Discussions on Home Care

Healthwatch Bristol and Healthwatch South Gloucestershire supported the Carers Support Centre to conduct focus groups with their users.

. It was produced because carers often hesitate to make formal complaints due to fear of negative consequences, meaning their concerns are underreported. 

Overall, the findings highlight widespread dissatisfaction with aspects of home care, alongside recognition that some care workers provide excellent support. The report identifies several key themes.

Firstly, continuity of care is a major issue. Many carers reported that a high number of different care workers visit service users, making it difficult to build trust or ensure consistent understanding of needs. In extreme cases, individuals experienced dozens of different carers within a short period, which was particularly distressing for people with conditions such as dementia. 

Secondly, concerns were raised about the role of brokerage systems and local authorities. Carers felt that decisions about care packages were sometimes driven by convenience or cost rather than the individual’s needs, leaving them feeling excluded or pressured during decision-making. 

Thirdly, carers frequently experienced care not being delivered as agreed. This included care plans being altered without consultation, tasks being carried out incorrectly, or visits being missed, late, or cut short. Some reported serious consequences, such as missed medication and long periods without any support. 

Fourthly, the quality of training among care workers was questioned. Carers highlighted a lack of knowledge, particularly in specialist areas such as dementia care, leading to inappropriate or ineffective support. 

Fifthly, the appropriateness and suitability of care workers was a concern. Carers reported limited choice, with issues such as mismatched gender for personal care and lack of sensitivity to cultural needs, which could cause discomfort or distress. 

Sixthly, communication problems were common. Carers described poor information-sharing between agencies, missed updates, and difficulty contacting providers, which contributed to confusion and reduced trust in services. 

In addition to these key themes, carers reported practical problems such as poor timekeeping, lack of respect for service users’ homes, insufficient visit lengths, and staff shortages linked to low pay and high turnover. Many also expressed fear of complaining, believing it could lead to worse treatment or withdrawal of services. 

Despite these challenges, carers also described what good home care should look like. They emphasised the importance of person-centred care, consistent and well-trained staff, enough time to deliver care properly, strong communication, respect for dignity and cultural needs, and collaborative relationships between carers and professionals. 

The report concludes that these findings should inform local authority commissioning and service improvement. Healthwatch and the Carers Support Centre committed to sharing the results with commissioners and continuing to monitor feedback to ensure carers’ voices are heard safely and that improvements are tracked over time.