Thursday, 5 January 2017

About the Care Communities project

Care Communities

A project for empowering adults in the care system
Last update April 2019

Why is there so much neglect and abuse in care homes? Why do we talk about a care system that is in deep crisis? I am a social care practitioner and writer currently researching alternatives to the failing profit-driven care model in the UK. What follows are some solutions based on my research results.  

1. The business model
The older adult/learning disability care models based on private profit-driven care chains is failing and the situation is only getting worse. Reports by the Kings Fund and other agents all point to a complete collapse of the system in the short term with big care chains pulling out of a business that is no longer profitable. Even if a new care model is implemented (e.g. the Japanese model) it would take years, and it would only address the financial aspects of funding care. Empowerment, choice and fulfilment are not guaranteed by more money. Only imaginative care projects can drive the sea changes needed in order to make the last years of our elderly really meaningful.

A nonprofit business model would allow the care concern to reinvest all surplus in improving the care provided and raising staff salaries.

Distribution of dividends from the care business is not only morally objectionable, but it is also in conflict with the Fundamental Care Standards. According to the CQC, institutionalisation is a form of neglect that happens when the interests of the care business are prioritised in detriment of the service user. It could be argued, then, that a profit-driven care business is always going to put the bottom line before the service user or, in other words, a profit-driven care business model will institutionalise service users by default.

Other existing advantages of nonprofit care concerns:
  • Can accept donations
  • Charge customers basic rate
  • Can work with volunteers

There are nonprofit care homes all over the world (including the UK) united in a basic principle of constantly improving the care they provide and maintaining the highest standards.

2. Volunteer system
Trained volunteers can help with meals, company, activities, hospital visits. And they can also keep an eye on the proper running of the home and help with safeguarding. But more fundamentally, volunteers can lighten the load of carers and dedicate time to keeping residents company. Also, they can contribute to brightening up the atmosphere of the care home. There are trained volunteers working in care homes across the country and in other countries too.

3. Intergenerational living arrangements - 
Family concept
A care home is called a home but it is rarely anybody's home. A care home needs to be a real home.
  • Some management and care staff live at the home with their families.
  • The home is open to the public and relatives are encouraged to visit and participate in the care given.
  • Some college students live and volunteer at the care home.
  • The home is a family where we care about people, so we find out about our clients and we share information.
  • Study room open to school children.
  • Games area.

4. Extra income
  • Humanitas style intergenerational living arrangements for students. Especially, medical students.
  • Side businesses such as child care, coffee shop, pool tables, fruit machines, bingo nights, etc.
  • A local charity could be set up to channel money towards the care home.
  • Funding: clients could buy into the business and relatives would sell the share to the next client.
  • Technology development.
  • Partnerships with local businesses. For example, flowers for activity sessions could be donated by a supermarket in exchange for publicity.

5. HR Strategy
  • Applicant aptitudinal and vocational tests
  • Five star hotel mind set
  • Incentives
  • Idea rewards
  • Volunteers lighten workload
  • Employee welfare strategy in place
  • Employee retention strategy in place
  • Carers are rewarded for their job both with better salaries and recognition
  • High employee turnover and lack of professionalism are addressed.

6. Management Strategy
  • Accountability and self-monitoring
  • Invite CQC to visit and inspect
  • Horizontal management style empowers staff
  • Management staff work alongside and support carers
  • Aviation industry style rewards for admission of errors.

7. Ideas for Leadership
  • Document and share
  • Learning/teaching care homes that organise exchanges with other care homes, universities and training bodies.
  • Training care homes could be set up for managers to learn.
  • New technologies are developed in collaboration with universities and private enterprise.
8. Hands-on research centre
There are academics, trusts, institutes and watchdog bodies, each churning out advice on care based on statistics and care theories. But they are not giving us anything tangible. In the whole of the UK, there isn't a single institute for elderly care that is a actually putting into practice any new or alternative models for care. We need to create a pilot care home that will try out first a bare-bones model that will work, and then implement more sophisticated ideas for excellence in elderly care.

