18 February 2019
Kate was born in 1919 and in 2006 was living alone despite being frail and having impaired memory and eyesight. A fall had convinced Kate and her family that she needed to consider care support. Kate had enjoyed living in her bungalow for many years and the option of moving into a care home did not appeal, so with support from a Social Worker a Live-in Carer Service was investigated.
The evidence showed that it was an option that might work, and Kate was able to secure State funding to help pay for the Service. The Live-in Carer Service was personalized to Kate ensuring that her domestic needs, personal care support and social activities would be provided as Kate and her family wished them to be.
Thirteen years later Kate is still happily in her own home, supported 24/7 by Able Community Care and the Live-in Carers she has chosen.
The above illustration, and there are many more, is an example of the current phrase ‘person centred care’. The definition of which is “Treating people with dignity and respect by being aware of and supporting personal perspectives, values, beliefs and preferences.”
Person centred care in 2019 does not give people like Kate or individuals who need less support, the choice to choose.
There are several reasons, the first is financial, the funding to pay for 24/7 care unless there is a substantial or critical need for care (short term by definition) is usually not available. Low or moderate care support is now rarely funded.
Secondly, Councils have brought in Approved Provider Lists from which care support with council funding can only be purchased. There are many care providers who do not wish to work with councils, this can be evidenced from the number of contracts which have been handed back in the last two years. Many providers, such as my organisation, no longer work with councils for several reasons, time delays in getting decisions, information, late payments, nebulous support when a care package was up and running and reviews/meetings/support were needed but were not forthcoming.
As a result, if this were the case in 2006, Kate could not have chosen her preferred provider but would have been told ‘which providers she could choose from’. If Kate was applying in 2019, a list of residential care homes would likely be offered.
In the instance where care support is needed and an agreement has been made to fund, it is possible to request Direct Payments which give an individual the funding into their bank account allowing them to purchase their care from whom they choose. Many older people and their families are not advised of this fact.
The current State funded care system is dividing the population into two, those who can pay and so have choice and the state funded sector who have little choice and are being told who will provide their care support for them.
Kate and others like her, are the lucky ones.