Good homecare means employers giving staff support and time to do their jobs

As we age, I’m sure most of us will want to continue living in our own homes. Respecting these wishes and preserving a person’s independence and dignity is an important part of maintaining their wellbeing. A report published last year by the Health and Social Care Information Centre reveals that 470,000 people in England used homecare funded by local authorities during 2013-14. Nearly 80% of these people were 65 or older.

We know that some parts of the country are managing better than others in the commissioning, planning and delivery of good homecare. According to the Care Quality Commission, more than two-thirds (68%) of homecare services inspected since October 2014 have been rated good or outstanding. This is encouraging, although a report published by the Local Government Information Unit last year highlighted concerns that some working practices could affect the quality of a person’s homecare.

This is where a new guideline from the National Institute for Health and Care Excellence (Nice) can help. Aimed predominately at those who commission and provide state funded home care, it promotes high quality services for older people across England.

It focuses on putting older people at the centre of the care they receive to help them to stay in control of their lives by choosing the care they want, in a way they want. Services should support the aspirations, goals and priorities of each person and focus on what each older person can or would like to do. A woman who helped develop this guideline told me how supportive homecare workers allowed her late mother to fulfil her wish of staying in her own home.

Homecare workers are often undervalued, but their role is crucial. Yet, it can be challenging: not all workers get regular training and short appointment times may mean they have to rush from one person to the next, choosing which tasks to complete and which to ignore.

Our guideline is clear: good homecare cannot happen without providers supporting their staff. Homecare workers need adequate time to do their jobs well. The independent group of experts who developed the guideline says that visits should generally be at least half an hour unless very specific criteria are fulfilled. Regular training and development for staff is also essential: not only will it lead to a more skilled workforce, but may help to retain staff by giving them more recognition and support. This is likely to result in better care. Nice makes a range of recommendations to help achieve this.

The guideline also includes recommendations to support homecare staff in recognising and reporting signs of abuse or neglect in the people they care for. Keeping people safe from harm, either self-inflicted or at the hands of another, is vital. There should be a clear process for reporting signs and workers shouldn’t worry about raising concerns.

We recognise there may be challenges for some commissioners and providers in implementing our recommendations, but it can be done. We hope the homecare sector uses this as an opportunity to look at how good care is delivered.