How a lack of transparency and visibility might be harming your homecare agency (and how to fix it)

Homecare businesses face a myriad of challenges: narrow margins, tough auditing processes, and a lack of staff among them. 

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However, while the challenges themselves are well-known, many homecare agencies have a tough time being able to get a good idea of how well their business is tackling them. For example, knowing how much time your care workers spend on paperwork (which might contribute to a lower standard of care), or being aware of which care professionals are unhappy in their roles and likely to leave. 

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We call these ‘blind spots’: those areas where managers and leaders lack the day-to-day visibility and transparency they need to be able to make effective decisions. Living with these blind spots means losses of efficiency, team engagement and ultimately, revenue. The most successful agencies aren't just aware of these blind spots: they actively work to address them. 

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In this blog, we'll delve into the critical issue of transparency and visibility, helping you identify where your blind spots are, and how to fix them. 

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How to know if you might have blind spots

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There are four key indicators that can signal a lack of transparency and visibility within your agency:

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• High staff turnover: According to a recent study by Hft and Care England Analysis, by CEBR March 2023*, the average staff turnover in 2022 was 25%, however a healthy value for agencies should be between 15% and 18%.
• Excessive missed or late visits: Transparency and visibility are crucial to scheduling and keeping track of your visits, and call monitoring is a key indicator of how efficient and healthy your agency is. If you're experiencing a high number of missed appointments, it could be a symptom of poor rostering management or a deeper problem with your care delivery team. While monitoring late check-ins is good practice, you should focus on the percentage of scheduled hours delivered vs. scheduled. The benchmark we set for this metric is anywhere between 60% and 80% depending on your agency, and the number of missed visits should be as close to 0% as possible, given that this is a serious safeguarding breach.
• Frequent billing and payroll errors: Accurate billing and payroll are essential for your agency's financial health, and errors can indicate a lack of transparency and visibility in financial management. With very thin margins in the industry, slow finance processes can have a huge impact on both your staff and your cashflow. New research by the Homecare Association indicates that over 8 in 10 homecare providers that hold contracts with the NHS and local authorities have experienced late payments. 
• Lack of accountability: In a transparent environment, everyone knows their responsibilities and understands their key performance indicators (KPIs) at a glance. If accountability issues persist, it's time to address transparency within your agency and ask the question, are you giving your staff enough visibility, and do you have enough visibility over their work? 

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What happens if you don’t fix your blind spots

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Neglecting transparency and visibility can result in increased inefficiency with clear consequences for your business, including:

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• Financial Loss: From late billing, cash flow problems, and lower productivity to increased staff turnover that leads to higher recruitment costs - one of the key impacts of lack of visibility is your revenue and profit margins.
• Quality of Care Issues: Care recipients rely on your agency for top-quality care. A lack of transparency and visibility over the quality of care delivery can lead to mistakes and potential safeguarding issues.
• Care Recipient Dissatisfaction: When appointments are missed or are consistently late, the care quality delivered suffers as a result. This can lead to complaints to the local authority or your regulator, with serious implications for your business viability.
• Compliance Risks: A lack of transparency can put your agency at risk of compliance issues, and will make your CQC (or Care Inspectorate) inspections much more difficult, stressful, and potentially risk your rating. 
• Employee Burnout & Dissatisfaction: Last but not least, if staff members are struggling due to inefficiency and a lack of clarity, they may experience burnout leading them to leave your business.

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A recent Birdie analysis* of the homecare sector estimated that the impact of these inefficiencies can increase your costs by up to 33%, meaning the average agency (assuming they are providing care for around 40 care recipients) could lose up to £72,000/Per Care Recipient a year if they fail to focus on these blind spots.

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How to fix your blind spots

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We’ve now established how transparency and visibility in your homecare business can harm both your agency's efficiency so here’s how to fix it:

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Operational changes to increase transparency & visibility

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• Papering over the cracks: A digital platform enhances transparency and visibility within a care agency by providing real-time access to information, enabling clear communication, ensuring accurate documentation, and offering insights into agency performance. 

