#SpeakUp: SACMHA

SACMHA Health & Social Care received a Healthwatch Sheffield #SpeakUp grant to explore the experiences of home care services among Sheffield’s African Caribbean community. The project involved discussions with 19 participants, including people receiving care, family carers and African Caribbean professionals working in social care. The review aimed to understand what worked well, what did not work well and what culturally appropriate, high-quality home care should look like for this community. 

Participants reported that the most positive experiences were associated with employing Personal Assistants through Direct Payments, particularly where carers shared a similar cultural background and understood personal, cultural, dietary and religious needs. Positive experiences were also linked to continuity of care, where clients knew who would be visiting them and had developed trusting relationships with carers. However, participants described widespread concerns about agency-based care, including high staff turnover, rushed visits, poor communication, lack of respect, inadequate training and inconsistencies in the quality of care provided. Many felt carers were not given enough time to provide genuinely person-centred support. 

A major theme was the lack of culturally appropriate care. Participants felt that care providers often lacked understanding of African Caribbean cultural needs and that there were too few carers from diverse backgrounds. Concerns were also raised about poor communication, difficulties raising complaints, carers failing to involve people in decisions about their care and fears that complaining could lead to poorer treatment. Financial concerns were significant, particularly around care charges, which many felt were unclear and difficult to understand. Direct Payments were viewed positively but were often seen as complex to manage without additional support. 

The report concluded that substantial improvements were needed to ensure home care services are person-centred, culturally appropriate and consistently high quality. Recommendations included improving recruitment and training, increasing workforce diversity, strengthening cultural competency, improving monitoring of providers, ensuring continuity of care, offering greater support around Direct Payments, providing clear information about costs and developing culturally appropriate advocacy services. Participants stressed that home care should respect individuals’ dignity, cultural identity and personal preferences, and argued that services should be judged on whether they work well for everyone, including minority ethnic communities.