Home care services: Healthwatch report

Across England there are more than 5,500 home care providers, collectively helping an estimated 673,000 people to continue living independently within their communities. Home care services help people live at home for longer by offering support, such as regular visits from a carer to help with personal care, getting dressed, using the toilet, shopping and preparing meals.

The new report Home care services: What people told Healthwatch about their experiences, analyses the experiences of 3,415 people, their families and front line staff across 52 local areas between August 2015 and June 2017.

Most people had positive things to say about their home care. These services are invaluable to many people, both for the quality of care provided and the support and company of care workers.

Older people in particular said that one of the most positive things about home care is that it enables them to remain in their own home and to maintain as much independence as possible.

Neil Tester, Deputy Director of Healthwatch England, said:

"It’s often incredibly important to people to be able to stay in the familiar surroundings of their own home. One of the most positive aspects of home care is that it enables people to hold on to as much independence as possible.

“We listened to people using home support services and those delivering care and they have given us a clearer picture of how the system works for them. We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn’t meet even basic standards.

“Given the challenges facing the social care sector, it is more important than ever that people’s voices are heard. So if anyone has a story they want to share or an idea they think might help, I urge them to get involved and speak to their local Healthwatch.”

Reacting to the report Matthew Kalupka, Director of Home Counties Carers, a family run home care business in Surrey, said:

"My immediate impression of the report is that there is a great deal more content given to the negatives rather than the positives. Thankfully there is mention that "Most people had positive things to say about their home care.

"Given everything that the sector has to contend with Carers do the most amazing job and are slowly being recognised for it.

"Agreed not all home care is not perfect. The sector could certainly do with a significant injection of cash but I don't see it arriving any time soon.

"From our perspective more money would be very helpful as more money means more time. More time would alleviate most of the issues highlighted in the report.With more time it is possible to keep care plans current and up-to-date, with more time the Carers can familiarise themselves with the care plan, with more time Carers can be given time to learn and develop themselves, with more time Carers can be supported, managed, mentored and developed so they don't leave the sector, with more time office staff can react to the constant flow of information that comes into the office 24 hours a day 7 days a week.

"We have to be creative, we need to be inventive. Time can be saved and made in other ways. There are now a number of innovative software packages that make care planning in real time a possibility. Enabling care plans to be updated constantly with new information being at the Carers fingertips almost instantly. We are using an App called Mobizio that has this functionality and will give Carers and the team in the office more time to improve our service.

"Another possible way to create more time is to reduce the travel distances between clients. By concentrating on providing care in smaller areas the time lost by Carers travelling can be spent with with Clients or on learning and personal development. To me it makes sense considering swapping clients between neighbouring companies to reduce travel distances, making more effective use of time.

"I believe all Clients deserve the best care and to achieve that you need the best Carers. For this we need time to train and retain the Carers.

"I fully appreciate there are many regional, geographic and socioeconomic variations across the country so nothing is ever as easy as it appears on paper but there are so many positives about the sector and with a little bit more time us providers will make it work."

Michael King, Local Government and Social Care Ombudsman, said:

“We welcome Healthwatch England’s report on the quality of homecare providers. Our own review of social care complaints showed that for people receiving care in their homes, it’s often the little things that mean so much to them in maintaining their dignity, independence and a good quality of life. Consistency of care is vital to those who rely on these services.

“Comments, compliments and complaints should be an integral part of any provider’s quality monitoring and improvement planning. Care users and their families should be confident that any feedback they share about their care will be responded to appropriately and that their providers will use any learning to inform service improvements.”

Janet Morrison, Chief Executive of Independent Age, said:

“With growing numbers of older people experiencing care needs, local authorities place a big emphasis on home care. This Healthwatch England report highlights too many things that still go wrong in domiciliary care.

"From missed appointments as care workers rush about under huge stress, through to medicines getting mismanaged, and unsafe care - in many areas home care still isn’t delivering what older people have a right to expect.

"However, as the report attests, at its best, home care enables individuals to remain independent, close to friends and family. The government now needs to come forward with its promised consultation because there is still unacceptably high variation in the quality of home care, and other social care services.”

Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said:

"Home care services provide the vital support for some of our most vulnerable citizens to remain independent in their own homes. Councils are committed to driving up standards of care and work closely with local providers to try and continuously improve services for people who rely on home care.

“This report shows that while most people report that their services are good there is a need to improve services. However, the financial pressure facing services is having an impact and even the very best efforts of councils are not enough to avert the real and growing crisis we are facing in ensuring older people receive the care they deserve.

“The continuing under-funding of adult social care, the significant pressures of an ageing population and the National Living Wage, are combining to heap pressure on the home care provider market. This study shows the strain providers are under, and emphasises the urgent need for a long-term, sustainable solution to the social care funding crisis.

“While the £2 billion announced in the Spring Budget for social care was a step in the right direction, it is only one-off funding and social care services still face an annual £2.3 billion funding gap by 2020.

“It is absolutely critical that the Government brings forward its Green Paper on the future of social care announced in the Queen’s Speech, and that it works with local government leaders in delivering a long-term sustainable solution for social care. This must address the issue of long-term funding, but it must also create the conditions necessary to ensure the development of the right kind of care and support services.

“This is the only way to protect vital support services, like home care, ensuring older people and those with mental health conditions, learning and physical disabilities live dignified and fulfilling lives.”

Margaret Willcox, President of the Association of Directors of Adult Social Services (ADASS), said:

“Home care is essential to enabling older and disabled people to remain in their own homes. They and their families need and deserve it to be of high quality.Every minute of every day dedicated home carers make a difference to over a million people’s lives.

“Most adult social care services in England are providing people with safe, high-quality and compassionate care.

“That they are doing this in the context of rising demand and inadequate funding is a tribute in itself but there is always room for improvement and this report provides helpful feedback that both commissioners and providers can use.”

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