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Most people ‘happy’ with home care in Wales, despite ‘fragile’ market – report

Our review of domiciliary care in Wales makes a number of recommendations for all partners involved.

Who we spoke to

We sent out a number of surveys to different groups of people. We received:

  • 283 responses from service users and their families
  • 213 responses from care workers and spoke to 196 staff during inspections
  • 215 responses from providers
  • responses from all 22 local authorities and 2 health boards. 

We inspected 6 of those local authorities and met members of local domiciliary care provider forums.

We also inspected 70 agencies as part of the review, undertaking in-depth assessments of the care being provided and the pay and conditions for staff.

We used focus groups, our stakeholder reference group, our own regional workshops, and some individual meetings to explore issues in more depth.

Why we did the review

This review was prompted by a number of concerns:

  • the sustainability and reliability of domiciliary care in some parts of Wales;
  • the use of 15 minute visits;
  • calls being rushed, shortened or crammed in without travel time;
  • investigations by HMRC in respect of the national minimum wage;
  • the introduction of web-based systems to find care for individuals.

What we found

  • Care and support arranged for a set time with fixed tasks is more likely to be inflexible and rushed.
  • Care purchased at low prices tends to lead to problems with recruiting and keeping care workers.
  • Good domiciliary care is based on building relationships between care workers and people who receive care.
  • Most people, most of the time, are happy with and appreciate the care they receive.
  • However, a small proportion of people experience poor care, especially regarding poor care worker continuity and unreliable visits.
  • Despite poor pay and working conditions, most care workers are very motivated and often go ‘above and beyond’, giving care in their own time.
  • However, there is a lack of workforce capacity, and the market is very fragile. Current approaches are not sustainable. 

What happens now?

Our report has been used to inform the five-year domiciliary care strategy for Wales which will be announced later this year. 

It will also be used to strengthen new regulations, standards and inspection methods which will be introduced in 2018.

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