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Cornwall council announces plans to improve home care following local Healthwatch investigation


Providers of home care turned to local Healthwatch for help highlighting their concerns about the difficulties they were facing in delivering effective care. We spoke to Debbie Pritchard from Healthwatch Cornwall to find out more.

Young carer with patient

What made you investigate this issue?

In late 2014, a number of providers delivering home care for Cornwall Council, via its Care at Home Framework, told Healthwatch Cornwall that they were struggling to make their concerns heard about how they were finding the new system untenable. They felt that patient care was at risk, so decided to step in straight away.

We held a meeting for all providers of home care services in Cornwall to hear their concerns as well as speaking to paid carers, and those who receive home care to fully understand the issue.

What did people tell you?

Providers raised concerns which included their ability to retain staff as it was not possible to cover the actual costs of care within the contract rate leaving them unable to deliver the care needed.

Both carers and providers indicated that the levels of pay and conditions for carers were inadequate and unsustainable and often left carers being paid significantly below the national minimum wage. This was exacerbated in Cornwall due to the rurality of the area, where carers had to drive for extended periods between visits and were not paid for this time.

We also heard from people using home care services and their families who felt stressed and confused because of the ways new procedures were being introduced. All three groups expressed stress and anxiety about the situation, leaving already vulnerable people in a possibly dangerous position. People felt angry at the way that council officials had treated concerns that were raised.

What happened as a result?

We made six main recommendations to Cornwall Council which included a review of pay and conditions for carers; an urgent comparison of council and NHS commissioning processes used to establish best practice for integrated commissioning, and to establish a public form for relevant organisations to discuss Cornwalls home care sector.

Cornwall Council has now confirmed that an additional £4.5 million will be put into the Adult Care budget to meet the costs of increasing the rates paid to the providers. This is really positive news and we hope that this will enable home care providers to recruit and retain paid carers and will minimise issues such as cancelled care due to capacity issues.

Cornwall Council have also set up their own arm’s length organisation to provide Care at Home services if demand cannot be met by existing providers, which will start operating in October.

We continue to have regular discussions with providers since these issues were raised.

What feedback have you had?

We have heard from Cornwall Partners in Care, a trade organisation for care providers, who said they welcomed the measures and hoped the outcome would help unite the sector which has become fragmented. 

It is great to see all sides working together for the benefit of those receiving care, and we are glad that we were able to help initiate that. 

If you would like to share your experience of home care services, get in touch with your local Healthwatch