The eBay Race to the Bottom in “Homecare scandal”

Panorama seems to be back on form. Last night I caught most of an excellent undercover investigation into the “services” provided by some private homecare companies. These companies had won contracts from local authorities to provide care packages to vulnerable residents at home.

Residents are often elderly, have learning difficulties or are even terminally ill. The overriding theme of the programme was that these privately owned companies win home care contracts by submitting bids which undercut decent organisations. They then make their money by simply not giving the care they had contracted to provide. Instead of providing 30 minutes blocks of care and support they overload their staff with so many cases that they cannot physically all their clients. So visits are curtailed to 10 minutes or less or just don’t take place. Needless to say that the staff they employ are only paid just above national minimum wage, with only statutory minimum holidays, sick leave and no pensions.

Undercover reporters worked for companies in England and Scotland and confirmed that they were sent out to cover work loads which the companies knew were impossible for them to complete. The company of course claimed the full amount for the time they were suppose to have provided. As pointed out in the programme surely this is common criminal fraud? Secret cameras placed in the homes of some clients confirmed that this practice was widespread. Not only were vulnerable clients not receiving the care that they or the local authority had paid for but vital care plans were not kept up to date. This meant an obvious significant risk to clients who may have received the wrong medication because of it.

I will declare an interest, my Mum lives in an over 50’s sheltered housing block run by a housing association. She has in the last few weeks started to receive home help services provided via the local authority. My “little” sister works for another local authority as an assistant social worker and most of her work involves assessing elderly clients for home care.

The most shocking fact that came out last night was that at least two local authorities had held “on-line” live auctions between organisations bidding for care contracts. In the reverse of EBay - organisations bided against each other to provide the lowest price. This is the race to the bottom. Companies are free to bid whatever is needed to win the contract. Decent companies know that they cannot provide quality services at that price so they don’t take part and lose contracts. This is part of a downward spiral with everyone the losers – clients, workers, local authorities and ultimately the taxpayer who largely funds all of this. The only winners are the greedy exploiters who make their money out of other peoples misery.

By co-incidence in a union meeting recently we were trying to benchmark housing and care organisation in terms of how they treated their staff. The private owned care organisations came bottom (and I think the worse example was actually mentioned on the programme). Once again I think that this demonstrates that the interests of workers and clients are interwoven. Organisations that treat their staff well will also tend to provide quality services to clients.

There are other worries in social care such as cuts in the Supporting People budgets and the removal of ring-fencing for this budget. What is needed is regulators with bite; the existing ones seem to be ineffectual. Proactive local authority commissioning agents who will effectively vet organisation before any tender process and will actively monitor contracts. Quality of services not price should be key benchmark. Legislative change is also desperately needed to ensure the end of 2-tier workforces in all social care contracts. If all companies had to honour not only existing staff contracts but ensure that new starters had to be paid the same terms and conditions then it should stop the cowboys undercutting.

The interviewer repeatedly asked the Scottish home care regulator if she would want her grandmother to be provided services by these companies. She refused to answer.