The Kings Fund

•  Commissioning and delivering the highest quality home care should be a significant objective of our health and social care system.
• Between 2016 and 2018, The King’s Fund carried out three pieces of research exploring: the factors driving commissioning adult social care; the mechanisms of purchasing and delivery of home care; alternatives to traditional models of delivering care at home. This report draws together the findings of those research projects, which record the stated opinions of commissioners, providers and other stakeholders.
• Recruiting and retaining  home care staff remains a fundamental challenge for providers, but the extent of the challenge varies greatly depending on geographical location, with those in some rural and also in some prosperous areas particularly struggling.
• Despite the challenges facing providers, most councils commissioning home care attempted to drive down the fees they pay. Commissioners and providers disagreed about whether quality of home care had declined  in recent years and, if it had, the role of fees in that process.
• Home care continues to be commissioned on a ‘time and task’ basis rather than with a view to health  and care outcomes. Nor is there much evidence that health and care providers are joining up commissioning of home care.
• Alternative approaches to home care provision have yet to demonstrate they can be scaled up effectively, while approaches using new technology have not yet had time to be properly evaluated.

What is home care?

Home care (or domiciliary care) is in the front line of social care delivery in England, with around 257,000 older people and more than 76,000 younger people using publicly funded home care in 2015 and others paying for their own home care. It
is estimated that around 249 million hours of home care are delivered each year. Most of this care is personal care – help with washing, dressing and eating – but the term also covers reablement services for those leaving hospital and broader support, for example to help someone with learning disabilities live independently. It is an essential part of enabling people to ‘age in place’ by delivering care as close to home as possible – where most people say they want to receive it.

Click here to read the full report.