Postcode lottery in home-based social care

New analysis by the IPPR think tank and CF has revealed that as many as 80,000 care home residents could be receiving social care in their own homes.

According to the two organisations, the proportion of care provided at home varies considerably across different councils - from as low as 46 per cent in Barnsley to as high as 84 per cent in Hammersmith and Fulham.  

Where medically possible, home care is preferable to care in residential care homes or hospitals. Research has shown people strongly prefer care in their home - and that home care increases independence, enabling people to lead more fulfilling lives. Where there is a lack of home care options, patients are more likely to end up occupying hospital beds without clinical justification. In some cases, this can lead to ‘non-beneficial treatments’, which impact quality of life. Alternatively, they may be forced into residential or nursing homes earlier than necessary.

According to the IPPR, failing to deliver equal access to home care constitutes a missed opportunity to maximise independence and quality of life.

The analysis suggests that if every local authority provided home care equal to better-performing similar councils, 80,000 more people over 65 in England could be receiving care at home. Levelling up home care across the country would also save English local authorities £1.1 billion per year from their social care budgets, with new analysis showing community care is around one third of the cost of more institutional residential and nursing home options.

IPPR’s preferred funding plan - free personal care funded by general taxation – alongside a levelled-up home care system would prevent an estimated 80,000 people from facing the catastrophic care costs that force people to sell their homes.

The report explains that while some of this local variation in home care access can be explained by differing demographics, much of it cannot be reasonably explained. The unequal provision of home care in unfair and must be addressed, according to the think tank.  

Among the proposals made by the IPPR and CF is the government introducing minimum pay standards, a new social care royal college to coordinate sectoral bargaining, and provide more training and progression opportunities. It also argues that, mirroring moves being made by the Biden administration, the UK needs to make a £5 billion upfront investment in boosting home care infrastructure, including rapid response teams, 24-hour support lines, home care packages and new technology to support patients and carers.

Chris Thomas, IPPR senior research fellow, said:  “The government needs to think through not only how social care is funded, but also how care is delivered to ensure people can lead flourishing lives, regardless of arbitrary factors like where they live.  

“Anchoring care in places people call home is an important way to achieve that. Everyone should have the opportunity to receive care at home, if clinically appropriate, from the first moment they need support. The care options available to you shouldn’t depend on where you happen to reside.  

“We urge ministers to deliver a funded and ambitious programme to enable care in the places people call home. A community first model of social care can save money, improve care quality, and align social care support with what people who use care want.”