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Home care in fragile state as some workers lack basic skills and ‘common sense’

Major concerns have been raised today about home care in England, as a report revealed issues with a number of areas in the sector.

The report, drawn up by Healthwatch, talked to 3,415 people, families and frontline staff across 52 local areas involved with home care in England to get a picture of the state of the sector.

And though most people had positive things to say about their care, researchers picked out four key areas where home care was failing to hit high standards.

Care planning was one area of concern, as many people in care said that staff were unfamiliar with their client’s care plans, and in cases where it was a staff member’s first visit to a client, often they did not have enough time to read the care plan in advance.

Healthwatch’s report also found that while staff were dedicated, often they lacked the right experience and basic skills and qualifications such as being able to wash someone or make them breakfast.

One woman in her 80s living in Bradford even said her carer could not boil an egg or make the bed, whilst another person said that social care workers needed to be taught “home care common sense”.

Other issues raised by the report include a lack of consistency, with staff coming at different times and missing appointments, and not enough communication and feedback to address problems early and prevent minor issues turning into complaints.

This reflects a similar report undertaken by Healthwatch earlier this month about care homes that found that too often older people were not consulted about how they wanted staff to go about caring for them.

“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,” said Neil Tester, deputy director of Healthwatch England.

“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,” he added. “We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn’t meet even basic standards.”

LGA: report reflects effect on sector underfunding

Councils responded to Healthwatch’s findings by saying that local authorities were committed to driving up standards of care work and collaborating with local providers to try and continuously improve services for people who rely on home care.

Cllr Izzi Seccombe, chairman of the LGA’s Community Wellbeing Board, stated: “This report shows that while most people report that their services are good there is a need to improve services.

“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,” she went on to say.


“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.”

Cllr Seccombe again said that the £2bn announced in the Spring Budget for social care was welcome, but not enough to improve care, and highlighted the importance of the government bringing forward its green paper to find a long-term solution to the crisis in the sector.

Social care leaders also agreed that there was work to do to bring home care up to the standard that it needed to be.

“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,” Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), said. “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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