Why I left the City to solve the home care crisis

What could be more rewarding than giving back to your grandparents?

My glamorous grandparents, 1951

The past 6 months have been crazy.

I left my job after just under a year, started a home care startup, spent 5 months sofa surfing to save money, watched my startup fizzle out when my co-founder left, started pursuing other ideas and then came full-circle back to solving the home care problem.

That’s what today looks like.

But let’s take a step back to the fizzling out part, since I suspect it raises questions. Informed by Paul Graham’s useful series of essays I realised that continuing as a solo founder was too risky.

Given my lack of a) capital and b) a track record that would persuade angel investors to fund a pre-revenue startup, I began considering other ideas. Ideas that lend themselves to simple prototypes I could launch on my own with limited resources.

That way, I reasoned, I might be able to generate enough traction to attract a technical rockstar. At least I had a plan.

Waaaait a second. Not so fast.

As if my life was ever going to be predictable.

I changed direction yet again when I met Alex Hersham and Joel Shamash, co-founders of HomeHeart.

I reached out simply to wish them luck with the home care platform they were building and offer my hopefully well-informed advice. I wanted the home care crisis to be solved even if I wasn’t going to do it myself.

But then less than two weeks later I joined the team. Woops.

And that’s just where the story starts up (if you’ll pardon the pun). I’m writing this post for three reasons; to introduce HomeHeart, explain why I’m involved and shed light on the critical - but misunderstood - home care sector.

One more thing…

I’m also writing this post out of excitement. The way HomeHeart is being built — and the values and principles upon which it has been founded — are awesome.

You probably don’t associate elderly care with the tech sector. It’s not sexy. It’s no Google or Facebook or SpaceX, and there are no rockets or driverless cars or artificially intelligent PAs.

But I think it’s amazing.

Last week I sat and listened to a 93-year-old WWII veteran tell me stories of trench warfare, life as a paratrooper and the harsh realities of being in a prisoner of war camp. Realities that most of us will never know.

Once a gent, always a gent

Working for a startup that is razor-focused on solving the biggest challenge facing this inspirational generation is unbelievably exciting.

An introduction to home care

Organising care for a relative is one of the most personal things many of us will have to do.

Watching relatives lose their independence — completely powerless to stop it — is heartbreaking. Fielding the unintended aggression that accompanies many age-related conditions would test anyone’s patience. And comforting your loved ones out of their tear-filled depression is something no grandchild should have to do.

And yet I did. Not just me; my entire family. For several years we had to find a way to make everything okay, when the spectrum of ‘okay’ had been unalterably skewed.

But caring for elderly relatives can also be one of the most rewarding things you’ll ever do. Not the part where they lose their independence, but the part where you do something about it.

The joy of seeing them stay in their own home, surrounded by familiar belongings and family members makes up for every bit of sadness. Seeing my grandmother’s face light up when I insisted she teach me to ‘ballroom dance’ was unforgettable.

She instantly forgot about her left-sided paralysis and started focusing on the things she could do.

I learnt that day that it doesn’t take much to change someone’s life.

The scary thing is that 1 in 10 of us actually have to arrange care for someone. Perhaps this doesn’t come as a surprise given our nation’s demographics, but don’t let that fool you into thinking it will be a walk in the park.

It deeply, deeply concerns me. Why? Because it is so terribly difficult to find an adequate, let alone outstanding, home care solution.

What made me come back to this problem and this idea?

As a founder or early employee of a startup you have to be very considered when you choose the specific problem(s) you want to solve, partly because your chances of survival are small and partly because a lack of commitment can have a proportionally larger impact than in mature organisations.

There are a couple of things I like to think about:

Personal connection ~ if you’re not personally connected to the problem you’re solving it’s harder to empathise with your customers and really understand how to improve their lives.

Commercial potential ~ if you’re solving a small problem, you have to be okay with solving a small problem. It might make a small group of people really happy, but it won’t change the world and it won’t be a scalable business.

Looking at HomeHeart in this context…

  1. It is deeply personal — I spent the best part of 5 years watching my grandparents rely on the home care sector
  2. It’s an enormous problem — the current care system is in danger of crumbling and unless we want our parents and grandparents to suffer, we need to act

But there is also a third factor in play.

