Healthcare and social enterprise is a booming sector and has the prospective of turning into a sustainable business. In United Kingdom, CCPs or clinical Care Programmes have been introduced with the objective of standardizing the different models of care for an integrated care delivery system. In UK, the cost of care homes is between 400k pound to 2m pound. However, homes below this margin continue to make generous profits. Care homes in the country have garnered adequate amount of media coverage in the past few years. The goal of CCP is to enhance the quality of care, facilitate access to different services in the healthcare system and boost the cost effectiveness. In this context, this essay explores and examines the variegated funding strategies about Running-home, a care home that is dedicated to the welfare and holistic development of the elderly population in United Kingdom. The essay aims to engage in a critical understanding of health and social care funding care services and evaluate their impact on the opportunities and social enterprise. Secondly, the essay aim is to engage in a critical debate regarding the prospect and strategies of funding of funding a an eldercare social enterprise through the analysis of Running Home. The themes that will be addressed in this essay are organizational aims and objectives, management structure, market Needs and Services, The target community, the delivery strategy, partnership working, organizational culture, policies and procedures, sources of funding and monitoring and evaluation.
The State of Social enterprise Report (2015) show that social enterprises in UK are booming, doing better than their mainstream SME counterparts in mostly all parts of the business such as the workforce growth, growth, job creation, business innovation, business optimism and growth. The public sector is exemplified by globally networked markets, social enterprises are the new wave of enterprises that are useful in dealing with environmental social issues that are plaguing the society. About 50 per cent of social enterprises are shown to have experienced a profit with a 26 per cent break (De Nardi, French and Jones 2016). The profits incurred from the investment are utilized for social and environmental objectives. Social enterprises in UK are subsumed under The Companies Act, audit, tax regulations and so on. It is predicted that the number of the aged people at 85 is expected to grow twice from 1.4m to 3.5m in the 25 years; hence there is a growing market for care home services (Thomas, Lobo and Detering 2017). The number of residents who are part of the independent-sector care homes is to experience an increase in 459000 by 2019. Those averse to nursing care in homes run by private investors for their personal care, the government is to their rescue as it pays around a quarter of fees compensated by the government. Given this context of the health and social enterprise in UK, the aim and objectives of Running home is to provide affordable intensive care to the elderly population in UK who are in need of care. The idea would be to provide them with nursing care, hygienic living environment and healthy food. There would be trained nurses and professional social workers to help to address the special needs of the elderly patients with dementia.
The elderly care home would be organized in the following way-there would be CEO at the top of the organization supervising the work along with the support services (administration and finance), this would be followed by the director of care (person in-charge) and below them will be the clinical nurse manager, activities co-coordinator, administrator, senior housekeeper and head chef. Below them will be senior health care assistant, physiotherapist, professional social worker, housekeeper, kitchen assistant and staff nurse.
According to Macaulay et al. (2017), venturing into social enterprise as a business model provides avenue and opportunities to the social actors to invest the surplus for socially relevant causes instead of distributing it among the shareholders and the investors. As a social entrepreneur of the healthcare sector, we devised plans that sought inspiration from a conceptual model that is corroborated by empiricism concerned with health and the welfare of the social enterprise (Sixsmith et al. 2014). The services that will be provided by Running Home includes community support and activities, counseling, special diet based on the requirements of elderly care patients, day care centers for elderly patients and special assistance for patients with dementia. Running Home also plans to implement strategies for its marketing that may range from establishing a new home to expand an existing one. It needs to be kept in mind that direct marketing is unethical; hence, advertisements may be carried out through the health professional pages and networks like Yellow Pages, specialist magazines and online means. As an alternative, word-of-mouth remains the key strategy in the promotion, advertising and marketing of old-age care homes. Owners can encourage the peers and families whenever they get the opportunity along with networking with the local level GPS (General Practitioners), healthcare professionals and nurses (Quint et al. 2016). The healthcare professionals can be invited to have a look at the standard and facilities of care. Prospective residents can also be made an offer of free trial for a period of few months, as it would enable them to sample the environment of the home and accordingly decide the suitability and compatibility of the homes (Munoz et al. 2015). Along with the factors of staff, décor, environment and facilities, location of the care home plays a determining factor for the prospective residents and their family members. Care homes that are situated at the close proximity to the parks, sea and other quiet and picturesque locations are quite popular with the residents (Carpenter et al. 2017).
