Home care workers must be given enough time to spend with elderly and disabled people and must have enough travelling time between appointments, a health watchdog has said.
The National Institute for Health and Care Excellence (Nice) said home help visits of less than 30 minutes were not acceptable unless part of a wider package of support.
It has published new guidance for councils that commission care as well as firms providing services.
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Freedom of Information figures published in the Daily Telegraph in February showed rising numbers of appointments were taking place in a matter of minutes.
Eight councils provided more than 593,000 care visits lasting five minutes or less in the three years from 2010/11 to 2012/13.
Previous research in December from Unison found three-quarters of councils commission 15-minute visits.
Charities have raised fears that vulnerable people are being neglected and are being forced to choose between being washed or fed.
Care workers have also complained that they do not have time to spend with their clients and ensure they have taken their medicines.
Many are also not paid for travelling time between appointments.
The new Nice guidance says contracts should “allow home care workers enough time to provide a good quality service, including having enough time to talk to the person and their carer, and to have sufficient travel time between appointments.
”They should ensure that workers have time to do their job without being rushed or compromising the dignity or wellbeing of the person who uses services.“
It said home care visits shorter than half an hour should be made only if the home care worker is known to the person, the visit is part of a wider package of support, and if the task can be properly completed.
People with disabilities and communication problems may need workers to spend more time with them, while some need help with eating and drinking, it said.
Government guidance published with the Care Act last year said short home care visits of 15 minutes or less ”are not appropriate for people who need support with intimate care needs“.
But it said such visits ”may be appropriate for checking someone has returned home safely from visiting a day centre, or whether medication has been taken (but not the administration of medicine) or where they are requested as a matter of personal choice.“
Bridget Warr, chief executive of the United Kingdom Homecare Association (UKHCA), chaired the group of experts which developed the Nice guideline.
She said the Nice guidance was clear.
”It suggests no visit should be shorter than 30 minutes unless it is part of a bigger package of care, that the person knows the carer - so you don't want strangers going in for less than 30 minutes - and crucially, that the task that needs to be done can be done safely and effectively within that time.“
She said there were ”very, very worrying practices around in terms of what local authorities are commissioning.
“There is quite a lot of payment by local authorities for payment by the minute, which is quite contrary to the wellbeing principle of the Care Act.
”It's impossible for the care workers to do the sort of work they want to do.“
She said it was ”hard to see the place for a five-minute visit,“ adding: ”As far as I'm concerned, I think that given the people receiving the care are, by definition, people who need support, it can be quite difficult to get access to their home in five minutes, let alone deliver care.“
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According to Nice, 470,000 people used home care funded by local authorities in England in 2013/14, and almost 80% were at least 65 years old.
Since October 2014, when a new inspection regime was launched by the Care Quality Commission (CQC), more than two thirds (68%) of home care services have been rated good or outstanding.
The CQC has no regulatory powers covering the length of visits but says providers must ensure care needs are being fully met.
Minister for community and social care, Alistair Burt, said: ”We asked Nice to develop this guideline so that everyone involved in providing home care has clear standards that we will expect them to follow.
The men and women on the frontline against Ebola and other hazards
The men and women on the frontline against Ebola and other hazards
1/6 Linda Dixon, 60, leads research into African swine fever at the Pirbright Institute in Surrey
"For more than 25 years I've been trying to develop a vaccine for the African swine fever virus, which causes death in domestic pigs, and has symptoms quite like Ebola. It came from East Africa in the 1920s and was transmitted to Georgia in 2007 via food from shipping that was fed to pigs. It has now spread to neighbouring countries and this year entered the EU via Poland, Lithuania, Latvia and Estonia. It's difficult to eliminate because it also infects wild boar, which populate large parts of Europe."
2/6 Simon Woodmore, 45, is a paramedic and operations officer for London Ambulance Service's Hazardous Area Response Team (Hart)
"I have a helmet for all occasions – five in all – as well as an array of outfits, including breathing apparatus and gas-tight suits, respirators and chemical protective suits. My job is to put paramedics where historically they could not have worked. We were born out of the Tokyo subway sarin attack in 1995, and have been running as Hart since 2006. There are 94 of us in London dealing with chemical, biological and radiological incidents, as well as building collapses and floods."
3/6 Simon Woodmore, paramedic and operations officer
"We've always dealt with contagious diseases and work with the Royal Free Hospital London high-level isolation unit to transfer confirmed cases, which fortunately is rare. A lot of it is communicating with the patient in a caring and compassionate way, which can be difficult when you're in full gear. There is an increased awareness of Ebola, but it's about reinforcing the processes we already have in place. Any personal risk is mitigated by our training and equipment."
4/6 Benjamin Black, 33, is a specialist registrar in obstetrics and gynaecology for Médecins Sans Frontières (MSF)
"In June I travelled to Sierra Leone, where one in 21 women of reproductive age dies in childbirth. This was my first mission, and the reason I got into medicine. I had my eyes wide open to Ebola; though it was still in its early days and concentrated across the border in Guinea, within days I had my first suspected Ebola cases in maternity. It was happening."
5/6 Benjamin Black, Médecins Sans Frontières
"You need a healthy amount of fear to be safe, as well as protocol and organisational back-up. The greatest fear then is how long you can keep getting it right. There is also a huge psychological element. I checked my temperature daily, but in a hot, humid country there's a constant feverish feeling anyway. We had scares and one of our national nurses was infected, probably in the community. He sadly died and it had a huge impact on the team."
6/6 Lisa Jameson, 29, is a National Institute for Health Research doctoral research fellow for Public Health England, based at the Porton Down facility in Wiltshire. She specialises in emerging viruses
"I was in the field watching patients come into the isolation centre next to us, often with their families. Sometimes they'd be walking and talkative, then die that night. It was tough but we were so busy, and being there made it feel like we were making a difference. When I got home after a month, I felt a sense of guilt that I was able to walk away. I'll almost certainly be going back."
“This will not only provide reassurance for countless families who rely on this care but for the thousands of workers who want the time and support to be able to give people the care they deserve.”
Andy Cole, campaigns director at Leonard Cheshire Disability charity, which also provides home care, welcomed the guidance, including on visits of less than 30 minutes.
“Care workers need time to care, to talk to people, to deliver compassionate, personalised support, and to maintain safety and quality,” he said.
On Monday, 20 care organisations submitted evidence to the Treasury ahead of the spending review, saying social care is facing a “deepening crisis” with regards to funding.
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