LGIU (Local Government Information Unit) Report

Home care should be about empowering people to live independent lives near the people and places that are important to them. It should be the way that we help people get back on their feet after a health or personal crisis. It should be the way that we save money by avoiding unnecessary hospitalisation and offering an alternative to residential care placements through support in a community setting.

But too often home care is not realising its potential. It is not working for older and disabled people who need help to live independently, and who often feel poorly served by an inflexible system that is defined by specific tasks and little continuity among care workers. It is not really working for councils, whose budgets are shrinking while needs are rising. It is increasingly not working for care providers who are competing on price and working from framework contracts that offer little predictability of work and revenue.

Perhaps most of all it is not working for the care workers themselves. They are the care sector’s greatest asset and yet many are poorly paid, little respected, essentially unregulated and ill-trained. Under these conditions it is no wonder that home care has amongst the highest staff turnover rate in the economy at around 21% – about twice the national average1. We are facing a recruitment crisis, with up to a million more staff needed over the coming decades and, without better investment in the sector, little chance of finding them.

Yet through the course of our work, we have found examples of where home care works incredibly well. It is a lifeline to many people. Sometimes home care is managed well with small teams of people supporting clients.

Many home care workers are exactly the kind of people you would want looking after you in a crisis. They are genuinely caring and dedicated. When they are skilled and compassionate, well managed, well paid and well supported they are the key to high quality care. The recommendations we make in this report aim to make this the norm.

Without a properly functioning home care system, we will be leaving hundreds of thousands of people without the support they need. We will simply spend more money on hospitalisation and residential care instead. The system needs radical reform and it also needs more investment. With a rapidly increasing older population the need to make care a career of choice has never been greater.

The political and financial reality is that it will take time to make all the changes we would like to see, but there are things that can – and should – be done now to make home care work better for everyone.