What is good home care? Commissioning home care for older people

I think to look at how people were and what people used to do is absolutely vital and [to] try to extend that into everyday life.’
Care provider [1]

Good commissioning of home care helps older people to stay in their own home, when otherwise they would need to be in residential care. To do this successfully, home care should address not just the person’s domestic and physical needs, but also their social, spiritual and emotional needs. This is challenging, as each person’s needs are individual and no one approach will suit all.

Good home care should:

support people to live well in the community
prevent people with significant health or care needs from having to use emergency services or being admitted to hospital inappropriately
help people with care needs to look after themselves in the community. [4]

Regulations and standards

The Care Quality Commission is the independent regulator of health and adult social care in England. A consultation on a new approach to regulating, inspecting and rating community adult social care services concluded in June 2014. [13]

The intention proposed is that inspectors should use their professional judgement, supported by objective measures and evidence, to assess whether services are safe, effective, caring, responsive to people’s needs and well-led. Services will be rated to help people to compare them and to highlight where care is outstanding, good, requires improvement or is inadequate.

The handbook for providers will be updated in September 2014 set out how community adult social care services will be inspected from October 2014.

Dementia Quality Standard (QS) relates to all settings and could be used by commissioners to inform what does good and excellent look like in home care for people with dementia.

NICE is developing quality standards on home care, due in 2015.

In Northern Ireland there are Minimum Standards for Domiciliary Care Agencies, which are used by the Regulation and Quality Improvement Authority to assess the quality of services provided by organisations. [26]

Taking into account the human rights of older people, and embedding their human rights into the way home care is provided, can deliver high-quality care without necessarily increasing costs. [1]