Home care support should be a “Race to the top” – not to the bottom: George

West Cornwall MP, Andrew George has warned that the re-tendering of home/domiciliary care in Cornwall will become “a race to the bottom”. Cornwall Council has reduced the number of home care agency contracts from 105 to 29.

Mr George held an urgent meeting with some of the Agencies and Home Care Workers affected by this decision at the weekend. They were concerned that the shake-up of home care services will have a detrimental impact on thousands of vulnerable and often isolated people they care for.

Mr George said, “This will be a false economy. Health Ministers and Health Chiefs say they’re determined to reduce avoidable hospital admission and to discharge patients sooner to their homes for budgetary as well as patient safety reasons. This initiative will push more patients back to hospital and slow down their discharge.

“Of course I understand that the Council is under severe budgetary pressure, but this is just a race to the bottom.”

Mr George has proposed to Government that it should establish a strong set of “benchmark standards” to better reward Home Care Workers and to raise their status. He said “the Government has a responsibility to reverse the current race to the top”.

Mr George has also asked Council chiefs to explain what their officers meant when they told Councillors that they should apparently set a “bare minimum” service; they advised “we don’t need to provide gold plated services – the bare minimum can keep us on the right side of the law. We need to be smart about what the bare minimum is”.

“I have also been informed that those who receive home care and who wish to retain continuity of the service they currently provide from a company which is not on the Council’s tender list, can use “personal budgets”. But personal budgets are only possible if the client visits their bank to set up a new account “in person”. Most of the people who need this care are not capable of doing this.

“The affected Agencies and their clients have complained about a lack of communication, very short notice given, insufficient information to clients. They have not been informed which agencies have been successful and so can’t check CQC reports on the companies which have been shortlisted in case they feel there is a need to change the agency that provides their care.

“All of this appears to confirm my concern that unless the floor is set in the provision of such services (as set out in my proposed Benchmark Standards) this “race to the bottom” which will “keep [the Council] just about on the right side of the law” will be the “bottom line” for all decisions taken.”

Mr George’s Benchmark Standards for home carers:-

– A living wage for care workers (currently £7.20 per hour).

– Travel time between visits is part of salaried time.

– A mileage rate with an at least minimum level of 35 pence per mile paid to travelling care workers.

– A minimum visit time of 45 minutes in exceptional cases but at least one hour for most visits, especially if it involves at least two of the following procedures for non/semi ambient clients; getting out of bed, dressing/undressing, toileting, feeding, washing, and mobility support.

– The introduction of an efficient and effective arrival and departure reporting/recording system.

– Support for registration of care workers, including formal structured annual training to retain qualification.