Interviewing residents receiving care at home

Healthwatch Islington gathered the views of people who use home care services.  They interviewed 26 service users and family members, gathered the views of 17 people via an Age UK survey and spoke to 10 providers.

Positive feedback

Most people had some good things to say about the quality of care, and a number of respondents were full of praise. Positive feedback tended to coincide with the resident knowing what to expect from the service and feeling in control. 

Many interviewees appreciated that their carers knew them by name and were aware of their individual preferences. These relationships were clearly very important. Some respondents spoke about having great affection for their carers or regarding them like members of their family. 

While not all service users regularly interacted with their care provider, those who did generally described the agencies as easy to contact. Though overall feedback on complaints was mixed, a number of people told us that their provider had listened to their feedback, responded positively, and made improvements to their care. These residents were more favourably disposed towards the service as a result.

Areas for improvement

Late arrival of carers was a frequently reported issue. Respondents felt that the consequent reduction in visit duration negatively impacted the quality and thoroughness of care. 

Continuity of care was sometimes an issue, with rapid turn-over of staff. This could make the home care service feel less personalised. 

There were repeated concerns regarding carers' lack of training in essential caregiving tasks such as preparing basic meals, making beds, and administering medication. 

Some users experienced mismatches between their needs and the carers assigned to them. In several cases, carers were reportedly unfamiliar with the health conditions or physical limitations of the individuals they support, such as neuropathy. 

Many service users reported being unaware of their care plan or not having a copy available. Changes to care plans, visit times, or assigned carers were not always communicated clearly or in a timely manner, leading to confusion and dissatisfaction. 

A number of participants were unaware how to make complaints either with their care agency or the local council. This highlights a need for improved information sharing and clearer guidance, both on the expectations people should have of home care services, and available channels for raising concerns

Issues for providers

Recruitment is a big challenge. Additionally, post-covid, many carers choose part-time hours and many prefer not to work early mornings. 

Providers felt that social workers were adding an unnecessary level of rigidity to the design of care and support plans, making care packages more difficult to bid for and deliver. 

Needs assessments conducted in hospital settings can be unrealistic, with patients’ actual care requirements significantly greater than those provided for in their care or reablement packages.