Providing sustainable home care in a rural setting across Sutherland
Sutherland Home Care is a rural care at home service using local people to support our own folk in the way it used to be done. This is not simply a service to provide personal care, but rather an encompassing service that supports those people to live in a homely setting amongst their own for as long as possible, doing the things they want to do. We believe that encouraging communities to take ownership of ensuring an excellent standard of care for their own elderly and in need residents is a key ingredient to the success of rural home care.
From Spring 2021, we will be offering a new Caring for the Carer programme aimed specifically at supporting carers at challenging times or to allow them to some respite, particularly during these difficult times with the ongoing pandemic.
From Summer 2021, Sutherland Home Care will provide a comprehensive care at home and respite service.
Sutherland Home Care will plough any surplus monies back into the local communities involved, through our Circle of Support model, for the benefit of all who live there, with the hope that this will build a lasting legacy.
Highland, like the rest of Scotland, faces significant demographic changes, large scale real reductions in public sector funding and an intractable gap between the life and health outcomes of the best and worst off in our communities. Against this backdrop there has been much discussion about the need for new approaches to public service delivery.
Mainstream health and social care service delivery remains largely designed to react to problems rather than to prevent them. There is growing acknowledgement of the shortcomings of this ‘deficit’ or ‘treatment’ approach to the delivery of public services. A change that goes beyond how to improve the existing system is required whilst also acknowledging the many strengths of what is already in place. Asset based approaches are ways of working that promote and strengthen the resources that individuals and communities have that help them to support the development and maintenance of good health and quality of life.
The report from the Commission on the Future Delivery of Public Services (Christie Commission) highlights the need for new ways of working. It calls for a radical change in the design and delivery of public services to tackle deep rooted health and social problems that persist in communities across the country. A key aspect of the Christie Commission recommendations is that “public services are built around people and communities, their needs, aspirations, capacities and skills, and work to build up their autonomy and resilience”. Central to this is the empowerment of individuals and communities by involving them in designing and delivering services that meet their needs and working in partnership to deliver services and improve outcomes.
The Community Empowerment Act 2015 creates a legislative backdrop for a wider range of participatory approaches, which exist to empower communities. The principles of community development underpin these approaches whereby communities have an active role in local decision making and the design and delivery of responses and services that recognise their knowledge, skills and lived experience. If well supported, community led approaches to health and social care can bring added value and reduce pressure on public services through a different model of delivery and distribution of resources based on community assets and community capacity building that can support communities to become resilient and self managing.
Rural isolation, loneliness and stigma are only some of the issues around the profound inequalities that need to be addressed in rural areas. When embracing geographical challenges, it needs to be clearly understood that rural areas probably have demographic profiles that impede normal services and support. Rural demographics usually equate to an upside-down triangle of support, i.e. few working people at the bottom supporting an unprecedented volume of older people at the top which results in challenges in trying to access and provide what tends to be limited services and support.
In small rural communities the lack of resources and infrastructures may be challenging, but most rural communities have a wealth of assets that can be unlocked and better utilised through working in partnership. Local knowledge and influence often rests by necessity with just a few people wearing a number of different hats, so tapping into the resources of those local pillars of the community can mean connections are made quickly and solutions are developed that are based on knowledge and understanding of local issues. This often results in finding creative ways around problems using community assets.
In 2019, Crossroads Caring East Sutherland, a major home care service provider withdrew their services from Sutherland, particularly in East Sutherland where our Dementia Friendly Communities Ltd, our parent charity, is heavily involved in community support. At that time they had a number of requests not only from worried service users, but also Crossroads’ workers and community partners aware of our work to investigate the possibility of adding home care to the Helmsdale Circle of Support. Bearing in mind there are real challenges for rural communities in relation to delivering sustainable services – that are generally more readily available in urban areas – our parent charity worked closely with a number of locals partners towards becoming a Home Care provider.