Home care in England: views from commissioners and providers

The King’s Fund | December 2018 | Home care in England: views from commissioners and providers

In the period between 2016 and 2018, The King’s Fund carried out three pieces of research exploring:

  1. the factors driving commissioning adult social care; the mechanisms of purchasing and delivery of home care;
  2. alternatives to traditional models of delivering care at home.

This research forms the basis of a new report: Home care in England: views from commissioners and providers, unites the findings of those research projects, which record the stated opinions of commissioners, providers and other stakeholders.



Key points:

  • Recruitment and retention of home care staff remains a fundamental challenge for providers, but the extent of the challenge varies greatly depending on geographical location
  • Most councils commissioning home care attempted to drive down the fees they pay. Commissioners and providers disagreed about whether quality of home care had declined  in recent years and, if it had, the role of fees in that process.
  • Home care continues to be commissioned on a ‘time and task’ basis rather than with a view to health  and care outcomes. Nor is there much evidence that health and care providers are joining up commissioning of home care.
  • Alternative approaches to home care provision  have yet to demonstrate they can be scaled up effectively, while approaches using new technology have not yet had time to be properly evaluated. (Source: The King’s Fund)

Download summary (PDF)

Download report (PDF)

See also:

The King’s Fund [press release]  Relentless staff shortage leaves home care sector struggling

The three pieces of research mentioned are:

 Adult social care: local authority commissioning behaviours

Understanding domiciliary care in England

New models of home care

All three are available from The King’s Fund 

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