Staff shortages severely affecting home care services

A new report has warned that squeezed funding and staff shortages are severely affecting home care services in some areas of England, in some cases forcing providers to leave.

Home care in England: views from commissioners and providers, published by The King’s Fund and the University of York, examines the ‘extremely fragile’ market for home care providers in the UK, finding that squeezed margins and low fees are forcing providers to leave. In more than one in three local authorities last year, providers handed back home care contracts, while some of the largest providers have withdrawn from the publicly funded home care market altogether.

The report says that the ‘relentless challenge’ of staff shortages are coupled with concerns that fees paid by some local authorities are too low to maintain quality services, which, in itself, leads to high turnover of providers and staff. Suggesting a link between prices paid by councils and the quality of home care provided, council spending on social care was three per cent lower last year than in 2009/10.

In the paper, The King’s Fund highlights that four in 10 home care workers leave their role every year and that more than half of home care workers are on zero hours contracts. In a 2017 survey, many council directors of adult social services reported having experienced home care providers ceasing to trade in the previous six months (39 per cent) or having contracts handed back (37 per cent).

Simon Bottery, senior fellow for Social Care, at The King’s Fund, said: “Squeezed funding and a shortage of workers have left the home care sector in a fragile state. Home care providers are competing for staff with other sectors paying higher wages, offering more stable employment and better working conditions.

“The 249 million hours of home care delivered each year, much of it publicly-funded, has huge potential to improve people’s health and promote their independence. The system needs a fundamental overhaul, beginning with the upcoming Green Paper, but the prize of a better, more effective home care service is worth having.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “This worrying report is further evidence of the funding crisis in adult social care and its consequences. The squeeze on local government funding overall, coupled with rising demand and increasing cost pressures in adult social care, mean many councils are having to make significant savings and reductions within adult social care, which is impacting on an ever more fragile provider market.

“Government needs to plug the £3.5 billion funding gap facing adult social care by 2025 to ensure that quality home care provision is available and continues to play its vital role in supporting people to remain independent and well at home, rather than in costlier settings such as care homes or hospitals. With the right investment and profile, the care profession should be made to be a more attractive, rewarding and fulfilling career. While one-off funding injections may help curb the severity of immediate pressures, they are only short-term. The government needs to be bold in its forthcoming Green Paper by setting out options to secure the stability and sustainability of social care for the long term.”