Homecare
What do people want from homecare services? How does care at home work best for people who receive paid care and/or support from unpaid carers in Wiltshire?
About the Project
Wiltshire Council approached Voice It, Hear It to undertake engagement work as part of their review of the current care at home (domiciliary care) frameworks. This review will inform the development of an options proposal for future commissioning.
Voice It, Hear It was asked to engage directly with individuals who receive care at home, including those receiving council-commissioned care and those who self-fund their support. The focus of this engagement includes understanding what people want from home care, exploring how care at home works best, the process of arranging care, community support, engaging with unpaid carers and looking ahead to the future of home care.
Key Findings
Consistent and Reliable Care
Respondents emphasised the need for consistency in carer routines, schedules, and continuity. Repeated changes in carers or visit times led to frustration and negatively impacted their health and stability.
Tailored and Person-Centred Care
Many respondents expressed that care services often fail to accommodate unique needs, particularly for those with fluctuating health conditions, disabilities, and dementia. Some described rigid care models that did not reflect their personal preferences.
Improved Access to Assessments and Care Options
Barriers to care assessments were a recurring theme, especially for self-funders and those in rural areas. Some found the process slow, bureaucratic, or unclear, and felt there was a lack of transparency regarding eligibility criteria.
Social Interaction, Mental Health, and Companionship
Social isolation was a significant concern, with many users relying on carers for companionship and human interaction. Respondents highlighted the positive impact of carers who are communicative and empathetic.
Carer Pay, Recruitment, and Retention
Low pay and poor working conditions were identified as key factors affecting recruitment and retention in homecare. This was particularly challenging in rural areas where higher wages in other sectors made care work less attractive.
Respite and Carer Support
Unpaid carers expressed high levels of stress and burnout, highlighting the need for better access to respite services. Some found existing respite arrangements inadequate or difficult to access.
Training and Skills Development for Carers
Concerns were raised about inconsistent skills and knowledge among carers, particularly in areas like dementia care and cultural sensitivity. Some also felt carers were not reviewing care plans properly
Improved Communication and Coordination
Poor communication from care providers was a recurring issue, particularly around schedule changes and staff handovers.
Funding and Financial Stability
Respondents reported that direct payments and funding allocations were often insufficient to cover care costs. The financial burden of disability-related expenses was also highlighted.
Access to Adaptations and Equipment
Many respondents reported challenges in securing home adaptations and mobility aids, which are critical for independence.
User Involvement and Empowerment
Clearer guidance on care options and direct payment management can empower users to take a more active role in their care planning. Respondents expressed a desire for greater control over care arrangements, including the ability to choose carers and influence care plans. Some users felt disempowered by bureaucratic processes that limited their input.
Homecare Report
As part of the project Voice It, Hear It created an online survey which was shared amongst partner networks.
Findings from the survey are presented in the report which you can download using the ‘download report’ button.
For questions about the report, please email: voice@communityfirst.org.uk
“My carers’ cheerful attitude uplifts me and makes my day better.”
“I’m worried about losing my carers because of low pay. It’s impossible to replace them where I live.”
Feedback and Next Steps
You Said, We Did
Following the completion of a Voice It, Hear It engagement project. Wiltshire Council will share a project update outlining how the feedback from this project has been considered and acted on. This update will usually follow within six months.
Funded by:
