It’s time to rip up the time and task model in home care

Trudie Fell, CEO and co-founder of BelleVie, a home care support service, has shared her views with Social Care Today about why it’s time to think of a new home care approach.

Currently, patients are being stripped of the care they desperately need and deserve and job vacancies within the social care sector are falling at their quickest rate.  

All of us working in social care know that something needs to change. There are around 13,000 people stuck in hospital beds in England who could be discharged if only the right support was in place. But with more than 165,000 job vacancies in adult social care alone, the system is under immense strain.

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Most people want to be supported to live in their own homes as active and independent members of the community for as long as possible. What if we could make this happen?

Twenty years ago, the Dutch healthcare system was facing similar challenges to what we’re experiencing in the UK. The Buurtzorg model revolutionised nursing and personal care by focussing on self-managing teams with significant autonomy on how they provide care. It’s improved job satisfaction for nurses, given back time to care, reduced hospital admissions and increased patient satisfaction.

If this could be done in the Netherlands, why couldn’t it work in home care here? Since 2019, when we launched our first team in Oxfordshire, we’ve embraced this radical approach. With a completely different way of caring for people in their homes, we’ve witnessed firsthand the incredible benefits it brings to both our staff and the people we support.

The essence of the Buurtzorg model lies in decentralising decision-making and building teams based on trust. In our organisation, local self-managing teams have the autonomy to decide how best to care for each person we support, managing their own rotas and sharing ideas about how to enrich each person’s life.

This empowers our care colleagues, or Wellbeing Support Workers as we call them, to make decisions about how to deliver the best support. They are the ones who truly understand the needs and preferences of the people they care for. They can be responsive and adapt to meet peoples’ day-to-day needs. A manager in a central office can’t do that.

To grow our workforce, we recruit people from within the local community. When workers are from the area, it strengthens connections and nurtures a sense of belonging. We actively seek out people from outside the care sector, using values-based recruitment that’s much more about who you are as a person. We demonstrate that care work can be a rewarding role with fair pay, sensible working hours and the opportunity to progress.

As someone who took on care work as a student, I’ve never understood why it doesn’t have the prominence and value it deserves. One of the remarkable outcomes of adopting this model is the transformation of care work into a fulfilling and meaningful career. We’re creating great jobs in the sector where workers feel valued, supported, and appreciated. This attracts and retains the dedicated people we need.

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Our Wellbeing Support Workers aren’t cogs in a machine constantly checking their watches. We charge monthly instead of hourly, so each person gets the time and dedication they need when they need it. This shift in mindset has a profound impact on job satisfaction. When staff flourish, they build genuine connections with the people they support, enhancing the quality of care provided.

Gone are the days of the time and task model where care was reduced to a checklist of duties to be completed. Instead, our approach is rooted in recognising the humanity of the people we support. They are individuals with unique stories, preferences, and emotions.

Care isn’t about the basics of survival; it’s about providing the support people need to thrive. This might be helping around the house, providing companionship, or helping with things like shopping, dressing or meal preparation. By focusing on building relationships rather than rushing through tasks, we treat everyone with dignity and respect.

We know this unique model of care holds the key to overcoming the challenges faced by the care sector. We’re championing this new way of working which is built on strong communities, thriving relationships and better outcomes.

We’ll continue to rip up the time and task model and embrace a more human approach for the benefit of everyone. And we hope the rest of the sector will follow suit.

Images: Georg Arthur Pflueger and JD Mason


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