Rural home care services are becoming unviable become of the combined impact of cuts and journey times between visits, according to the United Kingdom Home Care Association.
Providers say cuts are leading to lower fee levels and shorter visit times are creating problems in recruiting and retaining staff with the right skills and experience in rural areas where travel time often far exceeds time spent delivering care.
A UKHCA survey of decisions by 111 councils and health and social care trusts found a fifth had cut the rural rates premium, which takes account of the longer distances between visits. It also found 10% of providers had turned down work in rural areas or where visit times had become unprofitable or otherwise inadequate.
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"Carers have to do it in all weathers," said UKHCA chair Mike Padgham. "It could be late at night going down a farm track. Doing that on a Saturday evening in the mid-winter isn't always attractive to people so we've got to pay a fair rate."
One home care agency boss in Cornwall says it had lost up to 20% of its annual income because of cuts introduced by Cornwall Council two years ago. This included stopping paying weekend rates and extra for bank holidays.
She claimed nearly half of providers had ceased trading in the county leading to problems in meeting demand, and that she had lost some experienced staff to care homes.
"We pay barely above the minimum wage. We managed to give staff an increase of about 1% and that was by cutting [profit shares and bonuses] for directors." A Cornwall Council spokesperson said: "The adult care and support budget has been frozen this financial year, with a commitment for it increase in 2012-13. "We have a very positive relationship with providers and work closely with them to meet the challenges of providing domiciliary care in dispersed, rural communities."
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