Over the next two decades, the number of people aged over 80 is set to double in Britain. Public services must adapt to the challenge that this poses, central to which is the need to deliver social care to older people. Home-based care has the potential to reduce the pressure on more costly public services such as hospital beds and care-home places.

It can also enable older people to enjoy the benefits gained from remaining in their homes and communities for longer, significantly improving their quality of life.

Despite the importance of home-based care, a number of problems continue to plague its provision. Most significant is a lack of investment in the system, but Other problems also prevent home-based care from delivering on its potential, including low productivity, poor integration with health services, and a very fragmented market.

This paper explores the issue of home-based social care in London. It provides policymakers and commissioners with a clearer idea of what makes for good quality home-based care, the challenges that exist for delivering it, and how the increasing demand can be met. Our research identified three key tests to ensure home-care is of good quality.

  • Test 1: Care is provided by well-trained care workers who have enough time to care and can provide a consistent service
  • Test 2: Care is personalised to individual needs rather than prescriptive services
  • Test 3: Care allows the older person to be independent and reduces reliance on acute health services