The chief executive of the United Kingdom Homecare Association is stepping down, nearly 21 years after founding it. Lesley Rimmer spoke to Vern Pitt about her achievements and the challenges ahead
The domiciliary care sector includes many small providers working from spare rooms and kitchen tables. In the beginning, the United Kingdom Homecare Association, which represents and supports them, wasn’t much different. “The filing cabinets came down one weekend and ended up in the garage and we converted my dining room into the office,” recalls chief executive Lesley Rimmer. Nearly 21 years later, Rimmer is stepping down from her post, which is based in an office of more than 30 people.
When Rimmer was working from her dining room the sector looked very different from today. There were fewer suppliers and they operated largely in the private market while publicly funded services were mainly provided by councils. Since then independent providers’ share of publicly funded care has grown significantly and they now control 80% of the market.
At the same time, social care has taken centre stage on the political arena. “Its rise to prominence is long overdue,” says Rimmer. She recounts that she was writing about the issues of an ageing population in the 1980s.
The changing policy environment is something Rimmer describes as her biggest challenge during her time at the association. “When we set up our disclosure service [which advises providers on Criminal Records Bureau checks] the CRB system was delayed,” she says. “We had staff in post ready for it to go live and it didn’t go live for another year or so. We had to backtrack.” She also cites reductions in NVQ funding as difficult for the association’s training programme to adjust to.
Her greatest achievements, however, have been projects that have targeted policymakers and practitioners equally. She says the association’s research in 2000 and 2005 into the profile of the home care workforce both informed providers on where to better target staff development but also educated policymakers. “We were building a picture of the sector to allow people to make informed decisions,” she says.
The area in which Rimmer feels she could have done more is in raising the profile of service commissioning. “Commissioning is central to what providers can deliver and it’s often overlooked in the way the analysis of policy is framed,” she says. “When providers are pilloried for things like 15-minute visits it’s important people know they do that because it is what they are paid to do [by commissioners].” She accepts that this message may not reach the public but she would like it to register with policymakers.
She believes the challenges of the next two decades of the organisation, which was founded in 1989, will be different from those of the previous two. She predicts that the NHS trend for assessing services against how far they deliver quality, intervention, prevention and productivity will become a major issue for home care. “It will be interesting to see how the organisation relates to that environment,” she says.
However, Rimmer says the issues of workforce development will remain as prominent a priority as they have been in the past 20 years. She has seen the role of home care staff develop in its complexity. “It’s a lot more like health than it used to be,” she says. “Pay hasn’t risen enough to compensate, in my view. If you look at all the issues of dementia, we will need more people with specialist skills and we will need to pay for those skills.”
Dealing with those issues will be left to her eventual successor. Next, Rimmer plans to tend to her garden and spend time with her family but has not ruled out a return to the sector part-time if an opportunity arises. For now, her dining room table remains clear of policy papers.
A career in caring
A graduate in economics from the University of Kent, Lesley Rimmer started her career in social care as an academic lecturing on social policy. She has sat on the Family Policy Studies Centre and contributed to Community Care during the 1980s. She was awarded an OBE for services to older people and social care in 2008. “It was really nice. I wasn’t expecting it and I was really thrilled,” she says.