Media contact: Jen Pufky
Telephone: 07825 617 927
Strictly embargoed until: 00:01 Tuesday 21 March, 2017
LGiU / Mears say home care market is on brink of collapse
New report details the human cost of cut-price care
New analysis out today from the Local Government Information Unit (LGiU) and Mears has found that the current home care market is on the brink of collapse.
Paying for it looks at the human side and emotional cost of the home care market with stories from across the care system. It outlines why care is priced so low and how people in the system end up paying for cut-price care. These systemic problems make provider failure more likely and leave the most vulnerable in an even more precarious position.
In his Spring Budget, the Chancellor announced £2 billion of funding for social care over the next three years along with a Green Paper on long-term financing to address rising care demands. Our report outlines the need for a much wider systemic shift in way home care is commissioned and delivered – from a time and task approach to one that is focused on outcomes and results.
Some councils are already trying new ways of commissioning, such as flexible banks of care hours or other methods to re-focus care commissioning on outcomes. Kingston Council, for example, is working in partnership with LGiU and others to develop an app to support outcomes measurement. However, our research found that only around one in ten councils are making real strides toward achieving outcomes based commissioning. And, less than a third of councils are routinely monitoring changes to individuals social care needs and health conditions.
With the pace of provider failure accelerating, perhaps more than doubling for home care contracts in the space of around a year and a half, the report outlines the need for urgent action from the Government and local authorities on funding and commissioning mechanisms. A summary of the report recommendations are included below.
Jonathan Carr-West, Chief Executive, LGiU, said: “The current home care system serves no one well. Hospitals are short of beds because the frail cannot be discharged. Care workers are undervalued and underpaid. People who need care do not always get the care they need when they need it. Local authorities that commission care are having their budgets slashed so mercilessly that they are faced with a stark choice. Ration care further or pay for care at a rate so low that care businesses will limp along until they can go no further.
This is a systemic crisis. It has been caused by a system which over specifies times and actions at the cost of goals and outcomes. Too often, the system has been about procurement, rather than partnership.
We can no longer tinker around with small changes to commissioning or small uplifts in budgets or the price of care. We need radical reform in the way that we pay for and purchase care.”
Alan Long, Executive Director, Mears said: “I welcome the recommendations in this report. It comes at time when there is both growing awareness of problems in the market and the opportunity to address some of them through the forthcoming Green Paper. When the system no longer serves anyone well, it is past time to make a serious reflection on why and how we can fix it. Although much of this comes down to money, it is not simply about money, but about wider approaches to commissioning and a lack of transparency in accounting for costs and outcomes.
As a home care provider, we will play our part in improving the service we deliver, helping join up services and making a career as a home care worker more aspirational than it is today. We very much hope that we don’t have to give up any more care contracts due to unsustainable rates, but our first priority, will be to only work in areas where we have a chance of delivering the kind of service experience, that we all want and need.”
An embargoed copy of the report is attached and will be available online here.
The Local Government Information Unit (LGiU) is a think tank and membership body with over 200 councils and other organisations subscribing to our networks. We work to strengthen local democracy and put citizens in control of their own lives, communities and local services. For more information, visit www.lgiu.org.uk. For more information please contact: firstname.lastname@example.org (07825 617 927)
Mears Group; is the UK’s leading social housing repairs and maintenance provider and a major presence in the domiciliary care market – bringing the highest standards of care to people and their homes. Partnering with clients, 20,000 Mears Group employees work in communities across the country – from inner city estates to remote rural villages.
Mears New Homes, part of the Mears Group uses the experience gained from over 25 years of repairing and maintaining homes and seeing firsthand how design, specification and construction has worked, or not to offer a wide range of innovative, mixed tenure new build development solutions on behalf of Local Authorities, ALMOs and Registered Providers; as well as developing land-led opportunities for both open market and affordable housing. www.mearsgroup.co.uk
A summary of the key recommendations from Paying for it is included below.
Councils should look carefully at the impact of reductions to their hourly rate. Councils must recognise that when they make the choice to reduce their hourly rate below around £15.90 an hour, it is an active choice to reduce one of the aspects of care outlined in our care calculator in Section 4. There are costs to delivering care. Reducing the hourly rate below a certain level puts councils and providers in moral jeopardy.
Councils should require (and make full use of) open-book accounting arrangements with their providers. Councils should expect their providers to offer a clear account of how the hourly rate is disbursed. Commissioners who have a clear understanding of how this rate is broken down are able to engage more effectively with their providers and develop more trusting relationships.