Healthwatch is an independent organisation who obtain information about health and care services at local levels, which they can then share with the government and services on a national level by spotting trends and patterns, to inform change and help make care better.
Healthwatch’s report comes after two years of collecting evidence from home care providers, care staff, care users and their families across the 20 local Healthwatch areas. The report focuses on four key areas to obtain an overview of whether home care services are working well and which areas require improvement.
The report found that home care services (domiciliary care) stood out as an area of concern, with the number of local Healthwatch identifying it as a priority having doubled since 2016. This is unsurprising when considering recent studies carried out by the Lancet, referred to within the report, which found that if dependencies and care home proportions remain consistent, we will require an extra 71,215 care home places by 2025. The report considered four main areas and made the following findings:
Care planning
- Many local care staff went beyond the care plans, delivering extra services to their clients in order to ensure they are looked after, but Healthwatch noted that this is likely to mean that the care plan was not comprehensive enough in the first place. The report found that the best care plans were those that looked beyond the immediate physical needs of the client and thought about other challenges the individual client might face, such as social isolation. The issue of realistic timeframes for carrying out care plans was another area picked up on in the report, with staff reporting to Healthwatch Torbay that too often there were unrealistic staff rotas, leading to staff feeling exhausted. Medicines management was a particular area of concern, with one in seven care users reporting to Healthwatch Newcastle having experienced missed medication due to the health care provider. One in six felt the provision of medication was either partly safe or never safe.
Skills & qualifications
- Users reported carers lacking even the most basic experience such as making hot food and making the bed. Staff reported that the lack of investment in staff training and development contributed to the high turnover of staff experienced by this sector. The report comments on the significant workforce pressures facing the sector at the moment and highlights that retaining staff has to be a priority.
Choice & consistency
- 75% of care users who responded to Healthwatch Hampshire stated they did not feel adequately involved in the selection of their care provider. In Staffordshire, care users and their families reported feeling that care packages were designed to meet the needs of care providers, not users. All 20 Healthwatch areas highlighting problems with staff attending clients at different times, varying between two to three hours on some days, or missing appointments altogether. The report highlighted that users felt a better level of care was provided where there was a consistency in staff, but that there were issues in care providers communicating changes in rotas or staff attending to users.
Communication & feedback
- The report found that one in four care users in the area of Barnet were reluctant to raise a complaint for fear it may impact their care. In Bexley, care users reported that they did not want to make a complaint as they did not want to get staff, who they felt were under pressure, to get into trouble. The report also found that those who did raise a complaint often did not feel it was taken seriously.
Conclusion
Home care services are already an important service in the health and care sector and it is likely their importance will only continue to increase. The dependency on these services, which enable people to live independently in their own homes for longer, will be of key importance in taking pressure off care homes and other care services. This in turn will mean that regulation and scrutiny of these services will be magnified and it is important that care providers ensure compliance with the CQC and national guidance to promote the best care for clients. Healthwatch are looking to introduce ways to share intelligence more regularly with national regulators, social care bodies and local governments to provide this crucial insight. It is hoped that in turn this will ensure the future of the care sector and improve equalities throughout.
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