Last Updated on October 31, 2016

Most people are ‘happy’ with homecare in Wales, despite a ‘fragile’ market, according to a new report from Care and Social Services Inspectorate Wales (CCSIW).

The review was prompted by a number of concerns around homecare in Wales:

• 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; and
• the introduction of web-based systems to find care for individuals.

To conduct the review, the CSSIW sent out a number of surveys to different groups of people, including service users and their families, care workers, providers, local authorities and health boards. It also spoke to staff during inspections, inspected six local authorities and met members of local domiciliary care provider forums.

Added to this, the CSSIW inspected 70 agencies as part of the review, undertaking in-depth assessments of the care being provided and the pay and conditions for staff. It also used focus groups, its stakeholder reference group, its own regional workshops, and some individual meetings to explore issues in more depth.

The key findings were:

• 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. It says that current approaches are not sustainable.

The CSSIW's report is being used to inform the five-year domiciliary care strategy for Wales to be announced later this year. It will also be used to strengthen new regulations, standards and inspection methods to be introduced in 2018.

The report comes just a week after the United Kingdom Homecare Association's review into homecare in the UK. The Homecare Deficit highlighted the under-resourcing of state-funded homecare, including implications for recruiting and retaining homecare workers.