Improving Quality of Care With Less
I guess this sounds like a completely mad suggestion!
How on earth can care home owners be expected to improve standards to meet the Fundamental Standards / Essential Standards / KLOE’s / SCREWS, or whatever else the government decides is the current “benchmark of quality”?
The truth is that most Care Home owners either have no idea how to manage this, or are closing their doors and moving out of the sector. Hundreds of Care Homes have closed, and continue closing, due to the draconian measures being applied by various funding authorities.
Compare for a moment the Care Sector with industry:
1. We have a full order book
2. We can provide a range of quality products
3. Our product is the envy of many other countries
4. We have a highly skilled workforce
5. We are tightly regulated by Government authorities at various levels
6. We have a commitment from our Government to support our industry to ensure that the product is the best it can be.
Looking at these very simple comparisons:
1. We have a full order book
In most industries, a full order book means that the company can “pick and choose” its customers, based on a principle of raising prices to a level that the customer is prepared to pay.
Our industry is focussed on the most vulnerable in our society – and whilst there may be those who are able to elevate prices to ensure exclusivity, this is not the case for the vast majority. Our industry is caught in a trap of what the customer is able to pay and what a funder is willing to pay. Each year the funders are demanding better and better quality standards without even a suggestion that their willingness to increase fees might be a consideration.
2. We can provide a range of quality products
Our sector is able to provide a highly skilled and effective service to those in our care. However, Homes are being “required” to meet ever more stringent “quality” standards in order to retain their “approved supplier” status. In other words, they are required to run faster, harder and longer – just to stay in the same place.
3. Our product is the envy of many other countries
The UK models of care and the academic institutions supplying them are regarded as world leaders. Students come to the UK to try and understand the skills and complexities of the work we do. Both Bradford and Stirling Universities are held in esteem throughout the world for their work on dementia care. Sadly, this is not reflected in the treatment of Homes who deliver this care at “the sharp end”.
4. We have a highly skilled workforce
The staff in care homes may not have academic recognition and, in some cases, have struggled to complete NVQ level 2 or 3. What they do have is the skill of Care. This oozes from their every interaction with a service user. They have a collective empathy – often gained from a lifetime of looking after family members or others in their community. They bring a sense of care and feeling to the service users, who usually respond with smiles laughs and an overall improvement in wellbeing.
5. We are tightly regulated by Government authorities at various levels
The regulations and inspection of our industry is welcomed by everyone and has (for the most part) improved over the past few years. Everyone in the sector agrees that there is a need for regulation, to ensure that service users are receiving the best possible care. However, we still have a process where there are potential deep flaws.
a. Homes submit data to various bodies. This is often analysed by no-care people who make their judgement based on the responses to the questions posed. This may, or may not, trigger the requirement for inspection at an early or later stage.
b. Visits to homes are carried out by inspectors / assessors who very often have no practical experience of the working environment in a Care Home. (I am aware of at least one authority whose “fitness for Contract” inspections are carried out by admin staff from the Contracts Department).
Dementia specialist Homes inspected by paediatric nurses, specialist B.E.M homes inspected by all white inspectors etc. etc. the list goes on!
6. We have a commitment from our Government to support our industry to ensure that the product is the best it can be
There is a bombardment of rhetoric from various government ministers and departments telling us how our older generations are the most important people and that it is our duty to ensure that older people receive the highest levels of funding to ensure that their care is the best possible. We’ve even had a Prime Minister who promised that there would be a “cap” of £70,000 on payment for Care Home services.
Interestingly, that promise – just like that Prime Minister – are history.
If we, as a society, are truly committed to the belief that older people are valued, respected and important to our future, we MUST ensure that the services to provide the best care we can are made available at their time of need.
To do otherwise is a gross dereliction of our duty as human beings and not the caring people that we espouse to be.