Looking for a fairer deal for carers in teeth of looming staffing crisis

Private homecare services provider Bluebird Care is warning of a nationwide staffing crisis if the Government doesn’t move fast on funding solutions, writes Pádraig Hoare.

With an ageing population and the emergence of patients with ever more complex needs, managing director of private homecare provider Bluebird Care, Brian MacGoey, is seeing as many challenges as opportunities in the sector.

Limerick-headquartered Bluebird has 26 offices throughout the country providing health and social care services within the home setting and local community. It is a franchise model with every office independently owned and managed.

The firm announced plans to recruit 450 staff in recent months, with around 120 in the Munster region.

All staff are employed directly by Bluebird Care, which deals with the administering of payroll, taxes, PRSI and provides comprehensive public liability and employers liability insurance.

Mr MacGoey said: “We’re a little bit different from some of our competitors and other organisations in that we are a nurse-led business. We are a franchise operation with 20 franchises. We have 26 offices nationwide. Each one of those offices has a full management structure in place.

“From a clinical side, that looks like a clinical nurse manager and office management team in each office. We have a very good clinical governance structure in place nationwide. So we don’t just provide that governance from a head office and spread it out to 26 counties. There is a structure in each locality and each county.

“Our clinical structure is what makes us different. If you called to the customer today looking for homecare for either a parent or a child, in our organisation the person who visits you would be a registered nurse. The person who would visit you in most other organisations would not be a registered nurse — it could be someone with a commercial background or a social care background.”

The community-led aspect is a crucial part of Bluebird’s business model, according to Mr MacGoey.

Bluebird Care Ireland managing director Brian MacGoey at the offices in Riverfront, Howley’s Quay, Limerick. Picture: Brian Arthur
“We’re a young company, having started 11 years ago. What I really like is that every single office has a local director, a local owner, and that brings a much more integrated approach in the local community — they are known there, and have a real passion for their business and the quality of care they provide. We’re not a soulless corporate entity, we’re owner and nurse-led. Those are really good ingredients to have for a thriving business.”

Homecare is totally transformed from the past two decades, Mr MacGoey said.

“If you look at homecare 15 or 20 years ago, it started with home help where someone would come and light the fire or wash the dishes and hang clothes on the line and then leave. Now homecare packages are far more complex because people are living longer and their needs are far more complex.

“Traditional home help is becoming a thing of the past. Home care now is generally because people need it, plus you have conditions such as dementia or Alzheimer’s — those clients require far more competent training and safeguarding, both for the staff and for the clients themselves.”

Homecare is becoming more and more vital as the population ages, but it is a sector with huge challenges ahead, Mr MacGoey said.

“Anybody in the recruiting space will tell you it is challenging in this sector. But I believe we are a good organisation to work for, that is the first thing. We’re trying to build that culture — that we look after our staff and train them. One of the things we hear more and more is that they come to work for us because of our governance structure — they feel they are learning, they feel safe and directed by people with the right skillsets. That traditionally hasn’t happened in this particular sector.

“We need to make a full-time career for people. Pay is a big part obviously but it is not all about that. It’s about training — a huge amount of care staff providing services to the HSE and Bluebird Care only have a certain amount of hours a week to work because of social welfare benefits. That’s an inhibitor to services we can deliver.”

There is no joined-up thinking between the likes of Bluebird Care, the HSE and hospitals, and the colleges, according to Mr MacGoey.

The Government has said a Fair Deal scheme for homecare — akin to the Fair Deal scheme where people can make a contribution towards the cost of their care using their assets, and the State pays the balance — in the pipeline but is some years away.

Mr MacGoey said: “We are going to have a serious crisis even in another seven or eight years — we are not going to have enough staff in Ireland to deliver the services we are going to need to deliver. The Fair Deal scheme for homecare and giving people an alternative to residential care would be really fantastic.