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Key research findings regarding domiciliary care

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•         People want flexible, reliable and responsive service

•         There needs to be more constructive dialogue between commissioners and providers

•         The views of older people need to be heard and taken into account

•         Time-task care plans undermine choice & control. Need to shift to outcomes (as defined by older people)

•         An enabling/reablement approach is needed

•         The service needs to be funded properly

•         Workforce strategies are needed across agencies – commissioners should specify standards including level of wages, expenses and other conditions of service

•         Outcome focussed and person centred care largely equates to a flexible, reliable andresponsive service

•          The views of older people and their families can conflict, but supporting family relationships is central to providing quality care  – staff need training and support in this area

•         Personal qualities of frontline staff often more important than competencies

•         Frontline staff are generally undervalued and their needs are not often considered.

•         Frontline staff often do not have a clear understanding of their role and purpose

•         Agency and staff ethos and values are more important than policies and procedures – a kind ‘can do’ approach is needed

•         Continuity of care workers (small numbers) and the associated relationships with the older person are of fundamental importance

•         Local authority provider have the general advantage of having more time and higher levels of funding – pay and working conditions of staff important

•         Micromanagement of provider agencies by commissioners and frontline staff by provider agencies is unhelpful, time consuming and expensive

•         Local authority pre-occupation with only meeting eligible personal care needs can be controlling and destructive

•         The most common unmet aspiration is to get out – hence the need for domiciliary care to link up more effectively with day services and community based support

•         Recognise and value the workforce

•         Enhance the role of the workforce in assessing needs, planning, co-ordination, reviews and working alongside others

•         Address the workforce implications of developing integrated services

•         Support the workforce in delivering outcome and person-focussed services

•         Care Council Wales working with Skills for Care and Development should review the NOS, QCF, training and skills for commissioners, service managers and frontline workers to effectively underpin outcome-focussed working

•         A step change in collaborative assessment and care planning is required - involving service users, carers and the workforce on a daily basis – not all down to the social worker

•         Standardised processes and documentation in assessing, reviewing and delivering outcome-ocussed services are recommended.

Summary of findings:

·         80% of people were positive about their experience

·         Conversely, 20% indicated that they rarely or never receive good care
Things people valued most

·         A listening approach that led to flexible and responsive support

·         Staff who went the extra mile

·         Continuity of care staff
Things people did not like

·         Lack of expertise in dementia care

·         Not having enough time to provide appropriate care and support

·         Lack of continuity of care worker

·         Poor communication regarding service changes

·         Service providers need to engage directly with service users - rigid time task care plans drawn up by social workers need to be more flexible and outcome focussed

·         Continuity of care is important

·         It is not acceptable that almost 10% of people rarely or never have as much time as they need with their care workers

·         People need to be able to voice their concerns and access independent advocacy - we could work with newly established advocacy services in Swansea (e.g. Age Cymru Swansea Bay)

·         Frontline staff need to be able to voice their concerns if they know that older people are not satisfied with their service

·         We need to monitor effects of austerity measures - particular concern about decrease in number of people receiving 5 hours of care or less and 20 hours of care or more.

·         Staff need to be better trained in supporting people who are living with dementia

 

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Hilda Smith: a tribute by the Chair of the S Wales Area Committee, the Co-operative, 9 April 2013

As I’m sure you are all aware - with the death of Hilda Smith last month at the great age of 94 - Co-operation has lost a great advocate and worker. Hilda was a former member of this Committee and in such circumstances members would normally take the opportunity of a Committee meeting to pay tributes.

Our circumstances on this occasion are rather different as we have Hilda’s son David as one of our current members.

David has intimated to me that he has been very touched and moved by all the letters and cards of sympathy he has received from Co-operative colleagues expressing sadness at Hilda’s passing and for the wonderful contributions she has made.

He does not feel that he could emotionally cope with a series of tributes this evening and in these circumstances what I propose to do, as Chair, is to make a SINGLE tribute on behalf of us all, followed by a period of silence during which we can all privately reflect on Hilda as a person and a co-operator.

I have known Hilda for getting on for 20 years –not as long as some on this Committee have known her – but still a long time. When she joined the South Wales Committee of the Co-operative Group, I think in 2009, she must have been by a long stretch, its oldest “new” member, although she had been a member of many co-op committees before.

She was very active in what can now be seen as a golden age of Co-operation in the 1930’s and was particularly engaged in the campaigning illustrated in the wonderful films of the London Co-operative Society, with themes of Internationalism, Education Pacifism and Feminism. We have to remember, Hilda was not all that far behind the Pankhurst’s and she was born just after the ending of the First World War.

As many of us know, Hilda was completely passionate about what she believed in and was always a strong advocate for the same.  She was always a master of her brief and fastidious in studying her papers and making reasoned and detailed contributions.

She had a powerful intellect but was still very interested in making practical observations about what a store should stock, what services it should give to the customers/ members and how they could be engaged at shop level.

I remember her observing back in the early days of Recession, that the support work of the Co-operative Group, through such things as the Community Divided Fund would become far more vital, as Public Expenditure Cuts bite and she is being proven right.

To think when she arrived in South Wales in 1986, she did not come for a rest, because at the age of 76, she set about with vigour in a whole new co-operative and mutual scene.

 She was instrumental in establishing the Newport University of the Third Age, The Wales Food Alliance- together with David – which had a number of collaborations with the Group. She was a member of the WG Older Persons Advisory Committee and made a considerable contribution to policy formulation. Of late she has been engaged in modelling social enterprises to deliver home care.

I last saw Hilda at the Members meeting last year at St Fagan’s, when the meeting was somewhat hijacked by Disability Rights Protesters.  I will remember her contribution for a very long time. She was not prepared to sit idly by but rose to make an impassioned speech about how Co-operatives had been at the forefront of protecting and promoting the rights of the disabled for getting on for 100 years.

David, Hilda was highly principled, creative, dynamic not just a thinker and dreamer about the Co-operative Commonwealth but who has actually contributed to help make it happen over 60 or 70 years.

We are all the better for knowing her and she has left you with much to live up to!

Brian Rees

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