When brokerage gives short change
Devon Council is using personal brokerage in order to cut costs (“Going for broke”, 11 September, www.communitycare.co.uk/109326). The brokers cannot seem to get it right there are cases where the service users have been through the system several times because the brokers do not appear to have a clue as to what the individual service user wants or needs. Devon’s brokerage seem to have two goals in mind:
- To gain the cheapest deal going, whatever the cost to the service user, and
- To meet their own targets.
The personal brokers have experience only of elderly care, they have not received transition training for Learning Disabilities. Ideally they would need to have worked as providers or managers of care homes to fully appreciate the costs involved. The brokerage system is generic it is not tailored to each type of service.
Some service users are very vulnerable, have high anxiety levels, and are very complex individuals. Their cases therefore involve higher costs per user. Devon seems intent on accepting the lowest quote for every service user’s outcome statement regardless of the levels of care required.
Most clients with learning disabilities average out at a weekly rate of £2,100, yet councils are asking for the lowest possible quotes. Devon seems to average out at about £800 per week as the highest the lowest we have seen is £200 per week. Devon Brokerage is short-changing the service users – the people they are supposed to be helping.
Devon Brokerage does not seem to be adhering to the NMS, there is no initial care manager visit to the home, no series of visits by the service user to see if they like the new home. The family of the service user is now expected to visit each home on the shortlist provided by the brokers, their decision is then given to the brokers who may or may not accept it.
The family then have to go through the whole process, giving information to the brokers and care manager, the outcome statement is produced and then the providers are contacted by internet to bid as on E-Bay. This is what brokerage has developed into.
J Marks, Devon
Wales: disabilities plans are troubling
Some of your readers may be aware that large residential health facilities for people with learning disabilities are opening in Wales. It is the view of Learning Disability Wales that such developments run counter to Welsh Assembly Government policy which needs to be explored and if necessary challenged. A campaign group has been established and is seeking the following information:
- How many such facilities have been opened so far in Wales?
- How many people are being accommodated?
- What statutory authorities are buying places in them?
- What quality assurance measures do they have?
- Which external bodies are monitoring them?
- Are quality monitoring reports available for public scrutiny?
- What evidence is there of regular access and involvement from family members?
If any of your readers can assist in providing this information or would like to register their details, to be kept informed of this work, please could they contact Kai.firstname.lastname@example.org
Adrian Roper, chair of Accommodation and Support Committee, Learning Disability Wales
Don’t blame the private sector
It is disingenuous to suggest, as Peter Scourfield does, (4 September, www.communitycare.co.uk/109320) that private sector homecare providers wilfully choose to turn down contracts.
Quite the reverse is true. It is a last resort and they only turn down contracts when care becomes wholly uneconomic to carry them out. The root of the problem is not with providers, but with local councils who have made it increasingly unviable to do the work. Do the maths: councils’ in-house teams have an average gross hourly cost of £21.53, while they pay a gross hourly average of just £12.19 to the independent sector.
It is telling that we currently see a picture of councils divesting themselves of in-house provision, or turning their in-house teams into specialist services.
Councils quickly absorb the increasing costs of their in-house teams, while at the same time their employees are free to take industrial action to seek improvement in their pay and conditions. Staff employed in the independent sector do not take such action.
When the sector is squeezed it becomes less and less economically viable to undertake the work. This is not just a short-term problem, but one that impacts on the capacity of the sector in the longer term, just at a point when an ageing population will need more care services, not fewer.
We are all committed to providing professional care to those who need it most and to ensuring that we can do that in a sustainable way, as future demand increases. A fair price for care, recognising that all of us – public sector and private – are facing the same increasing burdens, is not too much to ask.
Mike Padgham, chair, United Kingdom Homecare Association
Disrespectful kids… go on, surprise me!
On the subject of the Redruth curfew, (11 September, www.communitycare.co.uk/109341) Ray Jones should remember that children of 40 years ago were taught manners and to respect adults. You cannot compare the young people of today – it’s a different era.
I mentor difficult young people. On initial contact we have to establish rules about not swearing, not making put downs, and saying please and thank you. Forty years ago you would not need to establish such protocols.
Secondly, everyone knows the younger you are the more sleep your body needs to grow, rest, develop. Unfortunately now everyone has the trendy idea to let kids decide their own bedtime.
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