Blog | Angela Gifford

The Unsustainable Care Sector


Once again in the last few weeks UK newspapers have the story of another domiciliary care agency pulling out of a local Government contract for home care. The reason quite simply is that the rates paid to the care provider do not cover the costs of providing care in a large rural area. (In this latest area, this is the second care provider to hand back their council contract). The result is that care workers have uncertainty of employment and they have to hope a new provider will be found who may take them on. The recipients of the care service, many of whom will be older people, will have an anxious and unsettling time and will need to go through the aggravation of being ‘signed in’ to a new provider, no one wins.

Regularly, I receive details of domiciliary care agencies up for sale. Care organisations who are getting out of the market place. One sales sheet sent a couple of weeks ago also gave information about how long the agencies on the sheet have been up for sale, not sure why this was published as it sent a clear message that those care organisations that have most of their turnover based on Government subsidized care packages are not selling.

For care providers with most of their client base in the private, fee paying sector, the success of their care business is in their own hands. If they provide services their clients want at a price that is agreed then they will flourish. If their service falls below their client’s expectations then the business will eventually fail as there will be other providers eager to take their customers on.
If they respect and treat their care workers well, pay them appropriately then they will attract and retain them. If they only have low pay rates to offer to their care workers, recruitment and retention of staff is difficult.

Many Government subsidized clients are suffering as they receive a lower quality level of care e.g. missed visits, too many different care workers in their home, reduced hours of care, untrained care workers, care workers without statutory checks being made, etc. Short cuts are taken, care workers leaving a few minutes early so they can get to their next client, the visit to each older or disabled person becomes task orientated only, no time to have a chat, the true quality of care drops, care workers become demoralised at the low pay rate and conditions of work and care homes find they cannot afford to take state funded residents, which leaves many with empty beds which are a financial liability.

The care system’s problem is financial and unless a financial solution is found, as the aging population increases, the situation will continue to get worse. The NHS and Community Care Act 1990 heralded a new beginning of optimism for both older and disabled people but this optimism has now long gone. Eligibility for state funded care now means that people who used to receive some care if they had low or moderate care needs are now unlikely to be deemed eligible to receive it. Some individuals who had been assessed as requiring a number of hours of care have now been re-assessed and as result the hours of care provided reduced.

The lack of sufficient funding in the care sector is leading to a second class care system for many whilst those fortunate enough to be able to pay for their own care can purchase the quality services of choice.

Ring fenced ‘care’ taxation has been offered as a possible solution and suggestions are made that families need to contribute more towards taking responsibility for their older members both in practical and financial terms including contributing to the cost of their relative’s care service. The reality is that somewhere a solution has to be found.


By:  Angela E Gifford
Posted:  13 Dec 2016


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