• Use Care Management Software: A care management system centralises care recipient data, care plans, and schedules, offering real-time access for stakeholders. This enhances transparency by ensuring everyone has current information. It enables clear communication, provides audit trails for accountability, and allows families to view care plans, fostering trust and compliance.

• Digitise Rostering: A digital rostering system offers real-time access to caregivers' schedules, ensuring transparency in assignment allocation. It enables instant updates and notifications, enhancing communication. With clear visibility into staffing, agencies can efficiently manage resources, reducing conflicts and ensuring all shifts are adequately staffed, ultimately improving the care delivered.

• Automate Financing: Automated financing provides clear, accurate billing records, ensuring transparent financial transactions. It streamlines invoicing processes and offers detailed reports for easy tracking and reconciliation. This transparency builds trust between agencies and care recipients, minimising billing disputes and promoting a clear understanding of financial matters.

• Analyse Data for Insights: Focus on insights rather than data. Ask questions like ‘what does this dataset mean for the business’, what “story” is this data telling you and what actions should you take - the key is to use your KPIs to construct hypotheses and actions to test these. This allows you to spot trends and challenges, and make informed decisions to improve performance. A good analytical engine embedded within your care management software should be able to guide you through this process.

• Conduct Audits: Regularly conduct transparency audits of your processes and procedures to ensure accountability across the business, and share the results with your team regularly so every team member is on the same page. In doing this, it demonstrates your agency's commitment to maintaining high-quality care standards. 

• An all-in-one solution: An all-in-one digital platform that combines all of the above is ideal, as it means all of your information and communications are in the same place, rapidly reducing the possibility of misplacing information, and removing the need for data integration. But be warned here - not all care management solutions are created equal! Do your research and see what works for you. 

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Read also - Best Care Management Solutions for 2023 

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Cultural changes to increase transparency & visibility

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• Encourage Open Communication: Create an atmosphere that fosters and nurtures open and clear communication, this enhances transparency and builds trust and cooperation among team members. Start to think about how to embed this value in your day-to-day communications and democratise the sharing of data and insights within your organisation.

• Invest in Training and Development: Invest in training and development programs for your staff. These programs foster a better understanding of their roles and responsibilities within your business and help increase employee retention rates and decrease recruitment costs. In a recent survey, 80% of employees said that better access to learning and development opportunities would help them feel more engaged on the job. Check out websites such as Skills for Care or Homecare Association for more learning resources for your team.

• Clearly Define Roles and Responsibilities: Ensure that roles and responsibilities are transparently defined, leaving no room for confusion. When everyone understands their responsibilities, your business operates more smoothly.

• Provide Transparent Feedback: Give transparent feedback and recognition to your staff, use individual KPIs outlined to validate this feedback and rollback into what this means for the business. This boosts morale and enhances overall performance within the agency.

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Read also - Care Worker Skills: Ensuring Quality Domiciliary Care in the UK

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Recognising and addressing inefficiency through transparency is essential for the success of your homecare agency. By taking proactive steps to enhance this, you can safeguard your agency's profitability and reputation.

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Are you keen to find out more? The following article discusses the hidden costs of bad care management systems and how the wrong tech can cost your business more than just money.

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Always wanted to know if your agency is spending in the right places?

Birdie's FREE Homecare Agency Cost Benchmarking Tool will take your numbers and tell you:

• If you're spending more, less or the same than the average on everything from per-hour pay to travel time
• If your profit margins per hour of care are beating your competitors
• Exactly where you need to make savings or efficiencies in order to improve the health of your business

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References

1. *Hft-Sector-Pulse-Check-2022-Single-Pages-Digital.pdf

2. **Birdie ROI analysis on time-savings: https://pages.birdie.care/ebook-state-of-tech-in-care-2021

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