Caring for the Care Sector: How Can We Support New Models of Home Care

Social care needs help. We can only describe a service as in “crisis” for so long until that becomes the norm, and the very name “domiciliary care” makes it sound like a chore that needs to be completed. In our drive to “fix” the social care system we have begun to speak about it as though it is a machine in a factory. We talk about the “model”, the “sector”, but all these terms neglect one key component – the people at their heart.

The challenges faced by social care are well known; from funding to staffing issues prior to Covid-19 to PPE shortages during the pandemic. The problems facing the social care sector have begun to dominate the conversation. As such, policy and research has begun to be dominated by a desire to “fix” the problems with any new services expecting to be able to scale and spread to address such issues.

We have created a system where those who are beneficiaries of a service are not enabled to live a good life and those who are providers of services are often low paid.

The report – Alternative Models of Domiciliary Care –  by the Wales Centre for Public Policy is a welcome review of some of the lesser well known or smaller models of home care, such as self-managing teams (Wellbeing Teams), micro-providers like those in Somerset, or care cooperatives (NW Care Coop). These models challenge the conventional model of home care – the time and task model which has long been proven to not meet the needs of those it is supposed to serve.

In my 2019 report, Radical Home Care: How Self-Management Could Save Social Care I explored not only the value new ways of working could offer social care but the underlying issues that, often, meant these new models struggled to develop beyond the innovation space.

As we explore the future of social care it’s important we don’t hold out for the silver bullet or holy grail which will create a “fix”. Just like the people social care supports there are many needs and many options that need to be explored to ensure social care meets the needs of our current and future population. The key thing we must address though is funding. Under-funding has fundamentally led us to the point we are at now. If we do not address this many people will continue to be under-supported and many staff under paid and the role of care worker undervalued and unappealing.

A challenge for social care is to move away from the idea that there a ‘mega-service model’ that can meet all these needs. We need to create a system that has space for the tiny services, for individual needs, no matter how complex they may appear, and for staff to feel valued, happy and well-paid. Ultimately, to enable people to have a good life we must enable staff to experience good work – the two are inextricably linked.