only one way to save costs: by cutting the length of calls. However, I know that buying on a time basis is not the only way to purchase care and I call on Local Authorities to consider more innovative approaches including “gain-sharing” contracts (where a fixed price is agreed and the provider manages with any savings on the price shared), “open-book/cost plus” arrangements where the expertise and quality is purchased and valued. I’m sure there are many other models that purchasing experts could propose.
However, whatever needs to happen must happen urgently. As a care industry, it is incumbent on us to reject any growing assumption that 15 minute calls are the acceptable, preeminent solution in commissioning care at home, or one that we, as home care providers, support or are responsible for.