Ethical Care Standard – a cooperative approach – Oldham Council

Posted on 19th May, 2014

Oldham Council is seeking to drive up standards in home care by taking a leadership role in shaping the way services are designed, delivered and accessed.

Why do we need ethical care?

Increasingly more frail elderly people live at home, and need high levels of good quality personal care to help them continue to lead an independent life.  Providing care is a skilled and demanding job, one which requires high levels of personal integrity.  To save money Councils and NHS increasing rely on care agencies to deliver this care on their behalf.  Most are private companies, some are charities.

We feel it is up to the Council to take a lead in setting ethical standards for the delivery of high quality care.  These standards need to ensure that the care is focused on the customer’s needs and guarantees a good quality of care that pays proper regard to the dignity of the individual.  Equally to ensure we attract and retain the right staff to work in care, we believe they should be fairly paid and treated, encouraged to gain qualifications and improve their levels of skill expertise.

To make this all happen, we need to encourage reputable care agencies to work in partnership with the Council and give proper incentives to ensure that they are judged on quality and not on price.

What are the key features of Oldham’s approach?

  • The customer can choose the care provider of their choice
  • If the customer asks the Council to arrange – we only use good or excellent care agencies.
  • All care workers must be paid at least the Oldham Living Wage, currently £7.22 per hour.
  • Staff must also be paid travel time in between individual visits to customers.
  • The vast majority of staff need to be employed on proper contracts not on zero hour arrangements.
  • Those care agencies with the highest level of qualified staff are given preference.
  • Those care agencies with the highest customer satisfaction rating are given preference
  • The customer and care agency can agree and vary the times and length of care each week.
  • There are no 15 minute minimum call times, except where customer and care agency agree.
  • The Council pays for every minute delivered, so there is no incentive to cut the length of calls.

How will this approach guarantee quality of care for the customer?

The key element is that the customer retains control of who provides their care.  So if anyone is dissatisfied they have the ultimate sanction of choosing another agency.  Most people look to the Council to help them choose a care agency.  We can now tell which companies have high customer satisfaction levels as our staff have undertaken taking hundreds of satisfaction visits to customers’ homes over the past 2 years. We can confidently rate care agencies as excellent, good, adequate or poor and we intend to publish and update these scores every quarter.

How will Ethical Care benefit the employee?

We recognize the real difference that experienced and skilled staff make to the quality of care.  We want to enable companies to recruit and retain experienced and trained care staff, and treat them fairly.  We will ensure that all the companies that the Council contract with pay their staff a “living using zero hours contracts for permanent staff.

What’s in it for the care provider?

When we consulted with our existing home care providers, they told us that they wanted to pay their staff reasonable pay and conditions, but felt compelled to offer much lower pay rates because of the cut throat nature of tender processes.  Most agencies agreed with the Council’s approach to tendering entirely on quality for a fixed hourly fee of £12.60 per hour.

When asked what would make their business more efficient, many companies asked for greater flexibility and some incentives to help people live more independent lives.  The new approach will give the care provider a block of hours over a 4 week period, which they can agree how best to use these hours with the customer.  Safeguards will apply where the customer lacks mental capacity, but most customers also want more flexibility to make changes to their usual pattern of care when it suited them. For example in the week before family or friends come visiting they might more hours of help to get their home ready, but they would correspondingly less in the week when family and friends were present to help provide some of their care.

The Council will also be offering an incentive to those companies that are able to help people do more for themselves, by offering to share any financial saving from Reablement with the care provider on a 50/50 basis.

How will we know if we have succeeded?

We expect that customers will see their service improve, and satisfaction scores will rise.  We hope that better pay and conditions will lead to lower staff turnover and an increase in the proportion of staff that are qualified.  We believe we have offered a fair contractual offer to the care agencies and that we will see more stability and better partnership working between the care agencies and the Council.

To discuss Oldham’s Ethical Home Care Standard, please get in touch with Paul Cassidy, Director of Adults and Children’s Services, who can be reached at Paul.cassidy@oldham.gov.uk