Inadequate central government funding for home care services in the UK has been exposed in a new report, with many councils unable to pay providers a fair price for care.
The report, published today by the Homecare Association, found that just 13% of councils and health boards purchasing home care across the UK are paying an average price at, or above, the organisation’s Minimum Price for Homecare of £21.43 per hour.
The minimum price covers the minimum legally compliant pay rate for care workers, their travel time, mileage and wage-related on-costs.
The rate also includes the minimum contribution towards the costs of running a care business which complies with quality requirements at a financially sustainable level.
Freedom of Information data collected for the Association from 312 councils and Health and Social Care Trusts in Great Britain and Northern Ireland shows an average hourly fee rate of £18.45.
Five public organisations reported paying average fee rates below £15.19 per hour, which is the direct cost of a care worker on the national legal minimum wage of £8.91 per hour, plus average employment on-costs, but fails to cover operating costs and risks non-compliance with employment and care regulations.
The report found that areas with some of the highest levels of deprivation also had the lowest average fee rates for home care, with 24 councils, CCGs and health boards paying less than £16 per hour.
The Homecare Association says low fee rates for home care are a direct consequence of inadequate central government funding, which leads to poor pay, terms and conditions for the workforce.
Chief executive Dr Jane Townson said: “Once again, the continued deficit in funding for homecare services for older people across the United Kingdom is exposed.
“At least 70% of homecare is purchased by the State, so central government funding of councils for social care has a direct impact on the fee rates they are able to pay for homecare. In turn, these fee rates and the way homecare is commissioned and purchased, determines pay, terms and conditions of employment of the care workforce.
“Scandalously low fee rates for homecare are paid by some public organisations, particularly in areas of highest deprivation, which do not enable compliance with employment or care regulations, never mind allow fair reward for the skills and experience of care workers.”
The Association is calling for urgent funding to enable care workers to receive £11.14 per hour – equivalent to Band 3 healthcare assistants in the NHS with two or more years’ experience.
This would require an additional £1.72 billion per year across the UK.
The body is also urging the government to scrap the purchasing of home care by the minute, and to place care workers on the Shortage Occupation List.
In the long-term, the Association is calling for and expert-led workforce strategy for social care and a 10-year workforce plan to be developed, as well as a professional register for care workers in England, in line with Scotland, Ireland and Wales.
Dr Townson continued: “Zero-hour commissioning of homecare at low fee rates leads to zero-hour employment of careworkers at low wage rates.
“It makes little sense to neglect people at home, wait until they reach crisis point, then admit them to the most expensive setting of care in an acute hospital. Here they may lose further function and require even higher levels of support and care when they are discharged back home, or to a care home.
“Councils are unable to meet needs of all older and disabled people requiring help in the community. NHS trusts are struggling to reduce waiting lists, as timely discharge from hospital is hampered by inadequate capacity in social care and community services.
“Greater investment is needed in homecare and community support to grow and develop the workforce and innovate, so we can enable people to live well at home, extend healthy life expectancy, reduce inequalities, take pressure off the NHS and reduce costs for the health and care system.”