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Care by design

Sebastian Nause-Blueml is a service designer with no care experience, yet for his final project on his Royal College of Art Masters degree course, came up with inventive ways to make the professional lives of home care workers more engaging, motivating and fulfilling.The demand for home care is increasing, with the positive shift towards wanting more people to have care and support in their own home. As a result, care workers are being asked to provide support to individuals with more complex conditions, which require exceptional technical and people skills.Care providers have adapted to this with increasingly professional and continuous training and development for their staff. Disappointingly, however, terms and conditions have not kept pace with the increased requirements of the workforce, with care commonly perceived as a low-skilled career with little progression.Indeed, the Kingsmill Report said that care work was in a “crisis” and called care workers “under-valued, under-paid and under-trained.”Mapping out complexity So how did a design graduate with no experience find solutions to this complex set of problems?The answer lies in the complexity itself – service design is about mapping out complicated processes and untangling the issues in order to identify problems and find ways to implement improvements.Increasingly, large institutions are turning to service designers to navigate through the complexities, unravel processes and uncover ingenious answers.According to the Royal College of Art, “the service industry represents around 75% of the British economy, yet the role of design in transforming both public and private sector services is just emerging.The programme examines how design can transform the experience and value of services, making them compelling to users, as well as attractive and profitable for the organisations that deliver them.”So, perhaps it’s no surprise that one of its graduates could offer some inventive solutions.Problem areasSebastian spent three months with a national care provider – professional integrity prevents him from revealing which one (not Mears) –shadowing frontline staff and interviewing clients and managers.From his research, and from his interest in studying theories in engagement and motivation, he was able to map out the problem areas and look for innovative solutions.Some in the care industry may say that the problems are already well-known, so what revolutionary ideas could someone with just three months experience have to offer?Sebastian says that outsiders bring a much-needed impetus to treating ingrained problems.“Experts in the field might get used to working with or around the problems, rather than seeing solutions. It’s easier for outsiders to bring a fresh set of eyes and a new mind-set to imagine different processes and new scenarios.“It’s also easier for outsiders to bring new people with different perspectives to the table – making fresh connections is key.“For a service designer, it’s important to be specific in how you approach the problem, but also diverge to look at problems from different perspectives. You need to talk to people and co-create solutions.”Innovative alternativesHe admits to being overwhelmed at first by the size of the problems in home care.“You have to be really open-minded and explore lots of possibilities, and identify not just the problems, but those which are worth solving ­rather than creating more problems, focusing on the right ones.”In the end, he identified three main problem areas:

  1. Isolation – “It’s not just the clients who are isolated but also the care workers themselves,” says Sebastian.
  2. Career progression – “I met one guy who’d been there 18 years and was still considered as only a support worker, despite his knowledge and experience.”
  3. Control – “care workers feel overly-monitored and controlled, with no room for flexibility when it makes sense.”

So what solutions did Sebastian come up with to these difficult and widespread problems?He calls he proposition Lift. He says “the goal of Lift is to make the jobs of care workers more motivating and engaging, increasing their quality of life and as a result, helping to reduce staff turnover and improving the quality of care overall. In short: Lift cares for carers.”Lift looks at many aspects of care work, including career progression through credit-based learning; control and flexibility of schedules; better and clearer pay structures, and peer-to-peer learning, through the creation of meeting spaces for care workers to share experiences. Find out more at Sebastian’s website – see link at end of article.Sebastian is now working with the LGiU to share his findings. But perhaps the biggest lesson that we can learn is this: if the care sector needs systemic change, design can provide practical approaches, innovative alternatives, and help us map the way forward.


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