22nd August 2018
A decision to get rid of the beds at a cottage hospital in Devon was the final straw for Julia Darby.
Darby had lived in Chagford near the village of Moretonhampstead for 13 years managing charities, fundraising and working with communities. She saw her friends dealing with aging parents and began to pick up work as a self-employed carer with a local group.
“The hospital was a good staging-home between acute hospital care and returning home for older people - and we live in a place where the population is older than the average,” she says.
Darby attended the meeting when the hospital announced it was closing its beds. When the managers said the beds would be replaced with care in the community and at homes, Darby knew that there wasn’t capacity for proper care.
So she sprung into action. The Moretonhampstead Development Trust provided some funding to look at the needs of the area. Darby spoke to GPs and ran a survey to find out what people’s experiences were and what they needed. They discovered that there weren’t enough services in the area for the local authorities to provide the care. Moretonhampstead is very rural and while there were commercial services in nearby towns, it could take up to 40 minutes for them to reach the smaller villages.
“We knew we needed to set up a regulated agency so everyone who needed care could get it where and when they needed it,” she says. “But we also knew that would take a lot of time and money.”
At the beginning of 2016, Darby formed NEDCare, a social enterprise to provide support and personal care in the area around north east Dartmoor. With a grant worth £20,000 from the Hospital League of Friends, a charity, Darby set up a fast, cheap service introducing people needing care to self-employed carers in the area. Within eight months, NEDCare was making one to two matches and facilitating around 1000 hours of care a week. NEDCare built a database of 40 self-employed carers, attracting more people into the profession.
“It proved the previously estimated level of demand and it gave us a pipeline of carers and clients,” Darby says. “The best thing for us as a developing social enterprise is that it showed local people that we were doing something immediately, and doing it well.”
Care agencies can be prohibitively expensive to set up. An agency needs a registered manager with experience and qualifications in the field. It took a crowdfunding campaign to raise £20,000 in crowdfunding, followed by a further grant of £70,000 from the Moretonhampstead Hospital League of Friends, before NEDCare could hire a manager in February 2017. Then it worked on putting procedures and systems in place to become regulated by the Care Quality Commission.
Since it was awarded regulated status in July 2017, NEDCare has been building the business to deliver 350 hours of care a month. It now employs 15 staff and a deputy care manager. It is working to deliver 1800 hours of care a month to cover the cost of compliance.
The UnLtd-supported business has been so successful that Darby started to receive enquiries asking how they did it. With support from Transform Ageing, Darby and her colleagues are creating a toolkit to help other areas replicate the model.
While there are other commercial models for providing care, NEDCare supports communities to build the capacity for care locally. It aims to help other communities create the same level of engagement locally by meeting GP services, pharmacies, parish council and community groups like the Women’s Institute.
Supporting innovative social entrepreneurs is key to Transform Ageing. The programme is funded by Big Lottery and run in partnership with UnLtd, the Design Council, the South West Academic Health Science Networkand the Centre for Ageing Better. It aims to revolutionise the approach to health, wellbeing and social care for people in later life.
“That level of engagement gave us an asset,” Darby says. “It has helped build local resilience because there are more people in our area who can deliver care and it has improved infrastructure. But also, the approach is empowering communities, because the power and the ability to increase social care is in the hands of the community themselves as opposed to a commercial agency.”
NEDCare has engaged the support of two partners to build the toolkit: a palliative care service and a business working to set up personal assistants for people with learning disabilities in Cornwall. The idea is to create a toolkit that could work for a range of different needs for launch in April 2019.
Together the partners are looking at the data for the whole of Devon to see which areas lack services. Then they identify smaller organisations that provide the community level ecology for a care service.
“The Transforming Ageing approach to design-led thinking mirrors the best practise approach in social care, which is about co-design and co-commissioning,” Darby says. “It’s about working with people to develop the services that they need. That doesn’t happen nearly enough."