New guide: Commissioning home care for older people

25 June 2014

Both my parents have been enabled to stay independent as long as they can due to the adult social care they have been provided with. They are able to enjoy a dignified life, in their communities, and remain in control and as independent as they can be.

Daughter, West Midlands, speaking in SCIE’s new guide.

Today sees new recommendations on how to improve care and support services for people who live at home. In response to the growing number of people over 65 in the population, a new guide suggests what commissioners can do to improve how they assess, plan, contract and monitor homecare services.

The guide is launched today by the Social Care Institute for Excellence (SCIE); it captures the latest research findings on an important and emerging area of social care; that of homecare for older people with complex needs. It’s launched at the Health + Care event at the London Excel centre.


SCIE conclude that good homecare should:

  • support people to live well in the community
  • prevent people with significant health or care needs from having to use emergency services and of being admitted to hospital inappropriately
  • help people with care needs maintain themselves in the community.

Commissioners should, for instance:

  • develop a clearer understanding of the complex needs of older people in their area, in order to commission the right services for them
  • identify which are the areas of poor performance in their region; the ones which increase demand. Commissioners should then develop a clear integrated plan for how they might commission services differently, to improve outcomes
  • involve users and unpaid carers at every stage of the commissioning process, as it is only through listening to what users and their unpaid carers want from services, that commissioners can really know how to shape those services.

The guide has been written and co-produced with an advisory group made up of people who have direct experience of homecare. Chrissy Wong, from the advisory group, who cares for her father, has told SCIE about her experiences. She’s told SCIE how, when her father was first diagnosed with Alzheimer’s, she was unaware of the help that might be available. So she wasn’t able to recognise good, or bad, practice. She says that commissioners need to know what users and carers, like Chrissy, say they want; a small number of carers, flexible services and co-ordinated care.

Care Services Minsiter, Norman Lamb MP, says:

SCIE is absolutely right to emphasise that the needs of older people, especially when those needs are complex, must be considered holistically and not as a series of separate conditions. The focus must always be on people themselves; their needs, wishes and aspirations. This guidance rightly stresses that they should have choice about, and control over, services that meet their needs flexibly; and that they should be part of the design and development of those services.

SCIE’s Chief Executive, Tony Hunter, says:

This guide is timely and helpful for commissioners. We have the latest research on how to commission homecare for older people. It’s a complex task, but you can do no worse than by starting with the people themselves and their carers. How do they want to see care and support? We at SCIE are keen on co-production and one of the recommendations in the guide is that commissioners should involve older people who use service, and their unpaid and paid carers, in designing services.

The United Kingdom Homecare Association’s Chief Executive, Bridget Warr, says:

The SCIE guide reinforces the vital role that homecare has in supporting those with complex needs and the importance of sensitive commissioning. Services that let people retain their independence by living in their own home, despite complex and long term conditions, will prove to be a winning formula as the population ages and the demand for complex care increases. Too often unnecessary hospital admissions occur, when homecare can be supporting independence and quality of life. The SCIE guide very ably shows how this can be achieved, and UKHCA welcome the timely publication of this valuable contribution to the planning of health and social care

President of the Association of Directors of Adult Social Services, David Pearson, says:

We very much welcome this guide to commissioning. It will help commissioners be clear that we are responsible for ensuring that a high quality and sustainable care market exists in our council areas. This is a responsibility which we share with our NHS colleagues. It builds well on the work ADASS did last year in our publication Ten Top Tips for Commissioners; work which our Immediate Past President Sandie Keene is now continuing sector-wide.


The guide, available on SCIE’s website, also looks at the funding and costs of home care. By 2030, the number of people over the age of 65 will make up 22% of the population. As the population grows older and the political and financial drive to keep older people out of hospital increases, the way care is provided at home is coming under the spotlight. The home care market is currently valued at £5.5 billion, with six million hours of regulated home care delivered each week.

Useful links

Press Contact

Mobile: 07739 458 192