Behind closed doors: a flagship report

Homecare Voices has published a report based on a questionnaire of 511 current and former homecare workers.

Behind closed doors: the realities of employment in domiciliary care provides rare, worker-led insight into what employment in homecare looks like in practice. In keeping with our ethos to lift the voices of homecare workers, the report includes an anonymous selection of unedited responses to a number of questions. Just look for the 🗣️ symbol on the contents page.

Key findings

• Headline hourly pay rates in homecare often mask unpaid travel and waiting time, with 72% paid for 'contact time' only

• Workers prioritise payment for all working time over increases in basic pay, with 70% identifying payment for all working time as the key to improved retention compared to 55% who called for higher basic pay

• Labour shortage narratives sit alongside widespread underemployment, with 47% unsure that when rota is published, they will have been given the hours they need and 67% of migrant homecare workers indicating their main sponsor does not provide sufficient hours

• Rota instability and legal breaches of rest entitlements are common with 87% not always receiving the legal 11 hours' rest between working days

• Sufficient visit time - including time for social support - is central to quality of care with 81% indicating that most or all of the people they visit experience loneliness on a regular basis

  
  

Recommendations

• Improved systems of oversight and top-down enforcement necessary in respect of all terms and conditions of employment in homecare.

• Enforcement of existing National Minimum Wage law must precede or accompany any new sector-specific minimum wage.

• Business and commissioning models should adapt to accommodate shift-based pay in homecare.

• A reduction in the number of homecare providers serving any one area may be necessary to address poor workforce utilisation.

• New guaranteed hours legislation requires close oversight in homecare.

• The social dimension of care work should be protected and fortified in the interests of both retention and of those who draw on support.

• An alternative case for investment in adult social care presents care work as socially indispensable and highly responsible

• Research to understand employment conditions for all homecare workers should follow this unfunded, grassroots, worker-led survey

The findings challenge several dominant narratives about adult social care - particularly around pay, labour shortages, and workforce reform. They suggest that many of the sector’s most pressing problems are not rooted in a simple lack of staff, but in the structure of employment itself.

Across pay, working time, rota practices and visa conditions, a consistent picture emerges: homecare workers are expected to absorb financial risk and instability in order to keep the system functioning.

1. Top down enforcement of employment rights is lacking

There appears to be little hands-on oversight by local authorities to ensure that the homecare providers they procure services from adhere to the terms and conditions of employment set out in contracts. Meanwhile, there is a significant grey area in HMRC's enforcement in relation to what is classed as payable working time between homecare visits.

Responsibility for raising concerns about terms and conditions of employment sits disproportionately on the shoulders of individual workers. Yet, due to a culmination of factors, workers are unlikely to take action.

If next year’s rollout of guaranteed hours contracts leads to requests for homecare workers to increase their unpaid availability-to-work, this would place yet further strain on work-life balance. It may also prompt people to opt back-into zero-hours contracts, ostensibly supporting an unhelpful narrative that workers prefer these. The implementation of guaranteed hours contracts therefore requires close oversight in homecare.

Improved systems of oversight and top-down enforcement are essential in respect of all terms and conditions of employment in homecare. In April 2026, a new Fair Work Agency will be established to bring together existing enforcement bodies, including HMRC. With sufficient resourcing, this change presents an opportunity to improve proactive enforcement of employment rights across the board, including clarifying the guidelines for National Minimum Wage enforcement in respect of travel and waiting time between homecare visits.

2. Headline pay rates mask systemic underpayment

Homecare roles are often advertised with comparatively attractive hourly rates. However, 72% of respondents are paid for contact time only, meaning time spent travelling or waiting between visits frequently goes unpaid.

Payment for all legal working time - including gaps between visits - was identified by 70% of respondents as the single most important change needed to improve retention, ranking above calls for higher basic pay (55%).

This finding is significant. It suggests that before introducing new sector-specific wage floors through the forthcoming Fair Pay Agreement, enforcement of existing National Minimum Wage law must be strengthened. Without clear guidance and oversight, any new minimum wage risks being undermined in practice.

