We spoke to people who receive home care themselves, care for others receiving home care or who had family or friends who received home care.
The key findings are as follows:
- Good care is based on relationships that are based on understanding, friendship, good communication, connection and trust and this stems from continuity.
- There were examples of good care and this rose from those with long term care needs however in the main the testimony describes a poorly managed system of service provision ill adapted to the needs of the client group.
- The most frequent complaints centred on the length of time for a visit with most saying it was inadequate and rushed.
- Flexibility, timing and a lack of choice around visit times was also raised as a cause for concern with a focus on work being scheduled to suit the shift rota as opposed to client needs and choice.
- Clients value it when carers respect their home and neighbourhood and there was also a mention around discretion and sensitivity to personal space.
- Staff was highlighted as a problem with the problem focused around lack of training, poor salaries and contractual issues such as zero contract hours.
- There are many issues around getting what you pay for with many thinking this is not transparent.
- A lack of consistency has an impact on family member’s emotional well-being.
- There was seen to be a lack of respite care which effects both the individual and those who help care for them.
Home care services are not working well for many people. Whilst it is clear that many people like their carer’s and value the work that is done, it is difficult when reading the testimonies not to feel that much of the work is slap dash and not value for money.
The current business and contractual model is not fit for purpose and none we spoke to including patients, family members, carers, staff or commissioners think that it works well.