Home care is inflexible and chronically short of staff, say inspectors

Home care services are inflexible and suffer from chronic staff recruitment and retention problems, a sector overview has found.

The Commission for Social Care Inspection report, published today, reveals significant unmet need, as councils tighten eligibility criteria, contrary to the government’s aim to increase early intervention.

But while many of the report’s messages – notably on low pay and eligibility criteria – imply funding gaps, it does not specifically call for extra government investment.

Instead, the CSCI focuses its fire particularly on council commissioners, citing major variation between areas in numbers supported and the quality of services, and contract specifications which cut short the time care workers spent with people.

CSCI chair Dame Denise Platt said: “As the numbers of older people grow, councils must reshape services to support people living at home with more personalised care. Doing more of the same will not be enough.”

The report also says relationships between councils and providers are “dominated by discussions about fees and/or characterised by a mutual lack of trust”.

Colin Angel, head of policy and communication at the UK Home Care Association, said councils’ concerns dominated meetings because they had major purchasing power in the market and many home care agencies were small.

The report, based on evidence collected by CSCI over the past two years, also calls on providers to improve their recruitment practices to be able to demonstrate compliance with relevant checks, with 40 per cent failing the national minimum standard in this area. But Angel said providers were improving on this issue.

Key messages

• Home care focused on fewer and fewer people.
• Serious recruitment and retention problems due to poor pay and conditions.
• Care plans based on inputs not outcomes.
• Many visits 30 minutes or less.