Letter to Maria Miller MP re: community care provision

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Yesterday we wrote to the minister for disabled people and carers. Letter follows; I will update if we get any response, though obviously it is unlikely.

Dear Maria Miller,

I am twenty-seven and my partner is thirty-two. He is now quadriplegic from a degenerative spinal defect and I care for him full time. After many many years of neglect we obtained some care support from social services, and after further problems with the care agency, are now on an individual budget. We find it very difficult to find care cover under this system. I don't want to harp on about the problems, but instead offer solutions. Our one A4 page proposal for solving this problem follows. I have attached some additional wireframes to this email but they may be stripped by your filters.

Regards, ********* and ********

Care Worker Exchange

Booking care could be as simple as booking a taxi.
  • * Simple low cost web application.
    * Small agile team of 6-10 developers coding an accessible and open source app with API available to allow specialised and individual access solutions.
    * Only accessible to account holders (Gated model: http://www.facebook.com/).
    * Automatic access through DLA care component and Social Services, but not limited to those channels (some care users don’t use those systems).
Care workers sign up with their profiles: picture, name, qualifications, experience, rates, CRB checks, verified references, locations covered, and shifts available. They can manually alter their calendar or any values except CRB and references.

Disabled people make their own (non-browsable) profile with their preferences and requirements: women only, track hoist use, sign language etc, which then operate as search criteria (matching) for the care worker profiles. They may add a specific description or criteria to a booking (shopping, hospital visit, personal care). They book care workers to their calendar; they can save workers to a preferred portfolio. Availability of preferred workers is shown on the calendar when booking shifts. The calendar is permanently stored and can be printed and exported for accounts.

On booking, care workers are emailed with the time, client and job description, contact details, and streetmap. They can choose to accept or reject the booking. The booking request is time limited. Once a booking is accepted the care worker's availability is changed on the site, so they can never be double booked, though their full calendars are not public or browsable.

Care workers can be dismissed from search results permanently without prejudice. After a completed shift, care workers can be marked as unsuitable and hidden from further results. Care workers repeatedly (at an agreed threshold) marked as unsuitable are suspended from the exchange. Disabled employers can not be marked as unsuitable. A care worker may reject any booking without prejudice.

Care workers can be marked as abusive but this must trigger external investigation not just site suspension. Care workers who are abused by their employers must similarly pursue complaints through their union, police, or appropriate authority. The Exchange does not duplicate existing structures.

Care workers choose to: work as self employed at their own rates, be paid through the site at fixed tiered rates, or be employed directly by the disabled person. This allows disabled people to manage the payments through Direct Payments/Individual Budgets, for Social Services to issue credits to people who cannot or do not want to manage their own budgets, and for people to access care for which they pay themselves without going through lengthy bureaucratic procedures. Care agencies could also participate.

Care workers may choose SMS notification for bookings. (Multiple market models: Google, Twitter, Facebook... Mobile phone penetration is very high.) Job Centres and libraries offer access to the site.


Simple guides to using the site are available in captioned screencasts, text, audio, and still pictures. A short, relevant FAQ is accessible in multiple formats. A help button on each page links to an expert user exchange where users ask and answer questions. (Knowledge network model: http://vark.com/).

With an open and friendly QA/Test/Debug and Contribute model (AO3 model) the site could be empowering and educational as well as practical and efficient. Partially fund by voluntary subscription and friendly subscription (effectively donation). Partially drive development through users on the Open Source model. We guess that the first API widget would be a wages calculator, so that can be easily accessed through a weekly/monthly sum of hours from the calendars.

Hi Sally

This is a great idea, let us know what the Minister sends back.

There is a similar system to this being pilotted at the moment by the Department of Health. The one in Hertfordshire is www.bookyourownbreaks.com

I saw a demo of this software recently and it works very much like you describe with workers having profile pages and the user just puts in when they need the worker, onto a calander and you get a list of who is free. It also has a running total of your individual budget so you know how much money you have left to spend. A worker can be booked with a few simple clicks and you can pick the person you like.

There is a video demo here

Carers who are using the scheme speak very highly of it as a life-changing system. Care workers are employed through Crossroads care - which is a care agency and charity, and they speak highly of it too.

Thaks for sharing this with us

Yeah, I have no illusions that anything will happen but it occasionally makes me feel better to dream of solutions. I got a million of 'em. Image

That does look good. Really I wanted to be able to employ carers not through an agency or charity or anything, but just independently. Our individual budget fixes the pay rate at £6.89 an hour. The only agency (after over 30 turned us down) that would take on our needs charges over £14 an hour. The agency workers are inflexible and not very competent, which is at least better than the previous agency, who were actively abusive. I'd really rather hire my own carers and train them in what we really need help with (moving and handling, motivation).

[edited for irrelevance] Individual carers are so hard to find on such a small budget with only 30 min and 60 min shifts. They can't afford to work so little and it takes months and months to laboriously go through the paperwork needed. We've just got the one care worker this way. This is why we thought of the labour exchange type thing] I suggested an open source model because it's my experience that the NHS and DWP are totally unable to move when encountering any problem. Simple things that could be easily fixed never are because of the crippling weight of the bureaucracy. I really wanted a system where when there was a problem, I could fix it, or someone else could fix it, rather than constantly going begging for help with things I could do perfectly well myself, if only I were allowed to. Frex, we recently had to turn down extensive rehab because the ward had no accessible call button. The button is cheap! The manufacturer had a website! I was happy to buy one and plug it in, but it wasn't allowed. It is my opinion that the government IT approach is monstrously wrongheaded and wasteful - I say this as someone extensively involved in open source so I obviously have a strong bias.

Anyway, I'm glad to see someone is getting something like it! That's very positive.