Fees paid to care providers were 3% lower in 2017-18 than in 2009-10 leading to high turnover of providers and staff, according to a report published by the health think-tank in collaboration with the University of York.
The report claimed high turnover of staff creates poor continuity of care and has wider effects on care quality. It also suggested some care staff were being paid below legal minimum wage levels.
The analysis, published on 11 December, found four in ten home care workers leave their role every year, and more than half are on zero hours contracts.
In 2016-17 around 500 new home care agencies registered each quarter and 400 left the market.
Simon Bottery, senior fellow, social care, at the King’s Fund, said: “Squeezed funding and a shortage of workers have left the home care sector in a fragile state.
“Home care providers are competing for staff with other sectors paying higher wages, offering more stable employment and better working conditions.”
But some local authority commissioners are sceptical increased fees will boost quality or staff wages, fearing the extra funding will go into care provider’s profits, the report said.
After interviewing care providers and local authority commissioners the researchers found that a simplistic ‘time and task’ approach to commissioning – where providers are paid hourly to provide care with no measurement of outcomes achieve – was not good enough.
The report suggested this style of commissioning must be abandoned and home care should be integrated more closely with health services and focus on outcomes for people in need.
Bottery added: “The system needs a fundamental overhaul, beginning with the upcoming green paper, but the prize of a better, more effective home care service is worth having.”
Glen Garrod, president of the Association of Directors of Adult Social Services, said: “These findings reinforce our calls for new money to be immediately injected into adult social care to give the sector much-needed stability and provide the vital daily support that older and disabled people rely on.”