The target community for Running Home would be elderly care patients above the age of 55 years who would be in need of special assistance. Elderly patients in need of day care centers will also be welcomed.
The delivery strategy for the elderly care home would be keeping the client at the heart of the service, bringing delivery that is close to the citizen and focusing on the wellness and health of the elderly residents in the elderly care home. The delivery strategy will be collaborative and there will be focus on delivering individualized and integrated healthacre through the collaboration between competent doctors, healthcare professionals and chefs.
Running home believes in engaging in partnership with associations who share our vision of integrated and intensive healthcare service at an affordable price. We will seek support from corporatees like who have a committed CSR (Corporate Social Responsibility) policy and make them a partner in our initiative.
Organizational culture refers to the experiences, values and beliefs and in the context of Running Home we believe in the principles of communication, transformational leadership and teamwork. There is also emphasis on staff and resident outcomes on the care facilities.
Running home believes in providing value for money service, therefore we would inform the clients about the cost of care per hour once they have a mail for query or if they contact us via phone. Running home will offer the families and the clients 41 per cent tax relief on the cost of homecare. The clients will also be allowed for homecare grants that can be applicable for any local healthcare centre.
Running Home is a start-up old age home that firmly believes that the socially disadvantaged people, in this case the elderly population need to feel confident, secured and skillful. A social enterprise demands the development of business skills that can be translated into social practice. Managing and supervising a social enterprise related to the elderly population requires skills, expertise, rigour combined with the external support or within the organization. This old-age home is at the forefront of adhering to a responsive and customer-care approach.
The first model of funding to be considered is the Money Follows The Patient (MFTP) that was introduced to provide a new leash of life to the Irish hospitals. This funding model provide grants and financial assistance to hospitals based on their quality and size structure. It also aim to produce incentives that would promote the treatment and medication at the primary level (Darker 2013). The first key features of the MFTP model are to support the equitable single system that provides insurance to all the concerned patients along with the financing of their care delivery. The second goal of the MFTP is to foster a fair system in regard to the distribution of the resources and hospitals will be provided government subsidies for the quality of their care. Thirdly, the objective is to catalyze high quality hospital services and promote efficiency. The DRG system familiar classification system in Ireland is responsible for the distribution of budgets for different hospitals. However, running Home needs to identify the shortcomings of DRG and like many healthcare professionals working in Ireland, it recognizes that DRG hardly has benefits for the hospital payment structures. The healthcare providers do not reap any benefit for their contribution to the improvement of healthcare. The DRG scheme might not prove to be fruitful for Running Home as earlier it has been found to forge segmentation and dissuade treatment in the suitable environment.
Another strategy for funding would be to depend on microfinancing. Microfinance is $65 billion market and around 90 million in some of the poorest countries in the world have harnessed the benefits of microfinance (Harvard Business Review 2018). Financial engineering is being looked as a new wave of change in the direction of funding for social enterprises. Dependence on this microfinance posits to be promising as the core value of healthcare homes. It is difficult to fund entirely through investment or sales. Providing the elderly population with affordable healthcare service, safe cleaning products and foodstuffs can be onerous for the care homes.
Another funding model that has been prevalent in Ireland and therefore, remains a potential funding plan for Running Home is the scheme of Commissioning of services. In this scheme, the onus lies with the CCGs (Clinical Commissioning Groups) to guarantee that incentives are provided to the healthcare service providers. Running Home can seek help from the Healthcare Commissioning Agency (Gozalo et al. 2015). This agency has the power to disseminate financial resources and healthcare costs through the direct payment of funds. This agency works directly under the supervision of the Department of Health of the government of Ireland. It retains a key role in the management of the flow of funds between the different levels and phases of the healthcare system.
