Time to Care? An overview of home care services for older people in England, 2006

A Report from the Commission for Social Care Inspection

Time to Care?, published on 18 October 2006, recommends that local authorities should re-think the way they organise home care services for older people. Home care services are central to the delivery of the government's policy of helping older people to maintain independence in their own home and to continue to play an active role in their communities. The implication of this policy is that further expansion in these services will be needed in the medium to long term, as well as changes to the way they are organised and delivered. The report aims to make a contribution to the debate about what kinds of changes are needed by setting out some of the evidence that will help national and local policy makers and commissioners make decisions about what home care services should be offered to whom, and what form they should take.

Some key points from the report:

• Home care is an essential service enabling older people to remain safely at home when they may otherwise be unable to cope.
• There is evidence that the current arrangements for commissioning and providing home care are likely to be unsustainable.
• The tight targeting of statutory support towards those with critical levels of need has resulted in a reduction in the number of older people receiving state-funded home care. This impacts on the opportunity to prevent crises and to promote the well being of older people in the community.
• While the DH White Paper, 'Our Health, Our Care, Our Say' places a new emphasis on early intervention there is no evidence that local authority expenditure on social care for adults is shifting in this direction.
• The challenge to recruit, train and develop care workers to meet new demands and ways of working will impact on the sector's ability to expand and improve services.
• A gap is developing between what people themselves want and need, and what is on offer from statutory services. Older people are beginning to press for more choice and control.
• Many local authorities and service providers are engaged in positive work to transform home care.
• For the debate to move forward, more robust data and evidence will be needed about the value for money of different service options, their impact on health and other local services, and the outcomes for older people and their carers.
• Further work is needed to consider new ways of commissioning and providing home care in the medium term and to evaluate the models that are currently being piloted.

Read the Time to Care? executive summary