New home care models across the UK
Project Background
Across the United Kingdom, home care services provide vital support which enable people to remain living in their place of choice within the community and for them and their family carers to have a better quality of life. The traditional model of home care has been based on ‘time and task’ models which provide little certainty and flexibility for the home care organisations and their staff. In two areas of the UK, Gwynedd (Wales) and Leeds (England), commissioners of home care have sought to introduce a new model of home care commissioning based around neighbourhoods.
Demonstrator projects worked with Leeds and Gwynedd to support them using these new models of home care as the foundations for radical change in how support was delivered and the outcomes which were achieved. They initially used a recognised model of change (ADKAR) to consider the progress of the change, and then developed a tailored process to be used within social care change.
The Change Process
Gwynedd Embedding Home Care Redesign
Gwynedd Social Services (Adults, Health and Wellbeing Department) had embarked on a new person-centred model of domiciliary care delivery and were about 6 months into delivering the new model when IMPACT started working with them. Initial intentions were for the Demonstrator project to support shared learning of best practice across teams to improve service delivery. The change had not yet been embedded operationally, and it quickly became clear that there was a disconnect between Contracting, Operational teams and the team responsible for transformation, the Supporting Health and Wellbeing Service, who, from the point of rollout, were left without full oversight and with unclear accountability boundaries. The operational teams, and their leadership, needed support and resource to fully adopt and move towards embedding. Internal project management resource that had been intended to support adoption had ended up being needed for fire-fighting, and therefore it was agreed to focus the Demonstrator on supporting workforce engagement with the change and on developing collaborative ways of working to move delivery of the new model forward. The IMPACT project hence focussed on Organisational Development aspects of workforce development in Social Care; enhancing workforce experience through supporting practitioners and leaders, and fostering collaborative working between the commissioners and statutory, voluntary and private sector stakeholders. Challenges remain about the future embedding of the improvement work carried out during the Gwynedd Demonstrator project.
Leeds Transforming Home Care Project
Leeds City Council had been proactive in seeking a range of support for the deployment of a new model of home care. The culture was of readiness to change, and resource had been allocated to support engagement and involvement across a range of partners. The Demonstrator project started at the point a procurement exercise that was in the final stages of development and a Citizen panel, held in preparation for this, was an obvious priority to recommence to support the change. No particular resource had been allocated to the panel and therefore it was agreed to focus the demonstrator on moving from a consultation to an improvement way of working and recruit additional citizens to move this forward.
Several evaluation reports had been written between 2021 and 2023 which were used to build on existing knowledge and strengthen insights using up to date published literature.