village companies

Older people want to be cared for at home. Micro-providers are the answer

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Gore Vidal famous said something along the lines of: “Every-time a friend of mine succeeds something inside me dies”. I felt that sentiment for a few moments before vigorously applauding the fact that someone has pulled off something akin to my idea of a village company. This article, tells us of a hugely exciting achievement in field of rural micro-care for old people. It explains:

Dutton [the founder of home care service] was inspired – and set up her micro-provider business a year ago with the help of Community Catalysts (CC), a social enterprise that helps people to develop grassroots solutions to address health and wellbeing needs. She found out about the organisation through her GP. It took her through the basics of setting up a business, helped her with insurance and criminal record checks and even gave her a grant to buy cleaning equipment. It also introduced her to the village agent, local social workers and other nearby micro-providers so that they could pass on referrals and provide holiday backup.

What CC is achieving in west Somerset is quite remarkable. In 2014, despairing of getting any established homecare provider to run a reliable service in the area, Somerset county council put up £75,000 a year of pooled council and NHS money to see if CC could spark development of small-scale enterprises to plug the gap. The gamble has paid off.

Given a target of 50 micro-enterprises, providing paid employment for 80 people, CC achieved 133 businesses and 180 jobs by the end of the initial two-year contract in November. Since then, the numbers have risen further to 173 social enterprises, providing 220 jobs and supporting a total of 700 older people. “The return on investment is phenomenal,” says Stephen Chandler, Somerset council’s director of adult social services.

UK care home sector ‘could lose 10% of beds in five years’

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I really am worried about the implications of this perfect storm of reducing budgets and increasing costs in terms of the likely availability of rural places for vulnerable elderly people going forward. This story tells us:

Almost one in 10 beds in Britain’s care homes will disappear in the next five years because of the financial crisis facing the sector, leaving the NHS to pick up a £3bn bill, a damning new report predicts.

As many as 37,000 beds, the equivalent of about 1,500 care homes, could be lost by 2020, according to the thinktank ResPublica.

Elderly residents would have to stay in hospitals instead, the report says, where they would take up one in four beds.

The findings underline the scale of the problems facing the care home sector and the potential cost to the NHS. Leading operators have already said they will close or sell homes if the chancellor fails to provide more funding in his autumn statement.

Care homes are being squeezed by a fall in the fees that local authorities contribute to residents’ care and a rise in staff costs. The latter will increase further when the “national living wage” comes into force next April.

The ResPublica report, which is backed by the GMB trade union, says the care home industry will have a shortfall in funding of £1.1bn by the 2020/21 financial year, with £382m linked to the costs associated with the introduction of the national living wage.

It says the industry can no longer cope with the failure of a major operator, as it did in 2011 when Southern Cross, the country’s biggest care home group, collapsed and rival operators took control of its homes.

MiHomecare: One of UK’s biggest care agencies being sued for paying below minimum wage

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This shocking story, based on seeking to deliver crucial life enhancing support to people on the cheap, eloquently makes the case for the mutualisation of rural domiciliary care through village companies. I can offer more insights if you email me. It reports on a tribunal case in terms of pay and conditions for a dom care worker…

The case is the first time a major care provider has been taken to court for its failure to cover travelling between appointments.

MiHomecare is the fourth-biggest home-care services company in Britain, employing around 4,000 staff in 38 branches. If successful, this case could have implications for thousands of its employees, as well as care workers in other companies.

It is estimated that 883,000 people receive care in their own home in the UK with more than 500,000 people employed in the sector. Lawyers say the number of potential claims could run into thousands, costing care providers millions of pounds in unpaid wages.

Caroline Barlow, 56, from Devon, who issued the claim at Bristol Employment Tribunal, worked for MiHomecare looking after elderly, disabled or infirm patients in their homes. Despite the fact that travelling between appointments was an integral part of the job in rural Devon, she was only reimbursed for her petrol and not paid for her time. She reported the issue to HMRC, which is still investigating, but  has now decided to take legal action herself.

 

Is NHS being overcharged by agencies – or are staff shortages the real issue?

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My village companies idea has identified a clear pathway for rural communities to mutualise their home care needs for vulnerable people. In our model they can pay well over the minimum wage to employees on contracts, with holidays, pensions and training and still retain a small surplus to reinvest in improving the quality of life of their residents. All of which suggests there is “another way” with many NHS costs. Makes you think in the light of this article.

So why is so much being spent on agencies?

Monitor found that overspend on agency staff arose from a need to “cover vacancies and unplanned demand”. Foundation trusts have consistently cited recruitment difficulties, particularly in qualified nursing and medical staff and in accident and emergency, the regulator said.

Trust pays an agency nurse £2,200 a day

This story is absolutely shocking. Its not an isolated event. At a more prosaic level if the average hourly fee for home care is £16.80 how is it that those delivering it in some cases get the minimum wage minus their travel costs? There is definitely a “third way” outside of state and private control and that is further delivery of non acute services at least by place based mutual. I have demonstrated how the formation of village companies can deliver surpluses, allow longer average visits and pay the living wage plus travel to locally recruited care workers to those in receipt of domiciliary care. I think there is loads more scope for rural innovation in that context and in relation to other rural health services. Watch this space! In the meantime…..

An NHS hospital has been criticsed for paying an agency nurse £2,200 to work a single 12 hour shift.

The record sum – a rate of £183.33 an hour – was paid by Shrewsbury and Telford Hospital NHS Trust, a Freedom of Information request has disclosed.

Last month an investigation found trusts paying nurses rates of more than £1,700 per shift, amid spiralling staff shortages, and an increased reliance on workers from overseas.

Co-ops help bring economics back to the people

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From European movements such as Rescoop to Manchester’s own Unicorn Grocery, this article recounts the contribution of cooperatives in meeting economic and social objectives and highlights their resilience in the face of the financial crisis. With community cohesion a central theme within the ‘big society’

Cooperatives provide a potent option for the development of community facing local initiatives which replace our dependency on the local state. Happy to share my ideas for village community coops off line if people are interested.