In this post, love2care’s founders Maddy (whose voice is in pink) and David (in blue) share their journeys, and how these stories intertwined to lead to love2care and where we are today.
I was 18 years old when I went into the Health and Social Care. Some would argue it was even before that when I used to support my stepfather who was unable to work due to ill health. I look back now and think, “Was I really ready?”.
I remember my first interview. I got lost looking for the barn! I was asked, “What is personal care?”, and I had no idea. I knew that the role involved washing and dressing, medications, meal support etc., but the I had never heard the term personal care before. Even so, the person interviewing me believed I could be responsible for providing care and support to vulnerable people in their own home.
It took me a little while to really feel confident in this role, but enjoyed every minute. It wasn’t easy. I made mistakes and lessons were learnt, but seeing people in their own home smiling… it was just beautiful.
It wasn’t long before the 6 days-per-week double shifts caught up on me. I was used to working and studying long hours, but being called on your day off because people were constantly sick took its toll. I sometimes questioned why I was working all these hours when others were constantly letting these people down. Even with these challenges, I felt I became more confident, more aware and I enjoyed going to work.
However after about nine months, my only issues were ‘the office’. I remember thinking ‘I could schedule these rotas better’. I started looking at other office-based jobs. To my luck – I found one. A local provider had a vacancy for someone to cover for person on maternity leave. I applied and to my surprise I was offered the position on a temporary contract. Woohoo! I remember Maddy arriving, all chatty and full of positivity. A quick thinker and a doer.
After working for this charity-based organisation for three months I was offered a permanent contract. I was coordinating 35 carers and I was determined to get this right for the team. I didn’t want them to be treated they way I was. I wanted to a do a better job for them.
Some of the team as you can imagine tested me, but over a few months we really got on well. We developed a mutual respect for each other. The team supported one another. I was able to build good working relationships, so I was able to know, week by week, who needed some extra hours, who needed to be left alone and who needed a cuppa and a chat. I built good relationships with the people we supported too. I always gave them time to talk and I listened to their concerns, acting where I could. My biggest regret was I never got to chance to leave the office and meet them all!
Sickness started to become quite a big issue. There was anxiety in the air, recruitment started to be challenging and it felt like there were just no more people wanting to work in care. I remember asking the team daily whether they could pick up more, cover an extra shift, and I thought to myself, “I’m becoming the person I didn’t want to be – nagging all the hard working staff”. It started getting harder. There was a fair bit of tension. Then it hit me… home care needed to change! I sat in an adjacent room to the coordinators, listening to them trying to cover the shifts and constantly asked when new people were going to start. I always tried to get new carers to start as soon as possible, chasing DBSs, references and getting their training sorted. As soon as you recruited, someone would leave. We all tried our best to keep the care workers, but they found working in residential care more financially rewarding as they get their hours in shifts, not paid by the contact time they were with a person. They didn’t need to use their car and therefore the cost of fuel, tires, breakdowns etc. was reduced. Working inside and not travelling around in all weathers was also a factor. The hourly rate was generally lower in residential care, but care workers weighed up the overall costs and the balance was always in favour of residential care. There were others who successfully went on to be nurses and work as assistant practitioners at the hospital. We were always pleased for the person, but wondered how we would cover them. There were times I sat at my desk and wonder, “Why do we operate like this?”. If we were a shop, workers would arrive at a set time and leave at a set time. They would be rewarded for the time they were at the shop and not paid by the interaction with each customer. I realised over time it was the way we were being paid that was causing the problems. If we were paid for contact time with the people we support, we could not offer carers anymore otherwise we would be unviable. In no other profession had I come across this. I managed social workers, nurses, podiatrists, care managers, occupational therapist and physiotherapist and they were all paid a salary and on a shift basis. Every month the Contracts Manager would come to the office and we debated the same old arguments. I remember asking him how he would feel if he was paid for the time he spent with his customers. You can imagine the sympathetic look, but nothing changed.
I was fortunate in my years working for this lovely organisation they were wanting to support my personal development I was put through Level 2 and 3 in Leadership and Management. After returning from maternity leave I was invited to do my Level 5 Health and Social Care Management. Wow – yes please! I felt like people really believed in me and I worked so hard. I had experienced some challenging situations because home care isn’t as simple as just popping in to someone’s home and saying hello. There were times where I would go home crying because the system felt broken and out of your control. The system we worked never made sense to me. Always planning a week or two ahead. The problem was always fighting the fires of people going off sick, versus planning ahead. The logical part of me said that if we allocate carers to ever visit, then this would roll forwards every week and therefore we would only ever need to cover sickness and holidays. The reality was so different. Coordinators were constantly fighting the fires, so the schedules were never planned that far ahead and it was like a dog chasing its tail.
