East Anglia’s home care costs under scrutiny

Care for the elderly.

Care for the elderly. - Credit: Archant © 2006

The amount paid for home care services for vulnerable people in East Anglia has come under intense scrutiny after it emerged the majority of councils across the country are paying less than the industry recommended minimum.

The UK Homecare Association (UKHCA), the representative body for organisations that provide personal care to people in their own homes, estimates that the minimum price for homecare services should be £15.19 per hour.

This figure is based on carers being paid the national minimum wage and also takes into account travel costs, national insurance contributions, pensions and all the other costs of running a care organisation.

Now the care minister has called for a revolution in the way that councils commission this type of care - saying they need to move away from 'paying by the hour'.

Norfolk County Council purchases 30,500 hours of home care a week with a variety of block and spot contracts. The rates range from £13.28 to £15.84 an hour with an average of approximately £14.71 per hour.

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Catherine Underwood, the council's director of integrated commissioning for adult care, said: 'In 2012 we carried out an exercise with Norfolk Independent Care, the care provider representative organisation, to test whether we were paying a reasonable price and used the UKHCA's model.

'That indicated that the cost of care at the time was being met by the fees the council was paying, even at the lower levels.

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'However, price is by no means the only way of assessing value for money – and when it comes to allocating contracts for care, quality is a the most heavily weighted criteria. In fact, potential service providers have to pass quality criteria processes before their price is even considered.

'All of our contracts with providers include significant measures for monitoring and assessing the quality of service provided – and taking action if any problems arise.'

The lowest hourly rate that Cambridgeshire County Council pays for week-day home care during the day is £13.68 per hour. The authority set a maximum price of £15.82 and a minimum of £13.50 per hour when it last tendered for home care services. However, the minimum amount paid has fallen as the rate in 2010-11 was £16.24 per hour.

UKHCA's policy director Colin Angel said: 'The price of an hour of homecare is a vital question for local and central government, statutory regulators, trades unions and the public. It is essential that a viable regulated homecare sector is available to support the care of older and disabled people who choose to remain at home. The prices councils pay for care must cover the costs of the workforce, including - as a minimum - full-compliance with the prevailing National Minimum Wage, including the time spent travelling between service users' homes.'

Care minister Norman Lamb said: 'There are too many care workers who are not getting paid properly. Breaches of the national minimum wage are quite widespread in this care sector, which is completely unacceptable. You will never get great care on the back of exploiting low paid workers.'

He said it was important for councils to move away from the idea of buying care by the hour, and the government had provided funding to help the Association of Directors of Adult Social Services to develop a 'gold standard' of commissioning to guide councils towards payment which is linked to better outcomes.

For example, providing incentives to the care provider to improve the mobility and wellbeing of the individuals in its care, which in turn has a knock-on impact in helping to reduce costs 'further down the line'.

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