Providing home care in 2019 / 2020

February 12, 2019

Updated: 25th February 2020

What has happened in the home care industry in 2019?

The care industry has undergone significant change in the last few years and is affected by funding and support for the NHS. In this piece we will show you some of the emerging trends and challenges facing the care industry in 2019 and look towards 2020 to explore possible developments for care homes and home carers in the UK.

We have provided a brief overview, but there are links throughout to various studies and reports that you can read for further detail into the topics covered here. At Cavendish Homecare we strive to stay abreast of everything that’s going on in the home care sector, using what we learn to employ excellent staff and provide the best possible care.

Find out more about our team here and the services we provide.

Staff shortages and funding cuts

2018 saw numerous reports of staff shortages in the care industry and more strain being placed on them and the NHS as elderly people suffer more falls and require care for all aspects of ageing, from mobility to dementia.

According to a report published by the King’s Fund and University of York, “four in 10 home care workers leave their role every year and more than half of staff are on zero-hours contracts.” The study also estimated “there are around 110,000 unfilled vacancies at any one time in the home care sector and said this is figure was likely to “increase significantly” as demand grows.”

The King’s Fund has previously stated: “securing an adequate workforce is one of the greatest challenges facing home care, fuelled by the low status of care work, which in turn is related to poor pay and job security.”

Looking a little further back, this report from on Health and Care of Older People in England 2017 showed “a £160 million cut in total spending in real terms on older people’s social care in the five years to 2015/16.” However, the NHS has recently announced a 5-year plan that will put more money into community care, mental health services and GP surgeries.

There are still some concerns that the elderly and their families (who often have to take on organising care for them) won’t have enough access to more specialised care. Dementia UK said the plans are “step in the right direction” but “in order to put weight behind these proposals” there needs to be “a serious commitment to providing more access to skilled professionals, such as dementia specialist Admiral Nurses”.

AI Developments

Artificial Intelligence (AI) already plays a part in many of our lives, in the form of self-service checkouts, chatbots online that answers questions and, of course, the rise of Alexa in our homes — playing music and controlling appliances. But it could also support the care industry. An international research project wants to develop the world’s first culturally aware robots designed to assisting in caring for older people.

The research group includes Middlesex University London and the University of Bedfordshire, with involvement from Robotics company Softbank and Advinia Healthcare Limited care homes. Funding is coming from the European Union and the Japanese government.

Softbank already has ‘Pepper’, a human-shaped robot originally designed to be a companion that can recognise and adapt to human emotions. This project will develop and expand on what Pepper can do including providing health-related assistance. Tasks like reminding someone to take their medication and raising the alarm in emergencies could become possible, but the research group would also like Pepper to be able to assist with everyday tasks like to-do lists and suggesting meals as well as playing music and accessing the internet.

Irena Papadopoulos, professor of transcultural health and nursing at Middlesex University London is working on the project and explained why she feels it is so important: “As people live longer health systems are put under increasing pressure. In the UK alone, 15,000 people are over 100 years of age and this figure will only increase.

“Assistive, intelligent robots for older people could relieve pressures in hospital and care homes as well as improving care delivery at home and promoting independent living for the elderly,” she said. “It is not a question of replacing human support but enhancing and complementing existing care.

“In order for robots to be more acceptable to older people it is essential that they can be programmed to adapt to diverse backgrounds, and this is where my expertise in transcultural nursing comes in,” she said.

Leading the team and testing and evaluating Pepper’s impact on care home residents, Dr Chris Papadopoulos, principal lecturer in public health at Bedfordshire University said: “The impact upon wellbeing we hope to observe includes boosting independence, reducing loneliness and ultimately improving quality of life. This should also relieve the burden that carers often carry and relieve some of the pressure hospitals and care homes face.”

How much need is there for home care?

As of May 2018, The Care Quality Commission counted 7,000 providers of domiciliary (home) care in the UK. Because the majority are small or private firms there is significant movement in the sector in terms of staff and provision of care. Lack of funding and staff can mean many are forced to close or are no longer able to provide care to as many clients. As reported in The Guardian last year “The UK Homecare Association (which represents home care providers) estimates that over a 12-month period, more than 20,000 people using homecare services may have been affected by providers exiting the market.”

Ruthe Isden, Head of Health Influencing at Age UK said this: “really impacts on older people’s continuity of care as day to day they don’t know if they are going to see the same care workers.”

She added: “We are increasingly hearing that people are finding it difficult to actually access homecare in some areas, either because the providers local to them have no capacity or there aren’t any providers locally any more. That is particularly a problem in rural areas where they might be the only person who needs care in that village. With care workers not being paid for travel, it can mean it’s not viable for agencies to take that person on – so they don’t.”

But the number of people that may need home care isn’t decreasing. The Office for National Statistics produced a report in July 2017 that said the population is “getting older” with 18% aged 65 and over and 2.4% aged 85 and over. The increase of elderly people could put even more pressure on the care home sector.

Read case studies from the families and people who have used Cavendish Homecare.

Other pressures

Specialist dementia care

Dementia is one of the most common conditions in older people using home care services with Alzheimers UK stating 70 per cent of people in care homes have dementia or severe memory problems.

Home care workers are likely to face rising pressure to respond to a wide range of needs, providing both general and specialist support. Currently there are 850,000 people with dementia in the UK, but this number is set to increase massively to over 1 million by 2025.

More staff are needed, but they will also need to be trained to deal with dementia and its impact on people in care.

Urgent and emergency care

The numbers of older people attending A&E departments have risen significantly over the last five years. Statistics taken from Age UK’s Health and Care of Older People in England 2017 report show that in 2009/10 there were 30,831 attendances per 100,000 of the age60+ population but by 2014/15 that had increased by 20.7% to 37,240. Attendances from people aged 70+ increased by 22.5%, from 39,110 to 47,920 per 100,000.

These figures could indicate that care home staff are not always equipped to deal with the number of emergencies presented, or that more staff are required to handle this rise in emergency cases.

What’s the future of home care in 2020?

There is potential for a lot of change for the home care sector in 2020. As well as more development and unfolding of the NHS 5-year plan, the promised Green Paper on social care from the Government is yet to be unveiled. The Government has previously said that the proposals in Green Paper will make sure “that the care and support system is sustainable in the long term”. Other topics potentially covered/included are integration with health and other services, carers, workforce, and technological developments. Until it is released, it is hard to know what effect the paper will have on policies and the care industry.

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