Home care in the United Kingdom

Home care in the United Kingdom (also referred to as domiciliary care, social care, or in-home care) is supportive care provided in the home. Care may be provided by licensed healthcare professionals who provide medical care needs or by professional caregivers who provide daily care to help to ensure the activities of daily living (ADLs) are met. In home medical care is often and more accurately referred to as home health care or formal care. Often, the term home health care is used to distinguish it from non-medical care, custodial care, or private-duty care which is care that is provided by persons who are not nurses, doctors, or other licensed medical personnel.

The COVID-19 pandemic in the United Kingdom saw a huge acceleration in digital transformation in the sector. Digital systems were used to create mandatory reminders for hand washing, symptom checking and sanitisation. Risk assessment forms, care plans and induction documents were digitised.[1]

The number of domiciliary care jobs overtook the number of roles in care homes in 2020. In 2021 the workforce in CQC regulated non-residential care services increased by 40,000 jobs or about 7%, while the number of care home jobs remained stable, or began to decrease.[2]

The vacancy rate in homecare reached 13.5% in May 2022. After the removal of the Infection Control and Testing Fund at the end of March 2022 96% of homecare workers got no or low pay whilst isolating after a positive COVID-19 test, causing many to leave for jobs where isolation is not required or full sick pay is available. Increasing fuel prices are also a significant issue.[3]

Home care providers

Home care is purchased by the service user directly from independent home care agencies or as part of the statutory responsibility of social services departments of local authorities who either provide care by their own employees or commission services from independent agencies. Care can also be purchased directly from independent carers or via care platforms. Care is usually provided once or twice a day with the aim of keeping frail or disabled people healthy and independent though can extend to full-time help by a live-in nurse or professional carer.

The United Kingdom Home Care Association is the trade organisation for providers of care at home.

Statutory regulation

Home care agencies are regulated by statutory bodies in three of the four home nations. The regulator's function is to ensure that home care agencies work within the applicable legislation:

England

Wales
  • Regulator: The Care and Social Services Inspectorate Wales (CSSIW)[4]
  • The Care Standards Act 2000[5]
  • The Domiciliary Care Agencies (Wales) Regulations 2004[6]

Scotland
  • Regulator: The Care Commission[7]
  • The Regulation of Care (Scotland) Act 2001[8]

Northern Ireland

Legislation covering the homecare sector in Northern Ireland is not yet fully operational (as at December 2007).

Regulator: The Regulation and Quality Improvement Authority (RQIA)[9]

  • The Health and Personal Social Services (Quality, Improvement and Regulation)(Northern Ireland) Order 2003[10]
  • Domiciliary Care Agency Regulations (Northern Ireland) 2007[11]
  • Domiciliary Care Agencies National Minimum Standards (not published as at December 2007)

The precise arrangements of a care package can have implications for planning law. Residential institutions fall into Class C2 while residential dwellings fall into Class C3. This distinction can have significant planning and development implications.[12]

See also

References
  1. "COVID-19 pandemic fueled huge digital acceleration in home care, report finds". Home Care Insight. 1 June 2021. Retrieved 28 July 2021.
  2. "Domiciliary care jobs overtake care home roles for second year running". Home Care Insight. 8 July 2021. Retrieved 3 September 2021.
  3. "Homecare vacancy rate at record level, Homecare Association finds". Home Care Insight. 6 June 2022. Retrieved 25 July 2022.
  4. "The Care and Social Services Inspectorate Wales (CSSIW)". Csiw.wales.gov.uk. Archived from the original on 23 January 2005. Retrieved 10 March 2012.
  5. "The Care Standards Act 2000". Opsi.gov.uk. Archived from the original on 25 May 2005. Retrieved 10 March 2012.
  6. "The Domiciliary Care Agencies (Wales) Regulations 2004". Opsi.gov.uk. 5 July 2011. Archived from the original on 27 June 2006. Retrieved 10 March 2012.
  7. "SCRC - Scottish Commission for Regulation of Care". Carecommission.com. 1 April 2011. Archived from the original on 22 March 2012. Retrieved 10 March 2012.
  8. "The Regulation of Care (Scotland) Act 2001". Opsi.gov.uk. Archived from the original on 24 May 2005. Retrieved 10 March 2012.
  9. Epic Admin. "The Registration and Quality Improvement Authority". RQIA. Retrieved 10 March 2012.
  10. "The Health and Personal Social Services (Quality, Improvement and Regulation)(Northern Ireland) Order 2003". Opsi.gov.uk. 4 July 2011. Archived from the original on 18 July 2005. Retrieved 10 March 2012.
  11. "Domiciliary Care Agency Regulations (Northern Ireland) 2007". Opsi.gov.uk. 6 January 2012. Archived from the original on 9 December 2007. Retrieved 10 March 2012.
  12. "In a class of their own? The continuing care-home conundrum". Lexology. 28 February 2019. Retrieved 12 April 2019.
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