The BBC is reporting today (4 February 2014) that councils across the country are paying too little to deliver effective care in people's homes.
The UK Homecare Association (UKHCA) represents care providers and is calling for councils to pay a minimum hourly rate of £15.19. This would cover not only wages but also travel, training and agency fees. Most councils outsource care to agencies rather than administering the care system in-house and agency fees are around 30% of the total. Even at £15.19 an hour the care worker is assumed to be earning only the minimum wage. Respondents to a BBC Freedom of Information request revealed that £15.19 represented the upper end of the scale and was paid in only 4% of cases with some councils paying only £9.09 an hour.
The research is focusing on the level of care that can be delivered at the lower end of this range with providers claiming that care needs cannot be met for so little. Costs obviously vary from area to area and a number of social and demographic factors affect the local cost. Councils also have significant purchasing power and some suggest they use this to drive down cost. In managing the public purse, councils have a duty to spend responsibly but the overall picture painted by this report is one where care needs cannot properly be met because funding levels are too low.
Today's data come on the back of Health and Social Care Information Centre (HSCIC) figures published just before Christmas, which showed that over the last four years there has also been a 25% fall in the number of elderly people receiving council-funded care.
Eligibility for home care and the number of hours needed are assessed individually but it is not difficult to find anecdotal evidence of recipients who do not receive care at either the times of day or the length of time they need to meet their personal hygiene and basic care needs. Inevitably, poor care most affects the elderly and vulnerable and the impact on their quality of life can be immense.
Commenting on the data, Andrew Clayton, associate in the clinical negligence team, said: "The figures the BBC has obtained highlight clear issues in current home care provision. The Health Secretary recently called for improved community care and ministers have announced additional funds in recent months but this is against a background of tighter overall budgets for councils. These steps are largely in response to the increasing demands on over-stretched A&E departments to try to ease that burden by addressing health and care needs elsewhere, including in the community. It is difficult to see how this can be achieved with fewer people receiving council-funded care at home and today's report on the impact of cost constraints on quality of care. Without effective care, it seems the most vulnerable will still depend on A&E, whether through declining health following inadequate home care or simply as a last resort for needs that are not being met elsewhere."