So I’m in a position where I’d almost finished my NVQ 5 and the company I work for was like a small community. Even though the pressure was on, everyone wanted to support one another. It was at this point we were told our contract with the local commissioner was not being renewed and a new model was going to be put into place. We were informed that the local authority were going for two big providers to cover all the work in the area and therefore we would be undergo TUPE to the successful organisations. It was a difficult time for everyone as we had to keep the service going, not knowing where our futures lay.
OK – so for some time, I had been saying the system needs to change? Maybe this was it! I was encouraging people that this move was a positive one. At this point all the agencies were struggling to recruit new workers, so a move to another agency offered opportunities – higher wages for care workers which was much needed.
My role was changing. I had been identified as someone who could build good relationships with local people, commissioners, brokers and other providers known as partners. My role then became Brokerage Manager. Prior to transfer to the new organisation, it was clear we would be taking all work from the local authority and either doing it ourselves or brokering to other agencies. This was a new function that a care agency doesn’t normally do and therefore I sought the expert knowledge of Maddy to take on this role as it was something she had done already, but on a much smaller scale. Exciting stuff! This was new to me, one minute it felt like a competitive market and next it’s sitting around the table all agencies discussing ways we can improve and do better. I have to admit I enjoyed this role. I felt that I was getting people the support they needed. I was getting them back into their homes – where they wanted to be.
Only very recently, through reflecting and having an open conversation with someone I realised that even though I thought I was doing great things and securing care for people in their homes that this was still not good enough. The care we were able to arrange didn’t meet their social needs, didn’t necessarily meet their health needs. Not necessarily because the quality of the services, but the ‘capacity’ in this sector. It was all about fitting someone in, offering a slot or time. It wasn’t taking into consideration that people may have health and hospital appointments, day services, trips out with families all the things that keep people active, happier and healthier. In the early stages it was great to see the providers’ hourly rate increase and carer get more money. It was a big bonus, but it didn’t seek to address the changes that were present before the change over. The system needed to change.
So what is the answer? I’ve now been in the sector for 7 years. All I want to do is home care, but still it needs to change.
A colleague and I made the decision go it alone and felt we could improve the situation. We didn’t want to walk away, as we were passionate the system had to change. We were fortunate – or as we like to call it, it was ‘synchronicity’ – and we had the opportunity to talk the Helen Sanderson who was contemplating redesigning home care services by developing a social franchise called Wellbeing Teams, in partnership with the charity Community Circles. After our first telephone call with Helen we realised this would be innovative and risky, but what we were both passionate about and felt we had to do it otherwise we may regret not trying to improve the care to people in their own home.
We have learnt so much about what more can be done for people in their own home. Focusing on what matters to them is key and drives us forwards. Only today I realised how far I have come – a friend said his Mother had just started to be cared for by a home care agency. He told me how much she didn’t want it. He asked me about the company Maddy and I were setting up. He asked what was different between what we were doing and his mother’s care provider. I didn’t realise how much I had to say. We were walking and I felt I didn’t stop talking – the differences came rolling off my tongue. I talked about Community Circles and how we will support people in other ways, not just by providing care. I explained about assistive technology and all the possible alternatives to care such as activities with family and friends, local churches… things that people want to do. I talked about Individual Service Funds that allow people to have a budget and use it in a way that suits them e.g. someone might want to go shopping instead of having a lunch call. He said this will cause problems to which I replied “no”, as all our wellbeing workers work as a self managed team and they would make sure this happened because they didn’t need to contact a manager to seek permission. I explained that the team were supported by a coach, so if they felt they were unsure, then they were not alone. I felt so proud of how far I had come since speaking to Helen and realised how different Wellbeing Teams are to the traditional model.
We have just finished our Values Based recruitment day. I was very nervous as it was a new way of recruiting people, but we had some amazing people come and have the start of our new teams. We are all talking via a mobile app we are using, called Slack.
This has been a journey of discovery – it hasn’t been without pain, but it is important to learn from what has happened and move on. The news constantly talks about the problems in Health and Social Care and talking about more money is needed. I can’t argue with that, but just providing more money will only solve things in the short term and we will be back to square one. We need to change the way we are doing things and make sure the people are at the centre of all we do. We believe Wellbeing Teams are the answer and will more than likely save money as well.
Here is a short animation about what we are doing, but feel free to give us a call at anytime – www.love2care.uk – we know there are other passionate people out there want to change the way we deliver home care.