When older people and their families/whanau are looking for aged care they have choices – commercial or voluntary/community sector? If we need residential care would we go for Oceania/BUPA/Ryman or look at Presbyterian Support/Wesleycare/Anglican Living. And what would guide our choices? What makes the difference?
In 2015 the New Zealand Council of Christian Social Services (NZCCSS) published Outcomes Plus. This examined the special contribution made by community and voluntary sector social service providers. What do they offer which is unique– their “added value” in other words?
The report concluded that these special attributes arise from the flexibility and innovation which the community and voluntary sector can provide: from their networks, accessibility and closeness to local communities.
The staff are local, they’re embedded in the community and have that local knowledge…. If you contract out to the big providers…. Those groups know nothing about the local community.
At the NZCCSS aged care conference, which I mentioned last time, a new piece of research was launched which matched the conference title – Valuing Lives, Living Well. This built on Outcomes Plus but looked especially at services for older people and especially at “faith-based” providers (in this case meaning Christian). What makes these distinctive? How do they differ from the corporate sector?
Looking at these questions from the outside, I thought it might have to do with image and culture. What does the title “Christian” conjure up? My dictionary defines it as “consistent with Christ’s teaching” therefore kind, caring, charitable and unselfish. And this is surely what we want in our aged care services. Secondly, people who have all their lives been immersed in the culture of their faith may wish to spend their later years in an institution where this is practiced, whether it be Catholicism, Quakerism or, for that matter, Islam or Buddhism.
But we must also look at the inner workings of faith-based aged care providers. Using interview material from clients, staff and management in 10 different organisations, the report illustrates elements of added value. These include mission, leadership, inclusiveness and volunteerism, summed up as social value and community development, and even more succinctly as “going the extra mile”.
Mission and leadership ideally demonstrate the Christian values which help to make a “people-centred” service – “people care about people here”. “We promote staff and residents as being one family.” In-house chaplains are frequently on hand to help people with unresolved issues and conversations about the end of life. Christian services have a long history of providing support for the most vulnerable and challenging people, and this continues. They often involve volunteers who can provide links with the wider community and have time to talk, listen and reminisce. This can enhance social inclusion for residents and is part of community development. “It’s like there is an open door between us and the larger community.”
All this adds up to social value and the rather more formal phrase “organisational specific capital.” It means the unique skills, characteristics and infrastructure which faith-based services have built up over time. As a care worker told the researchers – “Value doesn’t necessarily come in materialistic form. Value can be in the time taken… how much (older people) are listened to, or that they are in fact listened to.”
This leaves some very fundamental questions. Do faith-based aged care services have the monopoly of these desirable characteristics? How can they be measured when it comes to contractual requirements? How can these values be extended into parts of the system where they are lacking? And how can we ensure that funders and policy-makers recognise social value? Let me know what you think.
 The “Outcome Plus” report can be seen at http://nzccss.org.nz/news/library/outcomes-plus-25-may-pdf/
A really interesting and complex subject. I both volunteer in a faith based organisation and work for a ‘regular’ NGO, both of which provide social services to older people (although not exclusively).
My community links, personal characteristics, and values are innate. Both organisations appreciate and utilise them in the service provided. When it comes to measurable outcomes that please funders and managers, I can follow the rules, honestly report on what they want, however there is much more that doesn’t get a mention, and it’s this work that often has the most value in my opinion – the social value. I believe that social value isn’t easily recognised, understood or appreciated in a capitalist culture so I would like to see a shift away from competitive procurement (and the costs this incurs) that favour larger organisations, to resourcing community based organisations, (not necessarily faith based or geographical). This in itself is a step towards recognising social value. Of course this still won’t guarantee superior services, however being of the community, for the community, could make it more likely for community development and ‘going that extra mile’ to occur.
I agree with you, Robyn. But the problem is how to measure social value – the auditors of social services always want something measurable.
Thank you especially for leaving a comment on my blog – I get very little feedback.
I suppose one way that comes to mind is to measure not direct outcomes, but how the organisation is directing resources into the social value of their services. If an organisation truly values this side, they will resource it (if they can). This can be evidenced in policy and practices e.g. roles, meetings, discussions. One example of this is the Health and Safety practices or should I say mandates now. There are measurables, in terms of specific requirements that demonstrate compliance, and also I believe people are being made more aware of H&S practices. If something similar is built into place within organisations, this could go somewhat towards a measurable, however as always its not a perfect world.
I am at a stage where I feel I need to start engaging, instead of sitting back being afraid to say something in case my opinions aren’t ‘good enough’, or I sound naive. So thanks for taking the time to respond, you have such a wealth of knowledge and wisdom in regards to ageing, that I am benefiting from as I navigate my way through academia.