Councillor Paul Bell
Labour Cabinet Member for Health & Adult Social Care in Lewisham talks about transforming homecare to wellbeingCllr Paul Bell discusses Lewisham’s approach to enhancing wellbeing at home.
Social care is the Cinderella service. No one wants to talk about it until they need it or have a relative in the care system. Yet, the delivery model is one of assessment, the procurement of providers and the operation of a rota where underpaid staff go from one client to another, often not paid for their travel time or travel expenses. This is a transactional model, not a wellbeing approach.
Lewisham is changing this context. Instead of homecare, we are introducing Maximising Wellbeing at Home. A holistic approach where the person, council, provider, Wellbeing Worker and Unpaid Carer work together to deliver a wellbeing service.
Implementing the Fair Cost of Care uplifts early, we procured four lead providers working exclusively in separate neighbourhoods with smaller providers. We call this the neighbourhood model. The model has principles running through it. These principles are centred around embedding the voice of people with lived experience. The cared-for will interview their teams of Wellbeing Workers and choose who comes into their homes. The provider will have to comply. It will not matter who you work for as each Wellbeing Worker’s pay and terms and conditions will be the same. This is Proud to Care.
The service management and the wellbeing teams will be required to meaningfully involve people with lived experience and unpaid carers in the service delivery. The rationale is to ensure we embed the person-centred, outcome focussed process into wellbeing. All providers will also have to be CQC rated as good or outstanding and within three years are required to all be rated outstanding. Once the resident selects the wellbeing teams, the teams of up to 12 wellbeing workers must collaboratively design an ideal week with the client or their family. The teams will provide relationship-centred support, focus on what matters to the person and their wellbeing and enable people to be part of their community.
Five specialist advice, support and training providers are supporting the model to help the lead providers. The service will also be embedded in the wider Lewisham community offer, working in partnership with our Integrated Care System.
Wellbeing At Home will also offer career progression for Wellbeing Workers and promote care as a career of choice for Lewisham residents, where we will identify and nurture untapped talent by developing innovative roles delivered through apprenticeships.
The Fair of Cost Care proposals were about market sustainability and increasing provider rates. Lewisham has made it our own. If we are to pay more, we want a new service. That means treating the workers as health professionals. Built into the contract, we’ve specified full compliance with all three stages of UNISON’s Ethical Care Charter, including occupational sick pay, full hourly rates for travel time, not enhancements, as well as a commitment for the workers to receive the equivalent band 3 in the NHS of £12.75 per hour.
Employers in the Proud to Care family must be committed to the London ADASS Big Promise to address anti-racist practices.
Final thought
Wellbeing At Home starts on 1st September. New and innovative, this is about doing with and not to our fellow residents. It is about paying a decent wage and not forcing carers to work sick because they cannot afford to lose pay. It is about doing and being better. By taking care of wellbeing and enablement, we can reduce the use of care homes. No one should have to leave their home if there is a better way. Enabling a good quality of life in your own Home is what we’d all want, along with being part of our community and not isolated from it.