Profile: 'Neither the Government nor local authorities are prepared to acknowledge the true price of care,' says Dr Hannah MacKechnie

As the effects of the recession and austerity measures linger on, not least in the cuts to the care sector budgets, the managing director of highly respected Radfield Home Care, Dr Hannah MacKechnie, is rightly concerned about the issues of the day.

As she says: ““It seems to me that one of the key issues is the fact that neither the Government nor local authorities are prepared to acknowledge the true price of care. The lack of funding in the sector sadly means that there can be poor outcomes for those who are dependent on local authorities paying the fees, and at worst, their care needs may not be met.”

Indeed if Dr MacKechnie could have her way: “I’d like local authorities to take more financial responsibility for ensuring that contracts are priced appropriately, enabling providers to meet their legal obligations for carers pay which has to be minimum-wage compliant and include pay for travel time.

“One thing that local authorities don’t seem to take into account is the fact that a half an hour of care actually is more expensive proportionally than a whole hour – so just dividing the hourly rate by two for 30 minutes is not an accurate reflection of the cost.”

She thinks that Government bodies should give more support to care providers. She explains: “I’d like the Care Quality Commission to safeguard quality in social care, and to offer their support to ensure that providers are paid appropriately, as this is clearly linked to the ability to provide a quality service.”

Another major concern is the ongoing negative reputation that persists in the case of care workers. As Dr MacKechnie says: “There is also a massive task to be dealt with in that the profile of care workers and the social care industry must be raised. Recruiting of good people remains difficult – and is not helped by the negative perception of carers or the low wages. The profile of carers must be improved.”

Family business

Radfield Home Care was set up in 2008 by Dr MacKechnie and her brother, but in a sense she has spent her whole life involved in some way with the sector. She explains: “My parents owned a care home and I grew up living alongside the residents from the age of six onwards.”

A medical training followed and when working as she did for some time as a GP, Dr MacKechnie found this experience offered her invaluable insights into just what was lacking in the home care sector.

She says: “When I was a GP, seeing the home care being provided for my older patients gave me useful insights into what was lacking in the service at the time – problems with the length of the call, what tasks needed doing and so on – and this made me determined to ensure that any home care organisation I became involved in would provide the exact support that was needed, when it was needed.

Training and support are key

For Dr MacKechnie it’s a question of getting the basics right and following through with a proper system. “I think that key to offering good home care is ensuring that the carers are well trained and properly supported,” she says. “Radfield Home Care’s induction period lasts for three months and we have developed a robust and clear process of support. In addition, we ask for feedback from our carers and they are fully trained before they are allowed to attend a client call alone.”

Significantly, Radfield Home Care also provides a ‘Caring for Carers’ pledge to show how dedicated it is to supporting its invaluable carers. This includes a promise to invest in quality training, to listen to and support carers, and to provide ongoing learning and development opportunities to enable staff to strengthen their skills and knowledge. Perhaps as a result of this quality control, the retention of care workers remains high and “many of them have been with us since the beginning, “ adds Dr MacKechnie.

“We understand our client group very well and can empathise with their problems. Typical challenges for the age group include loneliness and isolation (which can put a big strain on family members, particularly if they do not live nearby); frailty and losing confidence; and developing new health problems.”

Small is speedy

Radfield Home Care is one of the smaller home care providers although it has grown since its inception to include four branches covering the Midlands and north England, and employs about 75 fully trained care workers who look after some 200 clients. There are no plans to change its family-owned status, which is arguably to the advantage of its clients. Dr MacKechnie says: “As my brother and I share similar values and a commitment to the company, these values are felt throughout the organisation. We are also a small company and that means we can respond immediately to issues.

"I think smaller providers are better equipped to handle issues such as changing internal processes quickly when new guidance comes out (for examples, for medication and things such as moving and handling). We're also able to alter our assessment process and risk management processes quickly and efficiently, and ensure all staff are brought up to speed straight away."

Award-winning home care

The winner of a number of awards, including a community award from the Mayor of Shrewsbury, and a Shropshire Partners Award for upholding dignity and respect in care, the future for Radfield Home Care is, according to Dr MacKechnie, a question of maintaining the high standards set. She says: “We want to continue to build on our successes. Quality is at the centre of our service and this must be assured at all times, so we believe slow and steady is the way forward for us.”

Interesting facts

First job: Working as a carer at Radfield Residential Care Home, which was owned by my parents

Favourite book: Knowledge of Angels – Jill Paton Walsh

Favourite film: Baraka

Favourite piece of music: Cry to Me by Solomon Burke

Best present you have received: My 30th birthday when my husband took me on a surprise trip to London and as an extra surprise invited my two best friends to fly in for the evening

Last holiday: Wales with my family and school friends and their families – chaotic but fun