9. Attitudes Ultimately, a nation-wide attitudinal change should be brought about by this project. We should go from an ageist model where care homes give residents only basic-needs care, where residents are allowed to wither without physiotherapy or psyschological care, to care communities where residents are encouraged to lead a meaningful life till the very last day.
Children are the future - Education
Attitudes towards the elderly need to change. School children need to learn to love and respect the elderly. Future generations need to be caring generations as a lot of jobs will be in care of the elderly.
It isn't just the Government's responsibility, we all need to help with elderly care.

  • A textbook for school children with case studies from children. How care of the elderly has affected them.
  • Work with schools and universities' careers services.
  • Invite school students to volunteer.
  • A study and games room at the home can be used by school students to do homework and socialise.
Elder Empowerment Matrix
©Alex Matthews 2017 -

Elements of empowerment

How can it be delivered?
Currently provided by care homes?
Decision power
Clients manage certain aspects of the home, such as selecting personnel.
Control over own affairs
Activities are not an end in themselves, for example, there could be a monthly menu design activity where personal preferences are taken into consideration.
Feeling useful
-Clients opinion is sought democratically before plans or changes are made.
- More able clients could have a job and earn money or a discount.
- Flower arrangement committee in charge of decorating home.
-Chicken coop, vegetable patch, etc. Produce could be sold.
Active role in society
-Nursery and study area for employee children help fight isolation and provide opportunities for interaction.
-Take part in plays or dance clubs.
Social life
-Volunteers, students, and family members are welcomed to the home.
 -Coffee shop open to the public offers opportunities for combating isolation.
Involvement in politics
Political parties are invited. Clients are encouraged to vote.
Sense of belonging
-Large dinner tables to avoid isolation and promote connectedness.
-Clients could own parts of the business.
Continuity in life environment
Family members are encouraged to visit. Friends are contacted. Pets are allowed.
Access to health care
Personal comfort
Domiciliary care agency. Care home.
Additional health care such as physiotherapy, dentist, psychologist.
-House psychologist.
- Visiting dentist.
- Exercise and physiotherapy are encouraged.
Financial security
Charity is regularly invited to help residents with queries.
Family life
Guest rooms are offered to relatives and friends.
Leisure and entertainment
Game rooms, dances, and community involvement, including local businesses.
There are key events to look forward to such as concerts, movie evenings, dances, etc.
Keeping pets
An effort is made to find a way to let people join the home together with their pets.
To be listened to
Community involvement, including volunteering.
Spiritual development
Residents are encouraged to continue practising.
Access to independent advocacy
Each client should have a personal advocate.
Access to external advice
Charities are invited to come and offer advice.

Founding principle: connecting people is beneficial to their physical and mental health. At an age when we are vulnerable, we need to come together and help each other.

  • Solidarity
  • Charity
  • Communality
  • Compassion
  • Learning
To be the leading institute for elder care in the UK. One that strives to empower older people in need of residential or nursing care in order for them to be in control of their own meaningful lives.
Some of my research sources:
  • The Wilverley Association run two residential and nursing care homes in the New Forest. They are a charity and accept donations.
  • My home life programme in the UK. They produce advice on exemplary care.
  • Solera Foundation (Spain). They run care homes, day centres and elderly hospitals. They are funded by fees and donations.
  • Canada's National Initiative for the Care of the Elderly. A project to get academics and practitioners from around the world together in order to tackle some of the care challenges.
  • The Little Sisters of the Poor in Spain run care homes funded by fees and donations. They are growing and building new care homes. They work with volunteers. They accept residents who can't pay.
  • Lares, Spain. They are a care home association. They manage to provide complex-needs care for only 420 euros a week (similar privately funded care costs £900 in the UK). They are so big they even organise care conferences. They are nonprofit and accept volunteers alongside school-trained carers.
  • Humanitas care home in The Netherlands where students can live for free if they agree to spend at least 30 hours per month socialising with the older residents.