CARE & SUPPORT
The ‘Care & Support’ tender to be discussed at Edinburgh City Chambers on 19.11.09 has not yet been ratified. Let everyone who truly cares about ‘Care in the Community’ make their voices heard. The lives of 777 ‘service users’ could be changed enormously - and not for the better. We are talking about quality: quality of care and quality of lives. In the current proposal, quality is supposedly a 70% consideration, and cost 30% - regarding care and support of Edinburgh citizens with mental health, learning, and physical disabilities, and also those with severe hearing impairment. Around 20 agencies in the city would be out of business - should this proposal go ahead; these agencies’ business? It is to protect vulnerable people in the community.
We have personal experience, for many years of a quality service offered by a well-established mental health organisation - Penumbra. Our mother has benefited from their care and support for 23 years. We cannot praise them highly enough - their staff are of an exceptional calibre - having received quality training which is then applied appropriately in the care of their service users. In fact, Penumbra’s last official feedback - from the ‘Care Comission’ was measured in terms of 17 out of 18 points for quality of care, staff and leadership. This was deserved and, importantly, unsurpassed by other agencies.
We are talking about supporting people: people who have to live with highly complex disabilities. We are also talking about continuity of care. Penumbra staff act, often, as a lifeline - for those living in supported housing in the community. Over the years, bonds of trust and friendship are developed; although staff must sometimes move on - there is always a core team of support workers remaining who know the people in their care well, and can communicate with great understanding. It is not easy work - it can be very demanding; but it can be very rewarding too - bearing witness to people enjoying a reasonable quality of life, in their own homes with quality support.
We do not believe that the quality of existing service provision is being respected or even acknowledged at all in the proposed ‘Care & Support’ tender.
Have the voices of the service users been heard? The answer is a resounding ‘No’. There has been barely even a token consultation. But, amongst those on the receiving end of the occasional official letter was our mother. Such impersonal communication has been very distressing for her: talk of ‘change of your provider’ and ‘the best provision’ simply made her fearful and anxious, and inferred that her current ‘provider’ was not ‘up to scratch’ (which is not the case). She lives with great mental health problems; and, yet - after decades (largely) spent in a mental hospital - does incredibly well in her own supported flat. However, her insecurities are many and profound, and sensitive ‘continuity of care’ is very, very important.
The members of staff who currently work in existing agencies have been told that there will be continuity of care. But those with whom we have communicated (and they, in turn, with other existing care providing agencies) do not see how this is possible. Indeed, it is not possible. Certain staff may be ‘kept on’ - but they do not currently know; they too are living with great uncertainty and insecurity, and also concern - both for themselves, and for those (often) vulnerable individuals in their care. However, there is no guarantee that those important bonds of friendship and understanding would be maintained.
How could they be - when the large majority of people and hours would be reallocated? Experienced, long-standing staff would not necessarily retain their positions - including those who have worked very much ‘hands on’ and who are now also working in management positions. “I love my work” said one such manager ‘… I have no idea what could happen within ‘community care’ provision in Edinburgh and am extremely concerned about the type and level of support that is proposed.’ Community Care agencies have calculated that only about 50 out of 777 people will maintain their existing support.
The truth is that private sector agencies who can (perhaps) meet the cost considerations - on paper - can certainly not meet the quality considerations. Those with mental health, learning, and physical disabilities are deserving of premium care and support - so that, wherever possible, they can be a part of our society. For a very long time, these issues have all too often been ‘poor cousins’ to any other. In the 21st century, we should and can do better.
Please let the existing agencies that do provide quality care continue in their very professional, considered, caring, experienced and human approach; for they know what they are doing - and they do it all exceedingly well. The long-term quality of life must not be compromised in the pursuit of short-term cost-cutting. Whilst we respect that costs are an important consideration for the Council - we urge that they again reflect upon and review this whole tendering process; for the very valuable resource that is ‘Care & Support’ means so much - to so many.
