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The Challenges Facing the Domiciliary Care Market
11 October 2021

Staffing levels, hours and recruitment

The proposed 1.25% levy on employee earnings and employer wage costs (totalling a combined increase of 2.5%) should raise an estimated £12 billion a year. This would provide much-needed financial aid for the healthcare sector; the extra funding will largely be focused on alleviating the pressures caused by the coronavirus pandemic.

Even with this extra funding, which is, in itself, a point of contention, this will not be enough to create meaningful change in the health and social care space. To make significant strides forward we need a workforce strategy from government; specifically addressing carer pay and talent attraction in order to address staff shortages and increasing demand.

Of the forecast £12 billion, there is just £2.9 billion over 3 years dedicated to making improvements and reform in social care. This, understandably, has raised concerns around the lack of financial support and uncertainties around the future of social care investment.

We have put together a report which highlights the above-mentioned challenges and explores solutions using technology. Our report focusses on adam’s ability to maximise supply capacity and drive efficiencies in the market.


There are numerous challenges facing the Domiciliary care market. These include: COVID19, Brexit, D2A and the home first approach, rising costs, and staffing shortages. This is creating a perfect storm for the sector nationally. adam’s new MIC (Market Insights & Consultancy) service has helped coordinate and conduct a fact-finding exercise on behalf of one of our customers. The customer required information insight from their local domiciliary care market to understand current conditions. This information would be used to support decision making for remedial actions that aid to prevent further challenges being faced.

The Findings

We spoke to 131 homecare agencies to compile the following findings:

• 74% cite recruitment challenges and staffing shortages as the main factor in their inability to take on additional care packages

• 98% of agencies surveyed are currently recruiting

• Recruitment is unanimously seen as very difficult at present

• Agencies have highlighted that lack of funding is having a significant impact on their ability to recruit

• Pay is cited as a major factor in the inability to attract and retain candidates

• Agencies feel that new recruits are being overwhelmed, creating a risk of staff turnover

• Several agencies are unable to recruit drivers. Although they have candidates, they can only take on a certain number of non-drivers as they must double them up with a driver

• The market is currently at 86% capacity in terms of hours. The remaining 14% is not being utilised as the hours are not in line with vacant care package call times

• The recent NHS Track and Trace isolation periods for staff, as well as the summer holidays and heavy annual leave periods have caused significant staffing issues

Key insights

A key aspect of this consultation was to identify the reasons why homecare agencies are struggling to take on additional care packages. Highlighting the challenges, they are facing with staffing and recruitment. The following pulls out the key themes which may later provide actionable recommendations to support MLCSU when considering how best to help homecare providers with capacity and recruitment:

• Advertising and attracting sufficient candidates –

“The quality and number of candidates is the worst it’s been in years.” – Prestige Nursing

• Improving the appeal of the role

• Addressing the pay gap between homecare and other sectors –

“63% are only paid for the time spent in the homes of the people they care for. By only receiving payment for time spent in the home of their client, care workers’ hourly pay rates fall well short of the governments national living wage.” –

• Support for new recruits

• Rota alignment and call times

• Lacking transport for carers

• Working in partnership with PA agencies

Find out more

This study forms part of our new Market Insights and Consultancy service; for further insight into the status of the domiciliary care market, please get in touch with us at
Alternatively, you can visit our website for more information on adam’s software solutions and how our public sector partnerships are helping support local communities.

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