The home care system is teetering on the verge of crisis with the most vulnerable people seeing a different carer every week, a root-and-branch examination has found.
The review, led by former care and support minister Paul Burstow, has hit out at the lack of organisation that threatens to fail those needing care in their own home.
In it, the Key to Care report describes how some service users were treated by 50 different members of staff in a year, and that the service - designed to free-up beds by keeping people out of hospital - is quite simply “not working”.
The report warns: “If home care is not in crisis yet, it soon will be. More people need care and there is less money to pay for it and not enough people willing to do the work.
“It is not organised nearly as well as it could be and it appears designed to keep caring professional relationships from forming between workers and those they care for.
“We are probably lucky there has not been a major home care scandal yet. If things do not change, it may only be a matter of time.”
The report states domiciliary care should offer an alternative to residential placements, allowing frail and elderly people to stay in their own homes for longer.
But the examination of Britain’s home care delivery identified how the service is “not realising its potential”.
The Burstow report adds: “It is not working for older and disabled people who need help to live independently, and who often feel poorly served by an inflexible system that is defined by specific tasks and little continuity among care workers.
“It is not really working for councils, whose budgets are shrinking while needs are rising. It is increasingly not working for care providers who are competing on price and working from framework contracts that offer little predictability of work and revenue.”
Acknowledging a significantly higher-than-average staff turnover than other professions, the report adds: “We are facing a recruitment crisis, with up to a million more staff needed over the coming decades and, without better investment.”
Mike Padgham, Chair of the Independent Care Group (York and North Yorkshire) said the report demonstrated clearly that the lack of funding was the key issue to the crisis.
“Here we have the evidence that at present homecare is failing both those who need it and those who provide it.
“Because there is no money in the system, we cannot create a proper, professional workforce that is properly rewarded and motivated to provide an excellent service.
“Instead we have teams of committed, compassionate and well-meaning individuals doing their best for their clients in a system that is close to breaking point.”
The report recommendations include more focus on personalised care, and better oversight of existing contracts to reduce poor practice.
Last month a report by the York-based Joseph Rowntree Foundation says “humanity” must be injected back into care homes, with personal relationships put at the heart of how they are run and regulated.