Lack of trust threatens to demoralise homecare workforce, MPs told

Jane Townson, UKHCA chief executive

A lack of trust in commissioning behaviours risks demoralising the homecare workforce, MPs have been told.

Care workers and executives told the social care: funding and workforce inquiry there was a lack of recognition and understanding of the role of homecare.

Agincare chief executive Raina Summerson said this was evident at both central and local government levels, leaving homecare workers ‘feeling undervalued’ despite having to carry out a ‘critical role’.

The health and social care committee was told commissioning behaviours, such as paying for care by the minute, had led to a lack of trust between parties. Summerson said: ‘If a provider is made to feel there is a lack of trust in the partnership then that filters down to the workforce…

‘Who would have thought this critical role of compassion and care can be broken down to paying people by the minute… it makes you feel like no one trusts you…’

Giving evidence, she said homecare workers had shown during the pandemic they were ‘resilient’, ‘adaptable’ and ‘hugely skilled’ but that commissioning practices of paying for care by the minute could ‘completely demoralise’ the workforce.

United Kingdom Homecare Association chief executive Jane Townson told MPs: ‘Imagine a clinical commissioning group saying to an NHS trust we’re only going to pay nurses for every minute they are by a patient’s bedside and we’re going to electronically tag them to find out when they are there. But we’re not going to pay them for when they are moving from one patient to the next; we’re not going to pay them when they are training; we’re not going to pay them when they are supervised; we’re not going to pay them when they doing their CPD.

‘Imagine the outcry there would be in the NHS under those conditions… It’s that lack of trust… measuring care by the minute; paying for care by the minute, which means providers having to employ by the minute. Nobody wants to do that but it’s the system that’s wrong.’

The two-hour session also covered integration, training, protective equipment and testing.

When it came to pandemic planning, homecare had been ‘at the bottom of the pile’ after care homes and the NHS, Townson said, with the 680,000 people employed in the segment ‘largely ignored’.

‘We have had to push really hard to get domiciliary care the recognition it deserves from central government and in local government too,’ she said. ‘I don’t believe the planning was adequate. I think we’ve been lucky in homecare that we’ve managed to avoid too much catastrophe…’

MPs also heard from Care England chief executive Martin Green and Skills for Care chief executive Oonagh Smyth.

While Green acknowledged the government had pumped ‘enormous amounts of money’ into social care during the pandemic, he claimed it was ‘through a floored mechanism’.

He said: ‘Local authorities are not a good way to deliver money to the front line of care and I think after this pandemic we need a long hard look at what’s local… and the performance of some local authorities in relation of how they supported care providers.’