Home care visits for elderly can cost more than a place in a care home

Just a few hours of care visits a day for elderly people in their own homes may be costing the taxpayer more than it would to provide around the clock care in a care home, according to a new study.

The research carried out by care provider, Four Seasons Health Care, found if a person has a need for more complex nursing care needs or they are receiving supplementary social benefits on top of basic state pension and attendance allowance, then less than two hours of domiciliary care every 24 hours could cost the public purse more than a full time care home place.

Authorities tend to offer domiciliary care support, provided by carers visiting people in their own homes, because it is widely thought to be the least expensive option but for many elderly people it is not the best way to meet their care needs and, when all the hidden associated costs are added, it is often not best value for the public purse, claims Four Seasons.

Currently around 600,000 people in the UK receive home care, with the overwhelming majority being funded by local authorities. Ian Smith, chairman of Four Seasons Health Care, the UK’s largest independent care provider said: “People should be supported to live in their own home provided it is what they want and in their best interests.”

However he added: “The decision should not be driven by ideology or financial considerations, rather there should be an informed choice that includes understanding the real costs involved. For this to happen requires a more joined up approach to health and social care funding.”

The study revealed that for people who have home care funded by local authorities and who are receiving basic state pension and attendance allowance and only require a carer in their home for a total of about three and three quarter hours out of every 24 hours, the total cost to the taxpayer is comparable or more expensive than it is to provide around the clock care in a care home.

But if the person is receiving more complex nursing care or receiving additional social support such as pension credit and housing benefit then providing between one and three quarter and two hours of domiciliary care every day is likely to cost the taxpayer as much as it would to provide a care home place.

When a high level of care is required, the care home will almost invariably be a more cost-effective and much safer option, according to Four Seasons.

UKHCA disputes findings

The UKHCA, the professional association for homecare providers, disputed the findings saying this is not the case generally. Although it does accept that in some individual cases it is less expensive for the state to fund people’s care in care homes.

Most importantly however, according to Colin Angel, UKHCA's policy director, is not the economic cost but being able to give people choice on where they want to live and be cared for.

He said: “Around nine in ten people would prefer to be cared for in their own homes if the need arose, with around just eight per cent expressing a preference for residential care,”(according to a 2012 survey by Saga/Populus).

“Successive governments have signalled the need for people's social care needs to be supported in a way which maintains independence for as long as possible, helping people through better support in their local community.

“UKHCA strongly supports the right of people to choose the most appropriate care setting to meet their needs and preferences. We remain committed to working with Government and bodies across health and social care to promote effective and efficient services that enable people to live well at home and in their own communities.”

Four Seasons' calculations are based on typical costs of nursing care in an independent sector care home of circa £583 and typical costs of independent sector domiciliary care of circa £14.90 per hour. If the domiciliary care is delivered directly by the local authority then the hourly cost typically is more than double the independent rate.

It is currently cheaper for local authorities to provide care for elderly people in their own homes because they have responsibility for financing the care support but under the current funding structure most of the other associated social benefits costs come out of central Government budgets.