A radical rethink on the commissioning of services for people receiving care at home and the terms and conditions of the homecare workforce is urgently needed, says United Kingdom Homecare Association (UKHCA) as it welcomes the publication of the Burstow Commission’s report “Key to Care” on the future of the homecare workforce (note 1). The Commission, chaired by Rt Hon Paul Burstow MP, launches its report today Tuesday 2nd December 2014. It is available to read and download from www.lgiu.org.uk.
Commenting on the Commission’s recommendations, UKHCA’s Policy Director, Colin Angel, said: ”We commend the Commission for seeking the views and experience of a wide range of stakeholders from England’s homecare system, including UKHCA.”
“Older and disabled people deserve excellent services from a workforce which is suitably trained, committed and adequately rewarded for the increasingly complex care required to be delivered at home.
“Homecare workers are our greatest asset and their services already support demands on a struggling health service. However, inappropriate commissioning by local councils is self-defeating and carries risks of rushed, undignified services which lack continuity by focussing on limited time for care and a constant pressure to reduce providers’ fees.
“It is essential that local councils reflect on the Burstow Commission’s findings to move away from ‘time and task’ commissioning and refocus on purchasing effective outcomes for individuals and also value the homecare workforce appropriately.”
This Association endorses the Commission’s view that there is a significant risk of high quality care providers being driven out of the sector by a race-to-the-bottom in the prices paid by local authorities, who purchase over 70% of all homecare services delivered.
We are pleased that the Commission has endorsed UKHCA’s recommendations on the minimum prices councils should pay for care to enable compliance with at least the Minimum Wage for careworkers and ideally the Living Wage (notes 8 & 9).
We agree with the Commission that where individual councils do not accept UKHCA’s minimum price they must be able to justify its decision with an alternative model, with oversight from the local Health and Wellbeing Board before sign-off.
In addition, we support the Commission’s call for an open-book approach to pricing from councils and providers. UKHCA’s on-line costing model provides a suitable tool to undertake this process (note 10).
These recommendations support recently issued statutory guidance to local councils issued under the Care Act 2014 (note 11).
In addition to a real-terms reduction in prices paid for homecare in recent years, UKHCA condemns the growing practice of “reverse electronic auctions”, with councils requiring local providers to bid increasingly low prices to provide care to older and disabled people.
We welcome that the Commission’s proposal for a ‘license to practice’ for social care workers, which will build on the forthcoming Care Certificate. This recommendation goes considerably further than the current proposals from Government and the Health and Care Professions Councils (HCPC) for either a ‘voluntary’ or ‘negative’ register of workers (note 12).
A suitable licensing regime has the potential to raise the status of care work and encouraging greater investment in the training and development of the workforce. We hope that Government give full consideration to this recommendation.
Reversing the current trends of homecare commissioning will pay dividends for home-based care, delivering better outcomes for people who use homecare services, providing greater continuity from reduced staff turnover and prioritising spend where it will be most effective.