The Care Quality Commission (CQC) recently conducted a survey in which 84%
of the survey’s respondents said that choosing care (whether home care or
residential care) for an older relative was stressful. I’m not sure that
finding exactly breaks new ground. It is more an affirmation of what we know
from our own experience or the experience of others who have sought care for
loved ones. And even if you have no experience of finding care for a relative
the CQC’s finding will hit you as being intuitively correct. Even the most
pleasant of life’s events are stressful. Finding care for a relative does not
fall into the category of pleasant events; therefore, it is of little surprise
that we find it so stressful.
The
CQC,
incidentally, is the independent body that regulates health and social care in
England. The survey was conducted during the period 7 July to 19 August 2014
and was prepared by Mumsnet for the CQC. All 259 of the respondents were users
of
Mumsnet or
Gransnet. You can read the full report
here.
The survey’s publication coincides with the announcement from the CQC of the
changes to its inspection regime for care homes and adult social care
providers.
The survey also offers some useful information about what is important to
people who are looking for care for a relative. There are a number of factors
that the survey shows are of critical importance to most people looking for
home care. I don’t think that this was intended to be an exhaustive list. There
may well be other factors that you might add to the list. The factors discussed
below just happened to be the ones that the survey chose to ask respondents
about the importance that they would place on each of them. Let’s examine these
factors.
Finding a homecare services that offers a choice of times for visits
It offers no surprise to me that
92% of respondents thought that this was a very or quite important factor when considering
choosing a home care provider. Domiciliary care provides some very distinct
advantages for its recipients. Not least of these advantages is that home care
allows you to remain living independently in your home and to continue with
your own routine. If, however, you are told that you cannot have the times you
want for your calls the effect can be to disrupt severely the routine you are
used to.
It is necessary to be realistic and
reasonable when considering the times that visits can be arranged. A good home
care provider will always go the extra mile to give its customers calls at the times
that its customers want. Why wouldn’t it? That is good business practice and
good customer service. Sometimes, though, there will be operational and
logistical challenges that make it next door to impossible to satisfy every
customer with calls down to the minute.
What is quite unreasonable, though,
is for providers to dictate the times that customers can have calls. Worse than
this, I should suggest, is for providers to dictate that calls will fall into a
designated time slot that might span 2 or 3 hours.
Every home care provider has times
in the day that might be considered pinch points: mornings between about 7.30
and 10.30 would qualify as pinch points for most providers. If every customer
wanted a call at, say 8.00, something would have to give. Of course, in
reality, customers, thankfully, do not all want the same time. Therefore, it would not be unreasonable for
providers and customers to work out a schedule that allows most (if not all)
customers to have a call within 10-15 minutes either way of their chosen times.
Finding a homecare service that
provides a choice around male and female carers
It is
not unusual for customers to specify their preference for a carer of a
particular gender. In my experience, it is more likely to be that case that a
female carer is preferred – often, but not exclusively, by female customers.
This is especially the case where personal care is involved. In the survey, 69%
of respondents thought this was a very or quite important factor when
choosing home care.
I think it is understandable that
customers will have a preference for the gender of their carer. It may be a
request that some providers are uncomfortable about acceding to – and I can
understand that. However, where possible I don’t think it is unreasonable to
offer this choice to customers. It’s also important that carers are not placed
in situations that may be acutely uncomfortable for them.
Finding a home care provider that works well with other agencies and
individuals
The precise wording of the question
that the survey respondents were asked was: “How important or unimportant would
you find the [following factor]: Finding a homecare service that works well
with other services that are involved in the care of my parents, spouse or older relatives e.g. dentist, GP practice or social
worker”, and 88% of those respondents thought that this was a factor that was
very or quite important to them.
When you
think about it, carers have a role that is of central importance in the lives
of their customers. Amongst a very large number of other people involved in the
care of any particular individual, it is likely to be that person’s carers who
have the most contact with him or her. In some cases, this contact can be
several times a day 7 days a week. Little wonder, then, that the ability to
work well with other agencies is regarded as so important.
And working well with these other agencies and
individuals often comes down to communicating with people. The ability
of human beings to use language is one of the things that separate us from the
animals. I know that we are told that other animals can communicate, but none
have produced the equivalent of the works of Shakespeare.
We human beings have this wonderful tool that we call language. With
language: we talk to each other, we listen to others, we text each other, we
use email and snail mail, we have social media presences and we read books,
watch television and listen to the radio. None of those things would be
possible without language. And yet so often we communicate so poorly with each
other.
Finding a home care provider that communicates with key people in the
customers life
As in the factor above the exact
question was slightly longer. It read: “How important or unimportant would you
find the [following factor]: Finding a homecare service that communicates with
me effectively by keeping me updated on my parent/spouse/older relative's care and involving me in decisions.”
This time 93% of respondents thought that this factor was very or quite
important for them.
The
person who is being cared for has to be at the centre of everything that a home
care provider does with regard to that persons care. However, it is very often
the case that there are other people in the customer’s life who need to be
consulted and involved in the care of that person.
It goes
without saying that providers must comply with the obligations of
confidentiality that are placed on them. However, these obligations are
manifestly not there to prevent significant people in the lives of customers
being reasonably involved in the care being provided to those customers.
Finding a home care provider that
treats customers as individuals
This question asked: “How important
or unimportant would you find the [following factor]: Finding a homecare
service friendly, compassionate and well trained staff that treat my
parent/spouse/ older relative as an individual, spend time with them and take
into account their likes and dislikes when providing care.”
I doubt that anyone will be surprised that 97% of respondents considered this
factor to be very or quite important.
There’s
a lot in that question, but essentially it reduces down to that fact that
everyone is different. There is no one size fits all with care. The very
highest standard of care can be achieved only when it is recognised that each
customer has his or her own requirements. And it’s not always possible to find
these out immediately.
Home
care providers will assess an individual’s needs and find out as much as
possible about him or her prior to care starting. But it’s virtually impossible
to discover everything immediately. And the truth is that providing care is as
much about building relationships with customers as it is about the delivery of
the technical side of care. Relationships evolve and as they do carers find out
more and more about an individual’s preferences. Much of this is about carers building
trust and confidence with their customers.
The very
best carers have outstanding interpersonal skills. In my experience, those with
the very best interpersonal skills have something that just comes naturally to
them. These are the people who, when their natural ability is combined with
first class technical ability, make outstanding carers.
Finding
a homecare service which provides specialist care for people with dementia (or
similar conditions)
At first
sight, it seems odd that just 71% of respondents thought that this was a very
or quite important factor to be taken into account when considering home care.
On reflection, however, it is understandable. In many cases, people may be looking
for care that is fairly general. The relative for whom care will be provided
may have no specific condition and the care sought may be quite generalised
personal care, companionship or other type of care.
However, where your loved one has a
specific condition it follows that specialist care will assume far greater
importance. In such circumstances, it is highly probable that you will want to
find out a little more about the training and experience that potential carers
have.
In Summary
I
think that what the survey tells us about the factors that are important to us
when choosing home care can be summarised succinctly as providing choice,
meeting needs and respecting individuality. We are all different. A generic
care template is a thing of the past. Individualised care is not just what we
all want; it’s what we should all be entitled to.
Garry Costain is
the Managing Director of Caremark Thanet, a domiciliary care provider with
offices in Margate, Kent. Caremark Thanet provides home care services
throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email
garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.
