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Home care visits should last at least 30 minutes

Person-centred care should focus on what people can or would like to do – not what they can’t

Louise Prime

Wednesday, 23 September 2015

Home care visits to elderly people should last at least half an hour and focus on what they can or would like to do rather than on what they can’t do, the National Institute for Health and Care Excellence said this morning. In its first ever guideline for the social care sector, NICE has made a series of “aspirational but achievable” recommendations for local authorities, clinical commissioning croups (CCGs) and others who commission home care services, aiming to promote independence in old age.

As demand for home care services is set to grow, NICE pointed out that some local authorities are already getting it right and delivering high-quality services – since the Care Quality Commission introduced its new inspection regime in October 2014, two-thirds (67%) of home care services inspected so far have been rated good and 1% outstanding – but a report last year by the Local Government Information Unit highlighted concerns that some working practices could affect the quality of a person’s care.

The new guideline advocates a ‘person-centred’ approach in which an individual’s needs and wishes are heard and respected, rather than a one-size-fits-all service. NICE said many of its recommendations require a change in attitude rather than additional funding; and that implementing them could help make savings elsewhere, through avoiding falls, injury and hospitalisation.

NICE recommends that commissioners ensure that home care workers are 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. It said: “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.”

It also calls on commissioners to check that support is delivered through a coordinated team, to promote integrated working and foster good communication; and for continuity of care to be made a priority, by ensuring the person has the same home care worker or workers so that they can become familiar and build a relationship.

Bridget Warr, who is the chief executive of the United Kingdom Homecare Association and who chaired the guideline development group, commented: “The help each person needs will differ and it is important that the homecare delivered is tailored specifically to the individual; his or her needs, wishes and aspirations.

“The guideline emphasises the importance of people receiving support from trained and competent staff with whom they are familiar. For this to happen, those commissioning and delivering home care must work together with the person wanting support to plan the right co-ordinated care in the way the person wants. They should be sure that there is adequate time allowed for the home care worker to provide good, sensitive support in a way that protects and enhances the person’s dignity, wellbeing and independence.

“The guideline spells out how this can be achieved and will, I hope, help to provide focus for those many providers and commissioners who want to ensure high quality, responsive, sustainable support at home is available to those who want it.”

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