Homecare supply at risk of destabilising, says association

Local supply of homecare is at risk of being destabilised because ‘a significant number’ of local authorities continue to pay unsustainable rates, Homecare Association research has revealed.

The average price being paid by public organisations for homecare in England after 1 April 2022 has remained below the cost of recruiting and retaining a skilled workforce and delivering high-quality, sustainable services, the association said.

It found the average fee rate paid for homecare in England by local authorities was £19.01 per hour, while the NHS paid £18.76. Both figures are below the Homecare Association’s minimum price for homecare for 2022-23 of £23.20 per hour. This is calculated as the minimum needed to ensure compliance with the legal minimum wage and provision of high-quality, sustainable services.

It argues the legal minimum wage of £9.50 per hour is inadequate and homecare workers should be paid wages at least equivalent to Band 3 NHS healthcare assistants, which is £11.85 per hour.

Research found seven councils were paying below direct staff costs, calculated at £16.57 per hour. This consists of pay at £9.50 per hour (national living wage), as well as national insurance and pension, and other wage-related on-costs, such as holiday and sickness pay, travel and mileage.

The association said without an increase in the workforce, demand for homecare could not be met. ‘Demand for homecare continues to rise while capacity in the sector is falling,’ the research report said. ‘This mismatch between supply and demand in homecare is leading to an increase in unmet need in the community and delayed discharges from NHS hospitals.’

In July, Skills for Care reported the number of filled posts in adult social care fell by 50,000, highlighting the recruitment and retention challenges facing the sector.

Homecare Association’s chief executive Dr Jane Townson said: ‘These low fee rates from councils and the NHS lead directly to homecare workers experiencing poor pay and terms and conditions of employment. It’s hardly surprising there is an exodus of homecare workers, as fuel prices remain high and they are struggling to pay their household bills.

‘Without investment from the government, the social care workforce will continue to shrink at a time of rising need,’ Townson said. ‘Older and disabled people are already having to sit on council waiting lists, unable to receive the care they need. NHS trusts are struggling to ensure rapid ambulance response times and to reduce waiting lists, as discharge from hospital is hampered by inadequate capacity in social care and community services.’

The association is calling for central government to invest an extra £1.7bn per annum in homecare so care workers are paid fairly. It also wants to see an end of councils and the NHS purchasing homecare ‘by-the-minute’, and the development of a workforce strategy.