Homecare: Meeting the challenge

Andrew HeffernanMembership and Marketing Director

Reconciling opposing forces

Cost focused commissioning practices

Increasing quality expectations

“Care is not a commodity”

Published July 2012 739 responses 90% of councils covered Highlights implications of

public spending on homecare services

Is “time and task” homecare dignified or personalised?

Raising awareness through the media

Commissioning short visits:73% are 30 minutes or fewer

<= 15 minutes

16-30 minutes

31-45 minutes

46-60 minutes

Over 1 hour

10%

63%

11% 10% 6%

Source: Angel, C (2012) Care is not a commodity

34% providers report dignity and safety at risk during shortest visits

27% 21% 19%

87%

6%7%

4%

England Wales Scotland Northern I reland

Providers reporting that dignity or safety are at riskduring the shortest visits regularly commissioned by their council

Dignity at risk Safety at risk

76% providers say their council puts lowest price above quality

76%60% 69%

53%

18%30%

23% 47%

7% 9% 8%

England Wales Scotland Northern I reland

Providers' perception of how their councils valuelow price or high quality more

Low price more important Equal priority Quality more important

Charge rates as low as £9.55 to £10.04 reported

12.03

17.00

14.50 15.2016.26

18.00 17.50

22.00

17.4415.35

17.21

12.77

10.50 11.00 9.99 10.76 9.9512.42 11.56 11.55 11.17 9.55 10.43 10.04

Minimum and maximum charges paid by councilsfor 1 hour of weekday, daytime homecare

(NB: Figures exclude any enhancememnts for shorter visits)

Maximum Minimum

Other key findings

53% of providers reported councilssetting maximum prices in tenders

77% of providers had prices frozen in2011-12 and 15% reported price decreases

Increasing use of “per minute” billing Lack of enhancements for short visits,

weekends and unsocial hours Only 24% of providers hold contracts with

guaranteed purchase

Impact of short visits

Shorthomecare visits bought by local authorities

Rushed, undignified care for highly dependent people

Travel time increasesas a proportion of total cost

Workers dissatisfiedwith their ability to provide care

High staff turnoverdrains skills & experience and increases costs

Potential non-compliance withNational Minimum Wage

Dissatisfactionwith homecare services andadverse publicity

But what can I do with UKHCA’s report? Understand the current and anticipated

trends in council commissioning Remind yourself how important self-funders are for your

business(!) Killer facts for pricing tenders Support your arguments with commissioners A great excuse to meet with your MP Supply the report to local journalists covering

care stories in your area

Why is quality a top agenda item?NHS and hospitals:

Winterbourne View and Morecambe Bay

Francis Report intoMid Staffordshire

Target-driven culture and failure to act on NHS mortality data

Whistleblowing and use of gagging clauses

Social care:

Dignity and nutrition reports

Meeting needs of people with dementia

EHRC report on homecare CQC homecare inspection

report

CQC Themed Inspection Report - Priority issues in homecare

Missed / late visits• Consider electronic

monitoring systems• Resist “call cramming”

Careworker continuity• Inform users of

unplanned changes• Training for coordinators

Quality monitoring• Need for QA Systems• Record and act on

feedback from users

Staff training• Performance review• Training & development

plans

UKHCA - responding to CQC’s Themed Inspection Report

Quality initiatives in progress

Openness and information high on the Government’s agenda

Provider Profiles on NHS Choices Provides a free directory listing:

NHS Choices receives >19 million visits / month No additional charges to enhance profile:

A text description of the service Images and videos; biographies of key staff Types of services offered

Profiles will be extended to offer: User reviews from 3rd party websites “Transparency measures” reported by providers Membership of organisations and quality schemes

Use your quality marks in public

Display your quality marks on your literature and website

Embed CQC’s “widget”on your website

UKHCA’s members benefit from our Code of Practice and logo

Consider signing-up for TLAP’s “Making It Real” programme

Some predictions and challenges Tough negotiations with councils

Use UKHCA costing model Use every available opportunity to engage with council Form links with councillors and MPs

Focus on quality Sign up for the “Transparency measures” NHS Choices offers excellent (free) opportunity Engage with customers and promote quality proposition

Growing interest from the media How will you respond to positive opportunities to

promote homecare and your services? UKHCA guidance on responding to negative enquiries

For more information

www.ukhca.co.uk

Thank you