Local authorities paying too little for home care, report finds

Many councils are not paying companies that provide homecare a high enough rate to cover costs such as travel time between clients, according to a new report from the Homecare Association.

The Homecare Deficit 2021 report found that the average fee for homecare paid by councils in Great Britain and health boards in Northern Ireland is £18.45 an hour.

The report details the findings of enquiries, made under freedom of information legislation, to 340 public organisations which purchase homecare across the United Kingdom. These consisted of local authorities, health and social care (HSC) Trusts in Northern Ireland, clinical commissioning groups (CCGs) in England, Local Health Boards in Wales and regional NHS Boards in Scotland.

Only 1 in 8 (13%) of organisations were paying an average price at, or above, the Homecare Association’s Minimum Price for Homecare of £21.43 per hour. This is a figure the Association calculates as an absolute minimum to ensure compliance with the national legal minimum wage of £8.91 per hour, care regulations, and to enable sustainability of services. In Scotland and Northern Ireland, the percentage of organisations paying this average price drops to 3% and 0% respectively.

Just over one in four (28%) public organisations were able to provide a calculation demonstrating a rationale for the fee rates paid for homecare.

The report found that five public orgnaisations were paying average fees below £15.19 per hour. These were Halton, Cumbria, Western HSC Trust (Northern Ireland), Ealing and Basildon and Brentwood CCG.

Careworkers are leaving the profession

At a time of rising demand for homecare, the report noted, more careworkers than ever are leaving faster than they can be replaced, and employers are reporting a 75% reduction in applications for jobs since January 2021. The government’s offer of £500 million over three years from 2023 for the training and well-being of the 1.5 million strong workforce “will not address long-standing issues with poor pay, terms and conditions of employment,” the report said. Meanwhile, the pandemic has left careworkers exhausted.

Homecare Association CEO Dr Jane Townson said that because at least 70% of homecare is purchased by the state, 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.”

She went on: “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 careworkers.”

Townson argued that “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.”