Keeping it Local: Building Neighbourhood Care Capacity

In recent years, community-based care support services, alongside the broader spectrum of public services, have witnessed significant levels of demand-related stress. Amidst rising demand, higher costs and the increasingly complex nature of needs placing services under strain, a shift is occurring in some areas. This shift is about moving the commissioning of home care away from traditional outsourcing at scale and towards unlocking the power of the community. This movement is supported by the growing “Keep It Local” campaign that was initiated by Locality. This article explores how ‘hyper-local’ support options can be identified and coordinated by ‘Introductory Agencies’, as an alternative to traditional home care-based care delivery models.

The Capacity Challenge in Social Care

The social care sector, reflective of broader public service challenges, faces ongoing workforce shortages amid ongoing budget cuts, especially at local government level. While wider national government initiatives like the ‘Care for Others. Make a Difference’ recruitment campaign have aimed to address these challenges, the structural issues of low pay and the undervaluation of care work remain significant barriers. The “Keep It Local” perspective suggests that the dominant approach of scaling up and standardising, leading to large outsourcing contracts, has been counterproductive and has entrenched a transactional, market-driven mindset, viewing people as passive recipients of services rather than care partners, exacerbating complex demand challenges rather than alleviating them.

Introductory Agencies as Care Connectors

The expansion in community led support includes services by Introductory Agencies, which can often be innovative, community-driven, and aim to provide personalised and flexible care alternatives (sometimes run by VCSE organisations).

Introductory agencies act in an intermediary role, facilitating connections between individuals seeking personalised care services and qualified self employed care workers offering support locally. They can provide a range of services including :

Matching Services: The core of an introductory agency’s offering is its ability to help pair citizens with care workers who can best meet their specific needs, preferences, and characteristics. This bespoke matching process ensures that individuals receive care that is both professional and compassionate, tailored specifically to them.

Vetting and Verification: Introductory agencies conduct a screening processes for care workers to ensure they meet standards of training, qualifications, and reliability. This includes background checks, reference verification, and validation of professional certifications.

Support and Guidance: These agencies offer ongoing support and advice to both care recipients and providers. This encompasses assistance with navigating the complexities of care arrangements, understanding legal and financial considerations, and ensuring that the care plan adapts to the evolving needs of the client.

Training and Development: Recognising the importance of continuous professional development, introductory agencies may also facilitate access to training and development opportunities for care workers on an ongoing basis.

Benefits

Personalised Care Solutions: By focusing on the individual requirements and preferences of clients, introductory agencies ensure that care arrangements are as effective as possible. Personalised matching means that citizens choose their care workers and can build lasting relationships.

Flexibility: Introductory agencies offer flexibility not only in the type of care provided but also in scheduling. Citizens can arrange for short-term, long-term, live-in, or visiting care & support based on their unique circumstances, providing a truly individualised arrangement.

Quality Assurance: The vetting process and ongoing support from the introductory agency mean that citizens can better trust the quality and reliability of the care they are receiving.

Community Connecting: In particular VCSE provided introductory agencies can be community based and emphasise the importance of community links, assisting citizens in maintaining social connections and participating in community activities. The Keep It Local movement advocates for building strong partnerships with community organisations, sharing power, and leveraging local strengths to develop new ways of working that unlock community power.

The Role and Impact of Personal Budgets

Direct Payments and Individual Service Funds (ISFs) are crucial tools to enable citizens to engage and pay for their micro-provider services. The Keep It Local campaign underscores the importance of simplifying access to direct payment and ISF processes and supporting local economic growth by keeping social care expenditure within local communities. This approach supports the broader local economy, emphasising investment within local communities rather than outsourcing at a national scale.

Conclusion

By adopting personalised commissioning models and embracing community-led solutions, local authorities can improve the resilience and responsiveness of the local care sector. This approach contributes to a sustainable, community-integrated public service ecosystem and promotes a future where services are not just provided but are properly co-created with communities and community businesses.

Local authorities who are looking to realise the potential of micro-enterprises and introductory agencies should align, at the strategic commissioning level, with the ‘Keep It Local’ principles and focus on system-wide collaboration but on neighbourhood-level service coordination.

The ‘Keep It Local’ movement, requires a paradigm shift in thinking, away from traditional outsourcing and procurement approaches towards to micro commissioning and community-centric approaches. It is about unlocking community power, emphasising the importance of building partnerships, fostering community capacity, and market shaping for services that are ‘local by default.’

Commissioning Considerations

  • Support the development of introductory agencies through market engagement. Encourage flexibility in services offered, allowing for a range of care options including live-in, part-time, and specialised care services that cater to a diverse range of needs.
  • Implement a framework for quality assurance and safeguarding within introductory agencies. Ensure that agencies adhere to high standards of care, with clear policies for vetting and continuous professional development of care workers.
  • Facilitate audits and ensure there are feedback mechanisms to maintain service quality and address any concerns promptly.
  • Encourage introductory agencies to invest in ongoing training and professional development opportunities for self-employed care workers. Support initiatives that promote skills enhancement, including specialised care training and understanding of the Care Act’s principles.
  • Work with introductory agencies on an open-book basis to maintain transparency in terms of fees, services offered, and the vetting process for their advertised care workers.
  • Encourage introductory agencies to work closely with local community groups, health care providers, and social workers to ensure a holistic approach to care and sourcing the workforce.
  • Support the adoption of digital tools and platforms by introductory agencies to enhance support delivery, improve care coordination, and facilitate better communication between care providers, recipients, and families.
  • Invest in technologies that support remote monitoring, digital health records, and online training resources.
  • Regularly assess the care market to identify gaps in service provision and areas of unmet need. Use this data to inform strategic commissioning intentions and support the development of services in underserved areas.
  • Consider funding models that support the sustainability of introductory agencies, including possible incentives for agencies that provide services to underserved populations or areas.
  • Harness the power of geo-spatial mapping approaches to better understand demand and potential supply at the neighbourhood level.

Chris Watson
Chris Watson is the founder of Self Directed Futures and the Chair of SDS Network England. With extensive experience in strategic commissioning and change management, Chris advocates for innovative, community-led approaches to adult social care.

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