Home Care diary – Outcomes

Thursday I’ve been on a training course. I’ve been learning about outcomes. It was all day – well, they said it was all day but it started at 9.30 and we had a half hour tea break in the morning and we had lunch which was an hour and then we had a half hour tea break in the afternoon and we finished at 4 so I wouldn’t really call that all day. Still, all day for me usually starts at 5am and finishes at 6.30pm so it made a change. I didn’t get paid for it which peed me off seeing as I had to lose a day’s work. Outcomes is the new thing apparently. Did you know that? Up to now it seems I’ve been doing it all wrong – I thought I was providing care to people but it seems I should have been focussing on outcomes. How was I supposed to know? Nobody told me. So, what are outcomes you want to know? Listen up grasshopper. It seems that we shouldn’t be talking about what we do for people, we should be talking about the outcome, in other words what they get as a result of the care we provide. So previously I would help someone get out of bed in the morning, but really I should think about the outcome which is that they got up. They maintained their independence as a result of my support. That’s the other thing that’s different – I support people to do things for themselves, I don’t do things for them. So now I’m getting a new job title – I’m going to be a Care Support Assistant. I’m not a Care Worker anymore. I suspect some people will still call me ‘girl’ or ‘you’ but I am a Care Support Assistant. I’m not getting any more money though. It seems that some clever people in the government have come up with 7 outcomes. These are:
  • Improved health and well-being
  • Improved quality of life
  • Making a positive contribution
  • Exercise of choice and control
  • Freedom from discrimination and harassment
  • Economic well-being
  • Personal dignity
Economic well-being – that’s a laugh. What about my economic well-being? Who’s going to pay my rent and my gas and electric and get Richard new shoes when he needs them? My Service Users are going to have their outcomes measured and if they achieve them I think they’ll get even less support than they do now. So I think that what will happen is that someone who used to get a half hour visit will now get a quarter hour visit, which means that instead of getting 3.80 for half an hour I’ll get £1.90. So, it doesn’t do much for my outcomes does it? Less food for Richard and for me. And I’m sorry and I’m not being horrible but most of my Service Users wouldn’t know an outcome if it bit them. They want what I’ve been doing for them for years to carry on, only they’d like a bit more of it and they don’t want less time, they want more time. A dirty bum is a dirty bum and a clean bum is a clean bum and you can give it any fancy title you like but my Service Users know what they prefer. Now you might think I’m being selfish but I have to live too you know. Am I alone in thinking this is the biggest pile of wank since the last great idea that smart civil servants came up with? You remember that story about the Roman Emperor fiddling while Rome burns – Caligula, was it, or Nero? – well that’s what this Government is doing: the whole social care system in this country is grinding to a halt, there aren’t enough staff, no-one wants to do care work, companies are going broke left right and centre, people are stuck in hospital because they can’t be discharged back to their homes; so let’s spend a fortune on consultants and think-tanks and they can focus on outcomes. Genius. The outcome is that it’s a mess.

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