How do we fix a care industry on the brink? Put people first

Care is in crisis.  This is not an idle soundbite. According to Age UK, the care system will start to collapse in 2017.

At a high level, the problems seem simple. Demand for care is increasing, while funding is being cut. We have an ageing population and there are more people with long-term conditions such as dementia. Incredibly, despite increased demand, local authority spending on care for older people has fallen by 17 per cent in real terms since 2010. They call it Austerity.

Care providers are being asked to do more for less – and they are finding it tough. Providers are withdrawing services or not bidding for financially unviable contracts. In some cases, they are going out of business. The private sector can no longer make enough profit to stay interested and local authorities have moved away from delivery (often for good reasons).

The issues go beyond demographics and economics. I’m not pointing the finger of blame at anyone – this is a difficult issue. There are wider systemic and cultural issues at play.

But it seems clear that we have commoditised care. And by doing so, we have devalued it.

We commission the shortest care visits possible – one in five councils in England are still commissioning 15-minute social care visits. And we pay our carers as little as is legal. One million frontline care workers received a pay raise with the introduction of the National Living Wage. Are humans equipped to care or feel cared for in 15-minute bursts? It’s not a system you would design from scratch. It is the sort of system that evolves through decades of hard choices.

It is hardly surprising that carers are turning their back on the sector. The chair of the Homecare Association reports that 900 staff are leaving the sector every day. As I write, there are 85,000 unfilled vacancies in the care sector in the UK. We do not have enough carers and those we have are leaving. It sounds bleak doesn’t it?

But there is some hope. And social business is leading the way. Big Issue Invest’s mission is to eradicate poverty in the UK and in doing so help the most vulnerable. Social care is one of key areas we look to invest in. Over the past five years we’ve invested over £4m in 10 social enterprises delivering adult social care. Our investees are making it work – delivering the impossible – more for less. Although they operate in different areas and geographies their success seems to be built from one key understanding. It’s all about the people.

Speak to Geoff Walker, CEO of charity Sandwell Community Caring Trust. He’ll tell you there are two key indicators he monitors in his social business: staff turnover and staff sickness. He’s measuring how happy his staff are. By striving to keep these KPls low he isn’t just keeping them happy, he’s saving enough money to make it work financially. By reducing staff turnover from 40 per cent to 10 per cent, Sandwell recruit 200 fewer staff a year – cost and time that can be focused on providing care. Things like providing training, improving the continuity of service and asking the cared for what they think of their service. By reducing staff sickness, he reduces reliance on expensive agency staff.

It’s an approach that requires invest-ment. It means treating carers decently. You need to pay them as much as you can, give them extra holiday and benefits, give them good training. You need to listen to them and involve them in the governance of the business. The financial savings will come. It can make a low-margin business sustainable. Make the impossible just about viable. With that, the provider can focus about things that really matter – the quality of care.

And then, chief executives like Geoff at Sandwell will talk more about his employees. He’ll talk about the bonds the carers form with the people they care for. He’s talking about the types of human emotions that make life worthwhile. Friendship, even love.

He’s talking about caring.

By Daniel Wilson-Dodd, Investment Director at Big Issue Invest – this article appeared in The Big Issue magazine.