3. A labour “shortage” coexists with widespread underemployment

There is no limit on how many homecare providers can operate in a given geographic area, and there are over 15,000 regulated homecare agencies in England alone. The laissez-faire approach to employment facilitated by zero-hours contracts allows homecare agencies to constantly advertise jobs and recruit, even when they are unable to find sufficient hours for existing staff. Workers' hours are therefore rationed according to the amount of care packages their employer succeeds in procuring.

47% of homecare workers said they felt ‘not very confident’ or ‘not confident at all’ that when a rota is published, they will have been given the hours they need. 67% of migrant homecare workers indicated their main sponsor does not provide sufficient hours to meet the minimum salary requirement attached to their visa.

Regardless of ever-rising need for adult social care, in practice, demand for homecare services may not outstrip supply. More research is needed to examine the true state of supply and demand in homecare, since experiences on the ground suggest a more complex scenario than a straightforward shortage of care workers. A reduction in the number of homecare providers serving any one area may be necessary to address poor workforce utilisation.

4. Instability is built into the employment model

Beyond pay levels, instability defines much of homecare work.

• 85% receive no more than one week’s notice of their rota

• 62% are not confident their rota will remain unchanged during the week

• 87% do not always receive the legal 11 hours’ rest between working days

• 69% do not consistently receive their legal minimum days off

  
  

Zero-hours arrangements, ‘contact-time only’ pay, and last-minute schedule changes combine to produce chronic uncertainty in income and personal life. Where a ‘contact-time only’ model of pay exists, as is the case for 72% of those surveyed, workers’ hours, and therefore pay, are directly influenced by natural changes to client levels. In any other employment scenario, such instabilities would be planned for and absorbed by the employer.

Models such as shift-based pay - already in use by a small number of UK providers and in other countries - merit serious consideration as a structural alternative.

5. Advocacy on behalf of migrant workers has exposed underlying issues affecting all homecare workers

When gaps between care visits are unpaid, migrant homecare workers must work exploitatively long hours to meet the minimum salary requirement attached to their visa.

Research into the experiences of migrant care workers has unintentionally highlighted the chronically poor conditions underpinning employment for migrant and non-migrant homecare workers alike.

This survey demonstrates that exploitation of migrant workers is not confined to rogue employers. Rather, structural features of the homecare employment model create conditions in which both migrant and non-migrant workers are vulnerable.

For migrant workers, moving to a new homecare employer is unlikely to draw a line under exploitative working conditions. Branches of the most reputable national homecare brands are known to offer substandard employment conditions.

Equivalent efforts to understand employment conditions for all homecare workers should follow this unfunded, grassroots, worker-led survey.

6. An alternative case for investment: homecare as socially indispensable, highly responsible work

Homecare workers consistently identified sufficient visit time to meet social as well as practical needs as central to quality of care.

• 81% reported that most or all of the people they visit experience loneliness

• 62% thought that only some people’s care visits were long and regular enough to meet both practical and social needs

Workers’ recommendations prioritised improved basic employment conditions and sufficient visit time over professionalisation measures such as mandatory qualifications or registration.

This challenges the prevailing policy emphasis on workforce professionalisation as the primary route to improving quality and retention. Respondents suggest that security of income, predictable hours, and protected time for relational care are more immediate and foundational concerns.

The social aspects of homecare should be protected and fortified in the interests of both retention and of those who draw on support. A focus on the high level of responsibility involved in direct care work may offer an alternative case for improved pay and investment.

Why this matters now

Adult social care is entering a period of significant reform:

• The development of a Fair Pay Agreement

• The creation of the Fair Work Agency

• The rollout of guaranteed hours legislation

• Ongoing reforms to migration policy

These changes represent a rare opportunity to address longstanding structural weaknesses in homecare employment. However, without explicit attention to how pay is calculated, how hours are distributed, and how rotas are managed, reform risks being absorbed into existing patterns.

Final note

Homecare is essential work. This survey makes clear that the people involved continue to shoulder disproportionate financial and emotional risk. The evidence presented here does not describe isolated bad practice. It points to systemic features of the current employment model that undermine retention, destabilise incomes, and constrain the relational nature of care itself.

If homecare is to become a sustainable, respected and genuinely secure occupation, reform must begin with the fundamentals: payment for all working time, predictable hours, enforceable employment rights, and protection of the social dimension of care. Only then will the sector be able to retain the workforce on which it already depends.

Read the report