What we mean by home care services
Home care, sometimes called domiciliary care, provides care and support to people in their own homes. This can include support with:
- personal care, such as washing, dressing and toileting
- taking medication
- preparing meals and helping people eat and drink well
- moving around safely
- maintaining independence and wellbeing
- being part of the community and taking part in social activities
- supporting family carers
- managing and maintaining the home
The aim of home care is to help people remain independent, safe and connected to their communities for as long as possible.
North Yorkshire has many different home care providers, with over 170 registered home care providers delivering support across towns, villages, rural and coastal communities. Thousands of people receive council-funded home care each year, alongside many people who arrange and pay for their own support.
Our vision is to support people to live well at home, maintaining independence, choice and control wherever possible.
How we currently arrange and purchase home care
The current arrangements have been in place for several years and are due to come to an end in November 2027.
We currently commission home care through an Approved Provider List (APL). Providers that meet our requirements can join the Approved Provider List and set their own prices.
When someone needs home care, we contact home care providers on the Approved Provider List. We look at which providers are available, where the person lives, the support they need, and the cost.
Whilst this arrangement offers flexibility and choice, it can mean that:
- similar care is purchased at different prices
- availability varies across local areas
- people may experience delays in accessing support
- it can be difficult to understand what is included within different service offers
What we are proposing
We are proposing to replace the current Approved Provider List with a new Home Care Framework. The framework would establish clear standards, agreed expectations and consistent arrangements for how home care services are delivered across North Yorkshire.
The new framework would create a core group of home care providers in each local area. These providers would give safe, personalised support that meets people’s needs and helps make sure local home care services are available now and in the future.
Under the proposed arrangements, home care providers would work together as part of a core group, rather than only working as separate organisations.
This means providers would work more closely with each other, local communities and organisations, health services and the council to support people to live well at home. For example, providers could share local knowledge, help cover care when there are staffing pressures, work together to arrange support quickly when someone leaves hospital, and link people with community activities or other services that help them stay independent.
How we have designed the proposed framework
The proposals have been developed through engagement with:
- home care providers
- people who use home care services
- unpaid carers
- health and care partners
- council staff
We have also considered:
- feedback from home care providers
- feedback from council staff who help arrange and manage services
- national policy and best practice
- the Care Act requirement to promote a diverse and sustainable care market
- evidence regarding current and future demand
- the actual cost of delivering home care
- our vision to help people live well at home
Our aim has been to design a framework that puts people first while supporting a strong, sustainable and high-quality home care sector.
Main changes being proposed
1. A core group of care providers in your local area
The main proposed change is to create a core group of high-quality home care providers in each local area who meet our enhanced standards. These standards go beyond the requirements expected of all registered home care providers.
We would build a core group of trusted home care providers in each local area. The number of home care providers in each core group would reflect the demands of each local area.
Each core group would be made up of the right number of home care providers who are able to meet the care and support needs of all the people who live in the local area.
2. Clearer and more consistent home care rates
Currently, home care providers can set their own rates for council-funded care.
Under the proposed arrangements, the council would set a minimum and maximum rate that home care providers would be paid. Home care providers that join the provider core group in the local area would then be paid the rates set by the council for delivering care and support.
The rates set by the council would be informed by independent cost of care evidence and discussions with home care providers. This would help make sure rates are fair, transparent and sustainable.
This approach aims to:
- make it easier to understand how home care is paid for
- support fair and sustainable rates for home care providers
- reduce the difference in rates within local areas
- help home care providers invest in their care staff and improve the quality of care they deliver
3. Stronger focus on quality and outcomes
The proposed framework would introduce clearer standards and stronger outcome measures, so providers are assessed not only on whether care is delivered safely, but whether it helps people live well at home. This would include standards for reliable visits, staff who know the person and their care plan, timely reviews when needs change, and clear responses to concerns.
Outcome measures would look at whether people feel safe, receive consistent care, stay as independent as possible, and remain connected to their community.
Home care providers would continue to be assessed against a range of quality indicators including:
- person-centred care
- workforce skills and training
- reliability and continuity of care
- safeguarding and safety
- independence and wellbeing outcomes
- service user experience
- engagement with families and carers
How these changes would affect people who need home care
Your current home care provider is part of the new arrangements
There will be no changes to your care service, and you will continue to receive support from your current home care provider.
Your current home care provider is not part of the new arrangements
Where possible, people will be able to stay with their existing home care provider. If a home care provider does not join the new arrangements or cannot meet our higher standards, we will work with people to move their care and support to another suitable provider.
Where a person's existing home care provider is not part of the new framework, but they wish to stay with that home care provider, we will work with them to consider whether a direct payment is an appropriate option.
A direct payment is money given directly to you by your local council or the NHS instead of them providing social care services. It lets you choose, buy, and manage your own care and support, such as hiring a personal assistant or using a home care provider.
If a person chooses a direct payment arrangement, the person’s budget would be based on the rates the council would buy the care at if it was arranging the care on behalf of the person.
If the person chooses a home care provider which is not part of the new framework, and the home care provider charges higher rates, the person may need to pay the difference to continue receiving care from that provider, by way of a voluntary top-up.
Support arrangements would continue to be reviewed in the normal way to ensure that services continue to meet the person’s needs.
Better information and transparency
People and families should have clearer information about:
- the services home care providers offer
- the level of care required
- how funding arrangements work
- what standards providers must achieve
Improved quality and consistency
The framework is intended to create more consistent expectations across home care services, helping ensure that people receive safe, high-quality support regardless of where they live.
More reliable and sustainable home care
The proposed framework would make sure there are enough home care providers across each local area to meet people’s needs, so people can receive a service when they need it.
Providers would work together to share capacity and respond to local pressures. This would help reduce disruption for people and support more reliable home care services within each local area and across North Yorkshire.
Potential risks and concerns
Some providers could choose not to join the framework
Some home care providers may choose not to join the new framework or may not meet our updated standards. If this happens, we will work to minimise any impact on people who receive care and support.
We are working closely with home care providers to design arrangements that are fair, sustainable and attractive to a wide range of home care providers, so that each community has a strong core group of home care providers able to meet local needs.
Next steps
The feedback received through this consultation will help shape the final design of the new Home Care Framework before any decisions are made.
No final decisions have been taken.
Summary
The proposed Home Care Framework aims to create a fairer, clearer and more sustainable way of arranging home care services across North Yorkshire.
The changes are designed to:
- support people to live well at home
- improve quality and consistency
- increase transparency
- better meet changing levels of need
- support a sustainable local care market
- improve outcomes for people who rely on care and support
This framework forms a key part of our ambition to help people remain independent, connected and supported within their own homes and communities for as long as possible.