Over half of home care providers delivered less care despite increasing demand, new research has found.

In the research by the Homecare Association, 54% of providers said they delivered less care in 2022 despite almost three-quarters (74%) saying demand had increased.

Homecare Association’s chief executive, Dr Jane Townson, said: “Vacancies in home care services in England are at 13%, more than four times the average for all jobs in the UK. Home care simply cannot meet the increasing demand for support and providers have no choice but to turn down work as they cannot recruit the staff they need. Sadly, thousands of people are waiting for care in the community or are stuck in hospital when they could be at home if care were available.”

Nearly two-thirds (64%) reported a rise in the quantity of care packages for hospital discharges. Furthermore, 71% felt that there was added time pressure to ensure a care package is arranged.

More than half (56%) agreed more complex tasks were now being commissioned by the NHS. Additionally, 85% said the people they support were finding it more difficult to access healthcare than this time last year. Despite the thousands of people stuck in hospital awaiting discharge, 46% of private-pay providers had expressed an interest in providing home care for discharge services but were not commissioned.

Townson added: “We saw the lack of capacity in home care impacting on the NHS last winter. Without adequate investment, we are concerned that, this year, there will be even more people waiting for help in the community or whose hospital discharge is delayed, leading to dangerously high ambulance and A&E wait times on top of growing waiting lists for diagnosis and treatment, which are already at over 7 million.

“Some regulated providers have capacity to accept people waiting for discharge from hospital but are not being commissioned. In some cases, this is because councils or the NHS will only work with providers they normally contract with. In other cases, it is because providers are unable to accept council or NHS fee rates that are too low even to cover the direct costs of staff wages at the National Minimum Wage (NMW) or the other costs of running a home care agency. In our view, public bodies should be funded to pay fee rates that enable compliance with NMW, good-quality services and the financial sustainability of providers.

“Without proper investment in home care, which would improve care workers’ pay and terms and conditions of employment, we will not be able to meet the growing demand for care, extend healthy life expectancy, reduce inequalities, take pressure off the NHS and reduce costs for the health and social care system.”

The Homecare Association calls on the government to:

• provide adequate funding to local authorities to enable them to pay a fair price for care, so that care workers can receive wages equivalent to Band 3 healthcare assistants in the NHS with 2+ years’ experience. According to the Homecare Association’s Minimum Price for Homecare 2023-24, this would require an hourly fee rate of at least £28.44
• End the practice of local authorities and the NHS purchasing home care ‘by-the-minute’, alternatively focusing on achieving the outcomes people want, enhanced by technology solutions
• Work with the sector to develop a credible 10-year workforce strategy for social care, aligned with the NHS People Plan.

A Department of Health and Social Care spokesperson said: “Most care workers are employed by private sector providers who set their pay and terms and conditions, independent of central government. But we have raised the National Living Wage by 9.7% to £10.42 an hour for workers aged 23 and over, and are working to reduce vacancies in the sector.

“We’ve previously announced up to £7.5 billion of additional funding for adult social care, and in the Next Steps to Put People at the Heart of Care plan we set out how we are spending up to £700 million on reform over the next two years – including at least £250million for the workforce.

“In the Health and Care Select Committee meeting earlier this month, the minister for care also outlined how we are working with the sector to create a stronger career pathway through our call for evidence, making care a career to aspire to.”