NEDCare, based in North-East Dartmoor, Devon, provides an example of the distinctive role that small community organisations can play in stepping up to deliver adult social care provision where no one else is.  
NEDCare is an example of how community organisations are providing, high-quality care for individuals in their local communities.

Our report, the Community Opportunity argues that community organisations play a distinctive role in the adult social care eco-system. And, in terms of the government’s objective to ensure that “people find adult social care fair and accessible”, NEDCare does just that. In an area which was in market failure for adult social care, meaning that there was not sufficient provision of care for the residents of this very rural part of the country, they have ensured that those who need to access care can do so. Their ethos is to provide person-centred care which enhances the lives of those drawing on it, as well as ensuring that the needs of their staff are met too.

NEDCare is an example of how community organisations are providing, high-quality care for individuals in their local communities.

In the four years following August 2017, when NEDCare formally became CQC-registered, they have delivered 32,550 hours of care and support for 115 individuals and their families and now have a core team of 22 carers delivering this.

NEDCare: stepping in to fill the gap

In 2014, the area in which NEDCare now operates was in market failure. There was a lack of access to care services with long waiting lists. The local cottage hospital was also in trouble, with the Clinical Commissioning Group (CCG) carrying out a consultation to permanently close beds with the assumption that individuals would be cared for at home. Seeing this failure of the system, a small team of local people decided to fundraise and set up a regulated care agency. As they began raising the money that they needed to become Care Quality Commission (CQC) registered, the group ran an introduction service which made matches between individuals with social care needs and local carers. This service supported 63 people over the eight months that it ran and proved the impact that connecting local people to care in their community can have.

In the four years following August 2017, when NEDCare formally became CQC-registered, they have delivered 32,550 hours of care and support for 115 individuals and their families and now have a core team of 22 carers delivering this. Between 50-60 % of the clients that NEDCare support are local authority clients whose care is paid for by the local authority. This is, however, supplemented by a charitable legacy which NEDCare has, as the local authority rate does not cover the costs of care. This year’s Home Care Deficit Report from the Homecare Association further shows that home care costs are outstripping funding from councils in many parts of the UK.14

In what is an incredibly rural area, with a population which is far older than the national average, NEDCare’s social care services are not just distinctive: they are absolutely vital. There is still no competition in the local care system, meaning, without their provision, there would be 111 people left unsupported.

And these services are having an important impact on both the wider health and care ecosystem and the individuals receiving that care themselves. NEDCare’s provision has been able to reduce hospital admissions amongst the people they work with, as well as the need for GP visits. Carers work closely with local health practitioners on early intervention and prevention, spotting issues before they become major problems and ensuring individuals are safe in their homes. Being able to swiftly get individuals out of hospital, providing a safe environment to return to their own homes not only helps recovery, but it can also provide individuals at the end of their lives with the dignity that they deserve. As Julia Darby co-founder of NEDCare said, “dignity in later life is what we have brought to this population”.

NEDCare has focused on building a values-led culture for their staff. Indeed, the continuous active learning, accountability and honesty that they promote as a team has provided an environment in which staff are supported in their work. This culture and the organisation’s values also mean that the committed staff are empowered to provide the best care that they can for the people they serve. They are not constrained by time pressures and will never leave an individual in a precarious situation. The organisation’s staff turnover is far below the average for the care sector at around 13% in 2020 compared with the 31% national average. This relative stability has a positive impact on those accessing care, with a greater consistency and an ability to build strong and meaningful relationships with carers.

Another important aspect of NEDCare’s success is that it is truly rooted in the community it serves. This, for them, is one of the defining characteristics which illustrates the distinctive role of community organisations in the delivery of adult social care. Providing care for the community, by the community. This is illustrated in the fact that there is one carer who is looking after an individual who used to babysit them when they were a child. It is their existing community relationships, paired with the relationships with other local community organisations, which helps to reintegrate individuals with their communities. It is also not just about connecting with the community, but with the local area too. In the case of one client, who had spent her whole life on and around Dartmoor, the care team were able to give her the additional help needed to take her back out on to Dartmoor. They received a phone call from the individual, weeping on the phone, expressing her gratitude at the fact that she thought she’d never see the moor again. So, the local knowledge and ability to use the natural landscape in care shows the level of personalisation that NEDCare provides.

Julia, and colleagues at NEDCare see the many challenges facing adult social care at the moment. One of the biggest challenges is around workforce. While NEDCare have been able to retain their staff at a much greater rate than in the wider care system, they too are experiencing difficulties in recruiting staff. They, like others in the sector, are contending against wrongly held perceptions that care is a low-skill job, and how daunted many people are by the responsibility carers take on and how much training is required. Another challenge is around the cost of care and how much local authorities pay for adult social care, the majority of whom use the UK Home Care Association calculation of unit cost of care, which the UK government also recognises. However, the Personal Social Services Research Unit (PSSRU) have calculated the unit cost of care to be far higher than the UKHCA. NEDCare believe that this disparity needs to be addressed for local authorities to pay a higher unit cost for care.

However, NEDCare also sees some opportunities. This year, they are turning their original care connection service, which is where NEDCare started, into a trading subsidiary. The new platform, Community Care Connect, will be an easy way of making connections between those seeking to access social care services and local carers.

Age UK estimates that around 15% of over 65s are not getting the care and support that they need. This has a lot to do with access and the availability of services. This model will enable different areas across the country to use the platform to enrol local carers and target specific gaps in social care provision. Community Care Connect will support local authorities and community organisations, and the platform will also provide valuable sector support to carers, bringing together a community of practice and providing advice, tools, and training.

Due to be launched later this year in Bristol, it is a shining example of how community organisations are taking a leading role in tackling the social care market failure, and care deserts. The very same things which led to NEDCare being set up in the first place.