Most home care visits should be at least half an hour

Home care visits to elderly people should last for at least half an hour and be centred around personalised care rather than a “one-size fits all” service, says NICE.

Last year, an investigation by Unison found that the number of councils in England commissioning 15 minute home care visits is on the rise.

In 2013/14, 470,000 people used home care funded by local authorities in England, with the vast majority, 79 per cent, people aged 65 or older.

In draft guidance -  the first of its kind to be developed by NICE for the home care sector - NICE recommends that commissioners ensure that home care workers should be given enough time to do their job without being rushed or compromising the dignity of the person who uses services. This includes having enough time to talk to the person and their carer, and adequate travel time between appointments.

Home care visits shorter than half an hour should only be made if the home care worker is known to the person and the visit is part of a wider package of support and the purpose of the visit can be properly undertaken in that time.

Visits shorter than half an hour can be used to check someone is safe and well, or to complete a specific, short time-limited task.

Person-centred care

Home care providers and commissioners should ensure services support the aspirations, goals and priorities of each person using services, rather than providing “one size fits all” services.

Support should focus on what people who use services can or would like to do to maintain their independence, not only on what they cannot do.

Everyone working with people using home care services and their carers should treat them with empathy, courtesy, respect and in a dignified way by:

•           agreeing mutual expectations

•           always respecting confidentiality and privacy providing a reliable service that people and their carers can trust

•           regularly seeking feedback (both positive and negative) about the quality and suitability of care from people using the service, including those who do not have a carer or advocate.

The draft guidance also stresses the importance of prioritising continuity of care so that care works become familiar to the person using the service.

Professor Gillian Leng, Deputy Chief Executive of NICE, said: “We live in an increasingly ageing population. As more of us live longer, effective and high quality home care services will become more important than ever.

“Without adequate support at home, older people can suffer from social isolation, malnutrition, neglect or may even end up in hospital, perhaps from a fall or other accident.

"Our guideline aims to support home care commissioners, managers and care workers carers to provide a high quality and consistent service to give older people the support they need to live as independently as possible for as long as possible.”

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission, said: “People who receive care at home have every right to expect services that are safe, caring, effective, responsive and well-led. The draft guidance from NICE gives clear signals about how this can be achieved.

“I welcome the clarity about the length of time for visits. If people have to choose between a bath or breakfast in the morning because staff do not have enough time, that is certainly not safe, caring, effective or responsive and no well-led organisation would allow it to happen.”

Anna Bradley, Chair of Healthwatch England, said: "The quality of home care services vary massively across the country, and care users are uncertain about the level of care they are entitled to and do not know how to complain when standards slip.

"National guidance from NICE could set a benchmark to help establish what we can all expect and provide local Healthwatch with a tool to challenge and advise providers and commissioners to deliver the compassionate and individualised care we all need.”

 

Without adequate support at home, older people can suffer from social isolation, malnutrition, neglect or may even end up in hospital, perhaps from a fall or other accident.

Prof Gill Leng, NICE

If people have to choose between a bath or breakfast in the morning because staff do not have enough time, that is certainly not safe,caring, effective,responsive and well-led

Andrea Sutcliffe, CQC