Not-for-profit quality care for over 25 years
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Vic Rayner on the Tea with Tobi podcast

It was an enormous pleasure to be asked back for season five of Tea with Tobi. Tobi and I always have such great conversations and this time around was no different! Tobi kicked off by asking me what I thought of when I envisioned the ideal care business. Of course, I leapt at the chance to extol the virtues of the not-for-profit care sector! 

I explained that within the category of not-for-profit providers there are many different types of organisations. In our membership we have traditional charities, either small community based or larger charities like Anchor or The Orders of St John’s Charitable Trust as examples, as well as housing associations, Community Interest Companies or CICs, Local Authority Trading Companies or LATCOs so there are many different types of organisations operating the not-for-profit care model. 

Where not-for-profit care providers differ from those that are owned by shareholders, or are ‘for profit’, is that the way they are constituted means that any surplus made must be reinvested back into areas like workforce, care delivery or buildings so ultimately, it’s the community that benefits.  Not-for-profit organisations are governed by certain principles under the leadership of a board that will be drawn from the community so has the community’s interests at heart. Being entrenched in the idea of ‘for people, not profit’ they also tend to be ahead of other types of organisations in all things ESG related and in fact we are just now establishing a new Environmental Sustainability Network with our members,, some of whom are setting really great examples in the greening of the sector. This is just one of the many Communities of Practice we provide, where members come together to freely share information, expertise and peer to peer support.  

Another way that not-for-profit care organisations benefit their communities is that they are routed in the locality, and so have great power to mobilise volunteering. In a lot of cases, they are linked to the local Church, clubs and groups such as Scouts and Guides etc, with volunteers from these organisations coming forward to enrich what not for profit care providers can offer. For example, our member, MHA has seen really positive results by building up a large team of volunteers. Their team of over 3,000 volunteers take part in a range of activities to support older people including driving them to appointments and running errands, running activities sessions and doing face to face or telephone befriending. Some even put their green fingered skills to the test by working in the care home and retirement community gardens.  Volunteers are hugely important to care providers, especially where people in receipt of care don’t have any family members close by as they can help reduce isolation and loneliness.   

From the workforce’s point of view, do not-for-profit providers perform better as employers? Well yes, data collected over the years certainly suggests that the level of staff retention and quality of provision is higher within not-for-profit care organisations.  

People’s understanding of the benefits of not-for-profit models of care are growing which is pleasing. Some recent research carried out in 2021 showed that 75% of people questioned said they wanted their care delivered through not-for-profit or public services. And interesting things are happening in Wales after the Welsh government launched a consultation around the elimination of for-profit provision of children’s services by 2026, with the ambition that all children’s services are delivered by NFP organisations.  

Another area where not-for-profit care providers are making progress is with the adoption of innovation and the development of new models of care, for example the village model which members like Belong have created by looking at international examples and learning from them. Technology is becoming an increasing factor too, for example our members WCS Care were early adopters of acoustic monitoring and circadian rhythm lighting in their care homes which has had positive effects for people receiving care and support and the workforce. Greensleeves as well have been ahead on implementing alternative models of delivery, for example Namaste. 

An overarching quality of not-for-profit providers, and our members in particular, is their willingness to share, collaborate and pool resources. We often organise member events held at different member services and there’s an openness to share results on how things that they’re trying are working. 

As our conversation moved on, Tobi challenged me to envision a future for a brighter social care sector and what the positive difference is that I would make, if there were no barriers at all. This has of course been front and centre of my mind as we head towards a general election. Our must haves for a future government focus on core areas such as workforce, new care models, technology and the central role of social care in communities. However, one of the central components of success for me would be a real shift to recognise the need for a care covenant within communities, where there was a shared understanding of our responsibilities, underpinned by the positive contribution of not-for-profit care and support.   

Harking back to the last time I was on the podcast, when apparently a comment I made about our sector needing its own soap opera went viral (!), we talked more about the challenge we face in getting the public to care about social care. Making care a ‘doorstep issue’ is the central theme of the pre-election campaign plans we’re working on with our members, and the importance of getting everyone to speak up for care. We know that our members have human interest stories galore to tell as there’s always something amazing going on every day and our social media feed is full of people living positive lives.  However, we know that the representation of care can often be much less positive, fuelled by a lack of understanding of what happens day in day out. We need to speak up for care and find ways for everyone to understand what it can do, and the difference it makes. Everyone equates the NHS with saving lives. We need them to be just as clear that social care changes lives. Care is a dynamic sector to work in and we want to encourage our amazing care workforce to be proud and vocal about how the work they do enables people to take back control.  It’s a powerful and inspiring message that should be reaching more people, particularly the younger workforce who are becoming more and more principled about the types of organisations they want to work for. 

We ended on a topic that is on everyone’s minds it seems: the potential of AI and how it can be successfully implemented into care provision. It’s not, of course, the first time I’ve been asked my opinion on AI and my response is always that we need to act quickly if we are to understand how AI can help us, before it’s either shutdown or it gets used in the wrong way and we lose control of it. At an event earlier this year I asked a group of providers to talk about their experiences of AI so far and there’s a universal feeling that we’re kind of making it up as we go along, trying a bit of ChatGPT here and there but not really making any specific strides to harness it. So many questions exist around using AI to develop care plans; will the people receiving care be happy about it and how will the regulators deal with AI generated care plans? Also, are we clear enough about how we will use AI to tackle the huge problems facing us with workforce shortages, changing demography, how we elevate care and help it take its proper role rather than just an adjunct to health? While considering these ongoing questions, I’d encourage us all to share learning and ideas and do everything we can to tell better stories of care so we can help the sector grow, attract the carers of the future and demonstrate to the world that social care matters to us all. 

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