Staff shortage sees ‘quarter of home care visits cut short’

One in four home care visits in Wales is cut short, research suggests.

An analysis of 2,884 home care call records by the Care and Social Services Inspectorate found 24% of visits were “clipped”, including 7% of cases where the calls lasted less than half of the planned time. A further 3% of calls had been missed entirely.

The watchdog, which published the findings as part of its review into home care services, said staffing shortages meant calls were being “crammed in”, especially at peak times of the day. Care providers were also scheduling back-to-back visits for staff but failing to factor in travel time, it added.

The staffing problems were exacerbated by the low fees councils paid providers for care, as this had a knock-on effect on the pay and conditions on offer to staff. Several providers had pulled out of contracts as a result of the fees squeeze, the inspectorate warned.

‘Market fragility’

Other findings included:

• Care workers employed by councils were on more favourable terms than those in other services.
• Commissioners were struggling to get providers to agree deliver care to people with more complex needs or who lived in more remote, rural communities.
• An “overzealous application” of procurement rules had resulted in a tendency to drive down prices in the short-term and punitive contract terms.

 
The report recommended that the Welsh Government undertake a review of the cap on charges to make funding available to pay for care at reasonable rates.

Ministers should also support the development of a standardised approach to contract monitoring, which includes ethical commissioning principles for the workforce, it said.

Providers should ensure adequate travel time is included in care schedules and that when visits are delayed they must ensure there is good communication with service users, especially those who are likely to feel anxious, the report recommended.

“There is a real danger that if we don’t invest time and resources in bringing order to the system now, costs across the health and social care system will rise significantly in the future,” the inspectorate said.

“More money needs to be made available in the system so that in years to come there is a resilient, competent workforce.”