Watchdog Calls For Longer Home Care Visits

Demand for home care is expected to grow in the coming years due to England’s ageing population. Many councils buy-in care from private firms and pay by the minute, so make visits as short as possible to save money.

Bridget Warr, chief executive of the United Kingdom Homecare Association (UKHCA), chaired the group of experts which developed the Nice guideline. “There is quite a lot of payment by the minute for contact time and it is impossible for the workers to deliver the sort of care they want to”.

Earlier this week, 20 organisations, including charities, care providers and the NHS, published a joint submission to the Treasury ahead of the government’s Spending Review in November to urge ministers to protect social care as is being done for the NHS.

NICE’s first guideline for the social care sector sets out recommendations that are aspirational but achievable.

Sandra Duggan, who relied on home-care services to look after her late mother, a dementia sufferer, said: ‘We had occasions where the carer simply didn’t turn up. Numerous recommends require a change in attitude rather than additional funding.

Nice’s guidance also called for the appointment of named care coordinators for each individual receiving care. Without good support, older people can suffer from social isolation, malnutrition or neglect. They may also be at risk of injuring themselves and could end up in hospital’.

The new Nice guidance says contracts should “allow home care workers enough time to provide a good quality service, including having enough time to talk to the person and their carer, and to have sufficient travel time between appointments”.

People with disabilities and communication problems may need workers to spend more time with them, while some need help with eating and drinking, it said.

The Nice guideline goes further than the statutory guidance under the Care Act 2014, which says 15-minute visits are not appropriate for the delivery of intimate care but may be for safety or medication checks, or if they are chosen by the person.

“But more than 70 per cent of home care is commissioned by local authorities or clinical commissioning groups and the funding from those sources for home care at the moment will not cover it. “The guideline is very clear about the length of time – it suggests no visit should be shorter than 30 minutes unless it is part of a bigger package of care”. But this isn’t happening everywhere and if workers are in a situation where they have to choose which task to do before they have to rush out of the door this isn’t acceptable. Aimed predominately at those who commission and provide state funded home care, it promotes high quality services for older people across England.

“They should ensure that workers have time to do their job without being rushed or compromising the dignity or wellbeing of the person who uses services”.

“Regular training and development is also important: not only will it lead to a more skilled workforce, but may even help to retain staff by giving them a better defined career path”.

We recognise there may be challenges for some commissioners and providers in implementing our recommendations, but it can be done.