The continued ‘under-funding’ of adult social care is placing the home care provider market under a lot of pressure, council chiefs warn.
A new study on home care provision by consumer watchdog Healthwatch England has outlined four areas where people's experiences of the service could be improved. These include care planning, skills and qualifications, consistency and continuity, and communication and feedback.
The report, entitled Home care services: What people told Healthwatch about their experiences, analysed the experiences of 3,415 people, their families and front line staff across 52 local areas between August 2015 and June 2017.
While most people had positive things to say about their home care, many complained of staff who were unfamiliar with their clients’ care plans. In cases where it was a staff member’s first visit to a client, according to the report, they often didn't have enough time to read the care plan in advance.
There were also concerns that some care workers lacked experience and basic skills, such as the ability to wash someone or make them breakfast. One person said care workers needed to be taught ‘home care common sense.’
The watchdog heard many reports of staff coming at different times and even missing appointments. One of the watchdog’s branches, Healthwatch Staffordshire, reported a number of people felt care packages were designed to meet the needs of the service provider rather than the service user.
The research also found many people had complaints about communication. Healthwatch urged providers to make greater and more regular use of feedback to address problems early and prevent minor issues turning into complaints.
‘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,’ said Neil Tester, deputy director of Healthwatch England.
‘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.’
Responding to the report, Cllr Izzi Seccombe, chairman of the Local Government Association’s (LGA) 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,’ Cllr Seccombe continued.
‘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.’
The Local Government and Social Care Ombudsman, Michael King, joined the LGA in welcoming the report. He said:'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.'
Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), also welcomed the report and said it provided ‘insight into a vital service’.
‘Most adult social care services in England are providing people with safe, high quality and compassionate care,’ she said.
‘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.’
Also responding to the report, Bridget Warr, chief executive of the United Kingdom Homecare Association (UKHA), ‘Healthwatch’s report adds to the growing body of evidence on the human impact of a fragile care system.
‘UKHCA strongly believes that the solution is properly resourced services, commissioned in a flexible way, so that front-line careworkers have sufficient time meet people’s needs in full.’
Ms Warr also added that councils needed to address the impact that their contracting arrangements have on service delivery, and care providers’ ability to recruit, train and retain an experienced workforce.