Most home care providers have seen a fall in the number of hours of care councils have commissioned from them, research has found.
Half of agencies (48%) reported a fall of 25% in the number of hours of care available to them to deliver, with a further 32% reporting decreases of less than this, found the Homecare Association.
The sector umbrella body surveyed members in July and August 2023, receiving responses from 225 agencies which, between them, provided care to almost 43,000 people and had 23,282 care workers on their books.
Loss of care staff
Agencies said the drop in the number of commissioned hours was leading to them losing valued staff because they could not give them the number of hours’ work that they needed.
Others raised concerns about their future viability, including some who had recruited from abroad in the anticipation of having increased work that they could not now provide to overseas staff.
Providers gave mixed responses as to what was driving the trend.
A third of those who responded to this question said it was down to councils commissioning less care due to squeezed budgets, while one-fifth cited delays in councils carrying out care assessments.
Increased provider competition
However, 41% said it was down to councils opening up their commissioning portals to more providers, while 27% attributed the trend to there being a rising number of providers in the local market.
Others referred to factors including councils providing more care in-house or assigning packages to the cheapest bidder, including at rates below the cost of care.
The findings come with the government urging councils to boost home care capacity in their areas to deal with what are anticipated to be severe pressures on the health and social care systems this winter.
The Homecare Association said agencies appeared to be doing better in areas where councils commissioned a limited number of lead providers to deliver care in specific localities.
Late payments
The survey also found eight in ten providers had experienced late payments from council or NHS commissioners, with a third saying that most of their local authority payments were late and almost half (47%) saying the same about most of those from the health service.
Public bodies are expected to pay invoices within 30 days. However, 57% of providers said their average payment time from councils was more than this, while 65% said this was the case for NHS commissioners.
The Homecare Association’s chief executive, Jane Townson, said that late payments were a “serious issue, threatening the financial viability of many home care providers”.
“Some are having to spend months fighting for thousands of pounds owed for care delivered, being pushed from pillar to post without resolution,” she added.
Home care ‘highly sensitive to volumes of care’
Townson warned that home care businesses were “highly sensitive to the volume of hours delivered”, both because of the costs of overheads, such as employing a registered manager, training and office rent, but also because of the impacts on care workers’ salaries.
“When the number of hours delivered are spread across a greater number of providers, it can mean that individual care workers are more likely to have gaps in their rotas reducing the amount of pay they receive each day,” said the association’s chief executive, Jane Townson. “This risks even more home care workers choosing to leave the sector.”
She added that, “without proper change we will not be able to meet the growing demand for care, take pressure off the NHS and reduce costs for the health and social care system.”
Need for ‘long-term plan for social care’
The Association of Directors of Adult Social Services (ADASS) attributed the findings to the lack of “a long-term sustainable funding plan for adult social care”, which had “hampered [councils’] ability to plan over the long-term, improve quality of care and deliver the care we want and need”.
“The impact is clear, with 66% of directors reporting providers closing or handing back contracts last year,” said ADASS’s joint chief executive, Sheila Norris.
“To create the right conditions to improve care and support in England, we need a long-term and fully-funded plan with long-term increases in funding.
“This investment and support will not only benefit those of us needing care, it will also reduce the number of hospital stays and residential care admissions, help grow our economy and boost jobs.”
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Might prevent residential care needs, but care homes will always still be needed. Especially where things like dementia are concerned.
This has been predicted for many years and while some local authorities (LAs) can be accused of some of the blame and some care providers, much of the blame is on the government.
LAs have been purposely kept short of funding, well before 2010, but so much more so since then due to the Tory imposed austerity cuts, so less financing has been available to all areas under the control of LAs.
I say care providers as some have not been looking after their carers as best as they could, some pay better than others, but all are guilty of not providing the best terms and conditions of employment they could. Holidays is one point in question as most bank holidays have not been recognised as such and just treated as another working day, no real sick pay and travel expenses way insufficient and more, but some of this could be down to the rates they receive from LAs. but the standard and degrees of training is also a factor.
LAs have been trying to eck out funding and contracts as best they could, but here many LAs could have done better. But the real villain is the government due to starving LAs of finance and this also reflects on the numbers of social workers available and to some degrees their training as well, as this reflects the ability to do care assessments both in quantity and quality.
The continued outlook for social care is far from good and this has serious impacts on the NHS, where more demands will be imposed. This is not just the ‘beds’ crisis, due to lack of social care, but increased health needs due to lack of social care for persons in need of social care thereby increasing their ability to deal with their own health needs. But this also extends to their families whose own health needs will increase with their own health deterioration as they will be supplementing more caring from families to mitigate the lack of social care from LAs and care providers.
The outlook for both social care with LAs, Care providers, care workers, those in need of care, their families and the NHS is indeed very bleak and will get much worse.
The government at least needs to reverse its austerity programmes, otherwise, we will all suffer very much more.