Another strategy would be to seek the support of state government subsidies, different charitable foundations and also philanthropists who are interested in making donations or are willing to bear the lower financial returns on the investment in the social enterprise. Despite, the moral and ethical outlook/worldview there is lack of invigorating approach to fund social enterprises. A business can make use of business plan and balance sheet provides different combinations of returns and risks for
The public sector is the primary source of income for the 27 per cent employees and 59 per cent social enterprises are engaged in business with the public sector (Social Enterprise UK 2018). About 44 per cent of social enterprise veer towards funding or finance whereas 39 per cent believe in the presence of a hurdle for their sustainability (Sackley et al. 2015). A meagre of 5 per cent of the SMEs is of the view that the issue of finance poses to be a barrier (Guest et al. 2015). Social enterprise like NGO is promising in the domain of finance and obtains repayable loans. Many of them can access to loan finance, balance of grants and equity or quasi-equity. The financial imperative of companies varies according to the changing time. For example, start-ups attempt to poll in economic resources with the aim to prove the validity of a new idea in the climate of seasoned and reputed establishments that will involve finance to foster growth or to neutralize the effects of cash flow.
The next key strategy for funding would be to seek the support of the government provision to promote and encourage social welfare enterprises. The government recognizes that social enterprises are committed towards some of the most revolutionary and pioneering work that would help to minimize the pressure on acute service. In Europe, the Public Services (Social Value) Act is promising as it paves the path for new and innovative thinking. On the national front, the Sustainable Development Unit and Cabinet Office are coming up with conversations with the NHS England and Public Health England on their vision regarding the social value (Roy, Baker and Kerr 2017). It was further revealed that 31 per cent of social enterprises are subsumed at the 20 per cent slab working for the marginalized communities in UK (Goodman et al. 2017).
Running Home is aware that patient capital is an important aspect of managing an old-age home. Pertaining to social enterprise, patient capital is a key investment. Although, it is a repayable finance, however it is usually repaid when the social enterprise reaps considerable profits that are sufficient to repay the loans (Coulter 2014). The profit generated from the investment is viewed as risky for the social investors. The long time horizon helps in the effective growth and the promotion of high-risk and high-impact endeavors.
Another strategy of Running Home would to be to approach the banks (The Guardian 2018). These include loans of working capital, cashflow lending and the provision of products related to finance. Another potential source of funding would be patronage from prominent social care organizations.
Another key concern of funding would be to tap the resources of the integrated care models pioneered by the government. The foundational premise of integrated care models is to provide a leverage in terms of financial advantages (Quint et al. 2016). This may be attributed to the cost reductions at the clinical and the administrative level. However, as an emerging player in the sector healthcare enterprise. Running Home needs to be aware that integration process comes with its own share of risks- there may be an increased risk without any scope for saving.
An inspection and registration system can be an effective strategy for the quality system for monitoring and evaluating the care provided to the elderly residents of Running Home. The CEO and the support services would be engaged in weekly evaluation and formulate monthly progress reports in association with the family of the clients to monitor the roles , responsibilities and functions of each of the units responsible towards the maintenance of Running Home.
Running Homes is aware that in the context of UK, social care and health services are exposed to severe challenges. The pressure for demand now surpasses the structured funding. The commitment of the government should be to mobilize resources in order to place social and healthcare services as a strong agenda. It has been found that whatever maybe the modes for procuring health related funds, ultimately it is the economy that equips with the modes to repay. There are thrust areas in reforming the funding system to create a culture of sustainable and predictable environment. In certain cases, there would be an increase in the revenue. Running Home aims to provide collaborative, integrated and individualized healthcare service to the elderly population in UK at a competent price.
Therefore the above discussion on the multiple aspects related to funding an elderly care home in the backdrop of Ireland exposes that there is going to be a rise in the number of elderly care population who would avail the service of care homes. In this context, Running home needs to incorporate adequate facilities combined with well-informed medical professionals who would share the vision of a social enterprise. Since, a healthcare organization is grounded on moral and ethical parameters. The motto of Running home should be to promote the care home through its proactive service and keeping a tab on the latest trends in finance for social enterprise in UK and make corresponding adjustments for a sustainable enterprise.
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