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Care at home that puts people more in control

In Lambeth, around 2,000 people receive home care funded by the council. We are looking into how home care can be improved, in order to empower people to feel more in control of their life. 

We wanted to find ways for home care to be more joined, and for people to feel more in control of their life.

Improving home care services in Lambeth

Over the past year, we have been working with Lambeth Council on a project looking into how home care can be improved. The aim was to use design approaches to find ways for home care to be more joined up with other services and to empower people to feel more in control of their life.  The project ideas have been fed into the council’s plans to make home care more localised.  The project was part of the Local Government Association (LGA) Design in Social Care programme.


What is home care?

Home care is a service for people who need support with personal care and household tasks. In Lambeth, around 2,000 people receive home care funded by the council. Most home care users are over 65 but the service is also provided to disabled adults and children.


Shifting the focus of the service

Home care is shifting away from a “time and task” model based on a list of jobs and time spent. Now the focus is on meeting people’s needs.

Home care has traditionally been commissioned (bought) by councils and delivered on a “time and task” model, prioritising a set list of jobs for the carer to do and the time they take, instead of focusing on meeting the needs of individual people. Now, in line with other parts of the country, Lambeth has been moving towards a “strengths based approach” to social care. This means putting people more in control of their own care, focusing on their personal goals and aspirations.


In order to achieve this, the project team wanted to explore ways of improving people’s experience of home care so the service can be more flexible, co-ordinated with other support and enable people to feel more in control.


What we did

The project involved:

  • speaking with people using home care services and their informal carers to ask about their experience of care and how they would like to see it improved
  • looking at the feedback to identify key issues and turning them into opportunities for improvement
  • brainstorming solutions
  • choosing an idea to test out.

For each step, the project team attended workshops run by the LGA and a specialist design company with several other councils across the country doing similar projects.  We also held a workshop with local home care providers to hear their own ideas.

We identified key issues, brainstormed solutions and chose an idea to test out.


What we found

We identified four key findings from our interviews with home care users:

  1. People want control and choice with their home care but don’t always expect to become more independent through the service
  2. Service users experience significant coordination and communication frustrations with carers, the agencies and the council
  3. People want the carer role to be more flexible
  4. Trust is crucial between carer and service users and their families, both for helping people to feel safe and to have the confidence to ask for the help they need.

“When I had my independence I wouldn’t have had strangers in, but this woman is like family, she is not like home care” – Home care user

Our interviewees wanted clear expectations all round about the service at the outset.  People also felt that the home care workforce needs to be valued and have opportunities to develop the right skills for the job.


Next steps

The feedback is now being used to:

  • test a new information pack for service users, to explain what people can expect from council funded home care service and how to get the most out of the service
  • help shape the council’s new neighbourhood based approach to home care, which links into the wider development of localised services. 

Healthwatch is also following up with more research on people’s experience of home care, to further explore and develop the findings from the initial project and to find out what people think of the council’s plans for the service.

Have your say

If you use council-funded home care, or look after someone who does, we would love to hear your views.  We will be doing interviews until the end of December.  To find out more, please contact Kate Damiral, tel: 010 7095 5764, email:

Volunteer with this project

You can also get involved in our project by volunteering to help interview people. Find out more by registering your interest via our volunteering sign up sheet!

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