The importance of home care

I have written a few times now about the need for parity of esteem between NHS workers and social care staff. Those who look after us in our homes and in care homes deserve no less, writes Peterborough MP Paul Bristow.

It was fantastic that we clapped social care staff together with NHS staff on Thursday nights. The Coronavirus emergency has helped to change attitudes.

This week, care workers and managers explained how much this change is overdue, as part of our evidence sessions at the Health and Social Care Select Committee.

Mel told me she loves her job. Yet often, she doesn’t feel valued, because she looks after clients in their own homes.

This is so wrong. Mel keeps vulnerable people safe, independent and out of hospitals. She also often helps her working-age clients to stay in a job, which is of huge benefit to them and to society.

Home care is the biggest part of our social care system – bigger than residential and care homes. It is increasingly involving administering medicines and taking decisions. Why do people still dismiss it as a low-skilled, unimportant job?

Staggeringly, Mel told me she gets comments like “you shouldn’t be wearing that in public”, with gestures to her uniform and tutting and sneering in queues. Domiciliary care workers have to wear their uniforms between travelling between people’s homes. I hope that would never happen in Peterborough.

She still recommends social care to anyone making a career choice. It takes a certain sort of person, strong but caring.

Mel and her colleagues are among our hidden heroes. They are truly some of the best among us and we need to do more on their behalf.

At present, local authorities pay a set rate per hour to cover all costs (its £17.88 in Cambridgeshire). Our City Council does its best, has increased funding by £5.7 million, and gets some impressive results. For example, Peterborough doesn’t have the delays to discharges from hospital that exist elsewhere.

Still, I’m not convinced that payment by activity is the right way to fund care. This is also a preventative service.

Because social care in the home starts early, it is the way to prevent people being moved into a care home. It is the way to prevent hospital admissions, saving money and improving outcomes.

If we commissioned for outcomes instead of hours, we could incentivise more of what we want to see. Simple things that people really value, like helping them to enjoy time going out with friends and family.

Social care often only comes into our lives after some sort of event. An episode of ill health or an accident. I remember it well with my father, who was a strong and independent man, suddenly needing support from others.

It wouldn’t be easy to design, but a system that paid for quality of life would be far preferable to paying for minutes of block time. Let’s pay providers an appropriate rate for supporting their clients out of care home and hospitals.

And if there was no stigma about needing help, might this change outcomes for those who struggle, often alone?

This is something for me, and other MPs, to push in policy circles. I’m convinced it would help those who need care, their care workers and struggling councils.

Meanwhile, let’s say thank you to those who help our grandparents, mothers and fathers, friends and some of our children, each and every day.