Download - Homecare: Meeting the challenge
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Homecare: Meeting the challenge
Andrew HeffernanMembership and Marketing Director
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Reconciling opposing forces
Cost focused commissioning practices
Increasing quality expectations
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“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?
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Raising awareness through the media
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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
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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
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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
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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
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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
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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
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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
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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
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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
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UKHCA - responding to CQC’s Themed Inspection Report
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Quality initiatives in progress
Openness and information high on the Government’s agenda
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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
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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
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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
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For more information
www.ukhca.co.uk
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Thank you