One quarter of home care providers in England are failing to meet key standards

Failing home care providers need to prevent substandard services ‘becoming the norm’, according to a national overview of the sector published today by regulator the .

The report ‘Not just a number’, was compiled from 250 inspections gathered between April and November 2012, which the regulator hopes will provide a clearer view of a sector that can present an awkward challenge for inspectors. As the report states: ‘Home care is one of the most difficult areas of care to monitor in terms of gathering the views of people who use services. Often people are in vulnerable circumstances but the care provided is harder to observe than in a hospital ward or care home.’

Of those providers inspected, 74 per cent were found to have been meeting all five of the CQC’s key standards, but of those services lagging behind a number of worrying trends are recorded. These include: missed or late calls; lack of staff knowledge or skill, particularly in regards to dementia; inadequate assessment of need; lack of detailed care plans; lack of visit coordination where more than one care worker is required; as well as poor communication with family and loved ones.

The report also includes feedback on care professionals’ concerns, which included a lack of support from staff or management; lack of planned supervision or performance monitoring; unmet or unidentified training needs; poor training in the use of equipment; and overlooked induction periods.

CQC chief executive David Behan commented on the findings: “People have a right to expect to be treated as an individual, to be able to exercise choice, and to make sure their carers are aware of their specific care needs. We found plenty of evidence of this however we also found elements of poor care which happen too often.”

Debbie Sorkin, acting chief executive of the , believes that strong leadership is the essential quality required to turn around these failing services, saying: “There is a body of research across the sector illustrating the strong correlation between quality of leadership and quality of services, and it is vital that the spotlight remains on leadership, and the positive impact it can have, in addressing issues around how to deliver consistently high quality care and support in times of austerity.”

Although the Skills Academy also praised those 74 per cent of services that are performing well despite significant funding pressures, a sentiment echoed by the (UKHCA), whose chief executive Bridget Warr said: “We should celebrate homecare services that provide vital support to over 700,000 people in England. People’s desire to remain at home for as long as possible requires high quality, reliable homecare services which are respectful of individual needs and which safeguard their well-being and choice first time, every time. However, we cannot be complacent when for a minority of people this does not always happen consistently.”

Chair of the Local Government Association’s Community Wellbeing Board, David Rogers, believes that the funding shortfall remains the crucial factor, however. He comments: “Councils are committed to driving up standards of care for the most vulnerable members of society. Local authorities will work with the Care Quality Commission and care providers to stamp out poor performance and will stop using those who fall below suitable levels.

“However, as this report highlights, 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 stark reality is that the current care system is underfunded and not fit for purpose.

“Local authorities are facing an estimated £1.89 billion reduction in social care budgets and we are concerned that without an urgent injection of money to meet rising demand in the short term, alongside a major revision of the way it is paid for and delivered in future, things will continue to get worse.”

chief executive Jeremy Hughes point out that the rise of adults diagnosed with dementia means that improvement is even more crucial.

Mr Hughes says: “Half a million people with dementia live in the community and as the brain gradually shuts down many will need help with everyday tasks such as eating meals, washing or going to the toilet. However, patchy quality means that some people are being forced to struggle with poor and in some cases undignified care.

“Good quality home care not only maintains dignity but also prevents people reaching crisis point and going into hospital unnecessarily or care homes early. If people are to be supported to live at home for as long as possible we must ensure that the good care highlighted in this report is being seen across the board.”

This increase of demand, caused by an ageing population, is verified by the CQC report, with figures showing a 16 per cent increase in home care providers during the 2011/12 financial year, with a further rise of 6 per cent in the first six months of 2012/13.