Price is not right for home care

The home care sector needs more money, but it is not enough. We
also need a new way of looking at the service and to ask what it
should do and for whom.

Fourteen years after the NHS and Community Care Act 1990 passed
into law, home care remains the foundation of community care. If
older people or those with learning difficulties are to be helped
to live as independent a life as possible in their own homes, who
is going to help them do so but home carers? And with the support
they can offer to frail individuals who have recently left
hospital, home carers play an essential role in helping to keep
bed-blocking levels down.

Yet last year’s BBC’s Panorama programme offered a bleak
picture of home care showing poor standards and inadequate
training. Attitudes to recruitment came across as cavalier and
workers were frequently hard pressed. The programme showed just
what an under-funded, poorly regarded service can look like; you
are not going to get a quality service for such a low price.

The situation cannot have been helped by the changes faced by
employers in recent months. Not only have national minimum
standards been introduced but fees for criminal record checks
increased and VAT removed from personal care.

In some areas the poor media reports have been correct with reports
of 20 per cent vacancy rates and complaints about workers’
attitude.

But is it any wonder? Many staff are leaving the home care sector
or being put off ever joining it because, for less hassle, they can
earn the same or more in the service sector. This is not surprising
given that wages are very low compared with national average
earnings. Yet the sector needs people who have a positive attitude,
a sense of vocation and a commitment to others. In order to keep
them they must, in return, receive high-quality training,
appropriate pay and be held in some esteem.

Some local authorities have rewarded years of loyal and good
practice by switching to a provider who has made a lower bid for
the contract. Perhaps those that now pay less for external home
care can see why their own in-house service cost more.

If price is the only criterion, then what are we implying, not only
to the staff but also about the people receiving the service? Of
course price will always be a factor, but it is our vision of the
kind of service we want that should drive the price, not the other
way around.

Miranda Wixon is a member of the national executive of the
British Association of Domiciliary Care.