Domiciliary Care from a Provider's perspective

Supreme Homecare is an independent care agency providing care to clients in their own home on a one to one basis. In this interview, their representative talks to us about the Domiciliary Care market in the UK, the challenges they face as a care provider and how Local Authorities engage with them to ensure people receive the services they need.

Can you tell us a bit about your company and what it specialises in?

I work for Supreme Homecare. The business started in 1996, and we currently provide services to Newham, Waltham Forest, Redbridge, Tower Hamlets, Brent Council and the NHS. We provide Domiciliary Care to the elderly, children with special needs, people with learning disabilities and people with mental health, in their own homes.

What do people want from their carer, and how do you tailor services to meet individual’s needs?

So we tend to provide person-centred care. We go out and do an assessment initially so that we can identify the person’s needs and the best way to provide services to them. During the assessment, we will also identify the right carer to provide the service.


"Everybody wants you to listen to what their needs are and their preferences."


Can you talk to us about the pressures you face in providing Domiciliary Care services?

One of the pressures is definitely meeting different people’s needs. And people’s preferences are very diverse; for example, they may want someone from a certain part of the country or they want someone that can speak their language. That’s difficult to accommodate sometimes.

Do you get quite in-depth details from Social Services about the care people want?

Most of the time, Social Services send out an assessment to us, but it’s not always up-to-date. We’ve had Social Services tell us that some people don’t have any preference and they don’t mind. But when we go to actually meet the person to ask, they usually do have preferences: the kind of care they want, the times they’d like their care. You then cross-check it against the Social Services assessment, and there are definitely differences. So we prefer to go out to do our home assessment before we nominate a carer and start working with the person. A few times we’ve actually had to create an emergency set-up, for instance when a person is discharged from hospital, where we can’t actually meet the person before their care commences; however, we still ensure we see them shortly after they’re discharged and adapt their care to suit them.

You currently support a total of five boroughs as well as the NHS; how do you prioritise requirements?

It depends on our capacity. Each requirement is different, so it depends on the staff we have at that time. That determines which packages we consider first and which ones we ask for more time in getting the appropriate staffing for.

You mentioned that you currently only supply one care package to a certain Council, but you are still required to meet all of their criteria in order to supply that package. What would that look like if it was through Digital Commissioning technology?

In this instance, the marketplace would be far more transparent and we’d probably be able to fill more care packages for Councils. For instance, with Waltham Forest, you are able to see all care packages that are available, whereas before you may have just had a lead broker that calls Supreme and there was no guarantee they’d call at all. With a CDS, you can see all the details about a care package and make your decision based on them. You can offer to fill as many care packages on the system as your capacity allows.

Waltham Forest recently started working with the adam platform; how has the process changed?

We’re now able to access information easily and it takes less time as there’s more information available about the package. It’s also more structured for us and helps us to make our internal processes more efficient by matching packages to carers more easily.

Have your payment arrangements changed?

Yes, we get paid more quickly through the adam platform. Before, I think that brokerage office had to do everything manually. Now, everything is on the platform and it’s quicker if the numbers are there as soon as the care package has been approved. All of the care packages are linked up by a unique number, so the likelihood of mistakes being made is also reduced.

Do you provide services to the private sector as well as Local Authorities?

Working with the private sector is similar to working with Local Authorities – we talk to them to find out what their care needs are and the type of care they want to receive. But it’s easier with the Local Authority because everything is pre-arranged. With a private person, sometimes you have to give them advice on how to arrange the timings, tax for the carers, etc, which you don’t have to do with people coming through the Local Authority. But the people who come direct, quite understandably, prefer to be in charge of their own care because then they’re able to make changes easily. With Social Services, changes to care can take a while.

How do direct payers or self-funders find you – from the Local Authority or direct?

Both. Some of them check the website to find out information about us. Some of them say we’re one of the providers that Social Services recommended to them. But almost all of them want us to visit them to tell them what we can do so they can make a decision. 

Do direct payers or self-funders look at different care Providers when they come to you?

Some of them have done that. Sometimes they call and say that they’ve been on our website and they haven’t looked anywhere else, but they want us to come out and do an assessment and see whether we can take the care package. Whereas some people will call around and check prices from several different providers to see which ones they can afford and then go from there.

How do you think your role as a care provider will change over the next five years?

At the moment, we aren’t actually exploring everything we can do with the adam platform. But so far, it has improved things for us. Before, we would have to go through the brokerage office on a weekly basis, whereas now the opportunities come to us. If this continues and we can develop the way we use it – for instance, measuring quality – and this will improve things for Supreme in the future.