3. Values

After numerous discussions with Joel and Alex I noticed the overlap between the values I want to honour and those at the centre of HomeHeart.

This had an enormous influence on my decision to join them; it’s critical for a small startup team to be hyper-focused, and having a common set of values ensures everyone is aiming towards the same end goal.

What exactly is the problem we’re solving?

If you have organised home care for an elderly relative you will be all too familiar with the challenges…

  • How can you ensure a caregiver is the right personality fit?
  • How do you guarantee they are properly trained?
  • How can you ensure the same familiar team of caregivers comes back consistently?

The first problem is information overload.

Where do you even start…?

Assuming you manage this hurdle, the second problem is implementation.

Standards vary widely, you have to put up with missed or late visits, there is massive variety in the specific carers that turn up and you, as the organiser of a care package, often have little power to drive change.

In other words, due partly to the under-supply of carers relative to people needing care, standards are — on average — far below those we would wish upon our loved ones.

What is the status quo?

Care providers are businesses. Naturally, they want your custom. But how do you choose who to give it to?

Seeking referrals from friends tends to work pretty well so long as you can request the same carers their loved ones had. Finding clinicians to help you make your decisions can also work, but they don’t usually know the carers personally.

Once a team of carers has been appointed, you also need to ensure they’re doing everything they should be doing which is difficult if you haven’t been through the process before.

What can we do about it?

In my opinion the solution is transparency.

As organisers of care, we need a way of knowing that the guidance we are given is accurate; that there is complete transparency.

If a provider doesn’t have a full team of carers who can offer outstanding care — but one of their competitors does — we deserve to know. If they can’t guarantee we will have the same team of carers all the time, we deserve to know. And if they can’t guarantee they will provide carers who are appropriately trained, we deserve to know.

Having been on the receiving end of advice that has proven to be misleading or incorrect, I am acutely aware of how important this is.

But for transparency to become commonplace, it needs to be baked into the values of social care providers. This is exactly what we’re trying to do at HomeHeart.

How are we doing this?

We are doing this in a number of ways:

  1. First and foremost we respect the sensitivities of this industry and always put clients’ needs above any business considerations. We’ve all been there and we all know how difficult this experience can be. This is what drives us;
  2. Our online platform displays profiles that include training and certification details as well as introductory videos for all of our caregivers. Clients can get a sense of who they are and compare them with any other alternatives, as well as benchmarking against other HomeHeart caregivers, before having to make any decisions; and
  3. We’ve got some exciting plans (to be announced shortly — watch this space) around how we can empower our clients through really cool transparency measures. I’ll say no more just now, but you won’t be disappointed.
Our objective is to build a future in which the focus is on you and your loved ones, not on us.

But that’s not all.

To build a home care system that is genuinely exceptional we need to do more than just provide transparency.

This is why we only accept 5% of the carers that apply to our platform, and why we pay them over 50% more than they are paid elsewhere.

You see, to have exceptional care it’s necessary to have exceptional care professionals. Given how vital their job is, they deserve our respect. They deserve to be treated like superstars and they deserve to be paid fairly.

We also believe that consistency of care is vital. Seeing lots of different carers is confusing, traumatic and puts vulnerable people at risk. Not acceptable.

Our technology allows us to go through a rigorous matching process and ensure all of our clients are paired with the person or team that is completely right for them. Once they’re matched and both parties are happy, they’re there to stay. It is as much about friendship as it is about dependency.

The future of home care

Many people recognise the troubling state of affairs in the home care sector. Having witnessed a lot of them myself, one thing is clear to me: a different approach is required. A novel and innovative approach; not simply an extension of the status quo.

If we carry on as we are there is a severe risk that we will fail to protect our nation’s older generations.

At HomeHeart we’re still learning exactly what the correct solution looks like — and that will take time — but the platform we’re building is a significant step in the right direction. Early signs suggest that it’s working, and if we stay true to our values we could very well find ourselves living in a radically different world.

If you’re concerned about elderly relatives and would like to talk, you can call the team on 0203 389 8147, visit www.homeheart.org or drop me an email on rowan@homeheart.org.

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