I really like Dragons’ Den, BBC2’s search for budding entrepreneurs. Particularly the way a pitch attempts to give a monetary value to an idea, often based on a rudimentary analysis of the target market. The recent ResPublica report on the ‘crisis in residential care’ seems to take a similar approach, suggesting that all delayed discharges from hospital could be resolved by investing millions of pounds into the residential care market.
My limited understanding of this subject suggests that this is a major over-simplification of a very complicated problem – but the underlying issue identified in the report is the declining number of people going into care homes.
However, is this a bad thing? How many people would voluntarily choose to live in a care home? There has been significant investment in home adaptations and new extra care housing over the last five years – which means that far more older people are now able to remain living independently in their own home for much longer.
Foundations’ research last year showed that an adapted home can delay entry into residential care by four years and the extra investment into Disabled Facilities Grants (DFG), as announced in last year’s comprehensive spending review, is specifically aimed at preventing even more people from needing residential care in the future.
With the DFG funding now sitting within the pooled budget Better Care Fund, it also means there is great potential for local commissioners to establish fast-track adaptation and home from hospital services that will allow many more people to go straight home.
A great example is run by Swan Care & Repair, a home improvement agency (HIA) in north east Essex. They found that many older patients in A&E fall between two support pathways: they need more than the one-off intervention provided by home-to hospital projects, but they don’t need an intensive four to six week care package offered by re-ablement schemes. As a result patients often have to be unnecessarily admitted and some have their discharge delayed because the right type of support isn’t immediately available.
Swan’s new gateway service integrates falls prevention, home from hospital and rapid response services in partnership with their own care provider Vivo Support. Handypersons and senior care workers are available seven days a week, 7am-11pm, and visit within four hours of a receiving a referral, backed up with up to six days of support at home.
At the HIA conference in April we’ll have our own Dragons’ Den of commissioners from health, social care and a charity to see how more of these types of services could be delivered in future and learn how to make a successful pitch.
Paul Smith is director of Foundations, the national body for home improvement agencies.
