Home Care Guideline: key recommendations for commissioners

NICE has published a guideline – our first for the home care sector – to help deliver personal care and practical support to older people living in their own homes.This document outlines the key recommendations for commissioners of home care services.

Importance of home care

  • Home care should be recognised as an important component of care packages for older people.
  • It should be considered for those with low to moderate needs to avoid, delay or reduce future dependency on health and social care services.

Focus on the needs of the individual

  • Ensure services support the aspirations, goals and priorities of each person, rather than providing ‘one size fits all’ services.
  • Ensure support focuses on what people can or would like to do to maintain their independence, not only on what they cannot do. Recognise:
    • that people have preferences, aspirations and potential throughout their lives, and 
    • that people with cognitive impairment and those living alone might be at higher risk of having unmet social care related quality of life needs or worse psychological outcomes
  • Ensure the person using the service, and their carers (if the person has involved them in their care), can direct the way home care is delivered. This is so that the person’s safety, comfort, independence and sense of security are always promoted.

Planning home care

  • Ensure providers give people and their carers (with the person’s permission) a copy of their home care plan in a format that meets their needs
  • Ensure the home care plan:
    • empowers the person as much as possible, by recognising what they can and want to do
    • is informed by the experience, skills and insight of carers, as appropriate
    • addresses the full range of support needed to help the person to live how they choose, including practical support as well as personal care needs (this could include, for example, support to help a person manage their own financial and personal affairs, do their own shopping and cooking, or socialise, or other help depending on the person’s needs and preferences)
    • describes how success and outcomes will be measured

Allow home care workers enough time to provide a good quality service

  • Ensure service contracts allow home care workers enough time to provide a good quality service, including having enough time to talk to the person and their carer, and to have sufficient travel time between appointments. They should ensure that workers have time to do their job without being rushed or compromising the dignity or wellbeing of the person who uses services.
  • Home care visits shorter than half an hour should be made only if:
    • the home care worker is known to the person, and
    • the visit is part of a wider package of support, and
    • it allows enough time to complete specific, time limited tasks or to check if someone is safe and well.
  • Consider contracting and monitoring in a way that allows services to be delivered flexibly to ensure the person can identify what is a priority for them. This might include, for example, allowing provider organisations (with the person’s agreement or at their request) to use time flexibly.

Implementing this guideline

Commissioners and providers should work together to implement the recommendations in this guideline. A costing statement has been published and other tailored resources will be made available to support implementation of the guideline.

Read the guideline.