'Underfunded' and 'unstable' home care sector puts older people at risk

The viability of state-funded home care is at risk due to ‘widespread and systematic’ underfunding, according to a report by UK Home Care Association.

In a report based on Freedom of Information requests sent to 208 local councils, UK Home Care Association (UKHCA) found that home care workers and people who rely on their services are being ‘short-changed’ by councils’ lack of funding in the sector.

Just one in ten local authorities were found to be paying an hourly rate of £16.70, UKHCA’s minimum price for home care. UK Home Care Association estimates that this is the rate necessary to comply with National Minimum Wage regulations, including travel time, and the costs of sustainably running the service.

Jane Townsend, chief executive of Somerset Care, said in a BBC Radio 4 interview: “We operate in quite a lot of rural areas and it’s not uncommon for our staff to drive a hundred miles on a shift, so that means they might be out for eight hours but only five of those are actual client contact time, and the local authorities only pay us for the client contact time.

“So even if you were to pay staff £9 an hour which is what the national living wage will be by 2020… that’s £45 but that has actually got to stretch for eight hours to cover the entire working time, and so £45 divided by eight is £5.60 which is below the national living wage.”

Providers like Somerset Care are then required to pay their workers travel time which puts them at risk of losses, particularly if they run a not for profit service.

Ms Townsend added: “We actually made a decision a year ago to pay our staff travel time at the full hourly rate, but of course that just sends us into further losses.”

‘An urgent situation which must not be allowed to continue’

The report by UKHCA revealed that seven providers contacted had an average price so low that it was unlikely to cover even the direct costs of employing home care workers. Just three were found to be paying an average rate that might allow providers to pay workers the Voluntary Living Wage.

The report highlighted a number of risks associated with underfunding, notably poor terms and conditions for the home care workforce, insufficient resources to effectively run the service, and insufficient training.

These risks could, according to UKHCA, result in providers struggling to recruit and retain workers with the necessary values, training and qualifications. This would put older and disabled people who use home care services at risk and no longer able to live independently at home.

Colin Angel, UKHCA’s policy director, said: “People who use homecare services are already experiencing the consequences of unstable care markets.

“Underfunded homecare is an urgent situation, which must not be allowed to continue.”

Janet Morrison, chief executive of Independent Age, the older people’s charity, added: “The impact of these pressures on the system can be seen through ever-increasing delays in discharging patients from hospital, a growing workforce gap in the care sector, and most importantly, older people not getting the care they desperately need.

“We urgently need an open and honest conversation about how we adequately fund adult care both now and in the future.”

UKHCA has called on the Government and Welsh, Scottish and Northern Irish devolved administrations to make sufficient funding available to state-funded health and social care providers and help ease the estimated £513m deficit that state-funded home care is experiencing.

Ray James, president of the Association of Directors of Adult Social Services, said: “The real solution to this has to be the Government bringing forward significant extra money and making it available this year and next year and not waiting until the end of the parliament.

“There is absolutely a case for making sure that both the NHS and social care are adequately funded so that, most importantly of all, older and disabled people get the care and support they need.”