“It is argued that the UK does not have the required infrastructure to move to a model of care that relies so heavily on family and community support, with significant extra investment needed if this were to happen. Without greater support, both financial and through more formal care, greater amounts of unpaid care could risk an erosion in the quality of care provided.”
– Lewis Cone, B2B Analyst
This report answers the following key questions:
- Does the sector still require a ‘cost cap’?
- Will the 2% council tax precept be enough to fill the care funding gap?
- Are domiciliary care providers doing enough to offer suitable care for those with the most intensive needs?
- What does the future hold for domiciliary care?
The market for domiciliary care covers a broad range of healthcare services provided in the home. This ranges from home help services, such as assistance with shopping, ironing and cleaning, through to the provision of meals and assistance with rising and retiring, as well as high-tech healthcare provision. Much of the market involves the supply of such services to the elderly, but receivers of domiciliary care also include people with long-term illnesses and disabilities, as well as those recently dismissed from hospital care.
This report covers the provision of domiciliary care services by a range of organisations, including:
- Local authority provision, including the supply of meal services, day centres, occupational therapy and consumer monitoring, social alarms and telecare. Local authorities purchase domiciliary care services through a range of service providers, including the direct purchase of LA providers; voluntary services, which are operated by charities and religious organisations registered with the LA; and private service providers
- Private purchase of domiciliary care, including informal care, includes the provision of services purchased directly either by, or on behalf of, the customer. Typically, this includes private clients who are either ineligible for LA domiciliary care provision, those who prefer a private provision rather than LA services, and those who are topping up LA packages
- NHS community health services, including care related to the early hospital discharge and rehabilitation of patients and the provision of high-tech domestic healthcare and healthcare services. This includes community nursing services providing direct nursing services, such as control of incontinence, drug administration and some forms of social care; community psychiatric nursing; community learning disability services; specialist nursing such as HIV, terminal care, continence and ostomy care, as well as occupational therapy, physiotherapy and chiropody services. Community health and para-medical services are typically purchased by health authorities or GP fund-holders and are provided by community NHS trusts
- Informal domiciliary care refers to care normally provided to individuals requiring low intensity care and is frequently used to supplement LA and private domiciliary care. Informal carers often help with daytoday tasks, such as shopping, housework, ironing and gardening. The sector includes individuals who offer services and assistance, typically in local newspapers. Friends and family, predominantly women, offering companionship also represent a marginal proportion of the informal domiciliary care market. Reliable, official data on the value of informal care is scarce so an evaluation of the market is subject to interpretation, particularly the hourly value of informal carers’ time.