Care at home is crying out for personalisation - so let's give it

TLAP's Director Sam Bennett's blog for the Guardian Social Care Network

The other week we saw one of those well choreographed moments when the BBC reported on shocking instances of sub-standard care at home - including hidden camera footage of a woman waiting in obvious distress for her care worker to arrive - on the same day the care and support minister, Norman Lamb, spoke about a crisis in care and the evening launched the government's initiative to address it: the Homecare Innovation Challenge.

The specific case on Panorama, and any case like it, is deplorable. And it is certainly possible, with the strain the homecare sector is under, that the next big care scandal could occur in someone's home. A clear message from the government's Homecare Summit was that part of the problem stems from a lack of personalisation in the services.

In theory, there can be no model of service provision more suited to a personalised approach than a service that comes to you and delivers the care and support you need in your own home. However, in practice, homecare can often feel like personalisation's last frontier, where myriad constraints, logistical challenges and low profit margins make for a service as likely to be inflexible and unresponsive as individualised and person-centred.

The barriers to delivering personalisation in homecare are well rehearsed. On the part of commissioners, there's an over-reliance on "time and task" commissioning, rigid service specifications, the purchase of 15-minute slots of generic care and a seeming inability to get commissioning for outcomes off the starting blocks.

For providers, there are the zero-hours contracts for staff and the lowest possible rates of pay, poor retention rates and the difficulties of achieving continuity of care in a fast changing environment. And then there's the ongoing challenge of the overall financial picture - something that at least everyone can agree on!