The pressures of administering medication as a homecare worker
- Sep 4
- 2 min read
Written by *Tia Williamson, a member of Homecare Voices. 365 days a year, domiciliary care workers administer prescribed medications to thousands of people who are supported in their own homes. No matter the weather, we strive to get to each person's house on time to ensure medication is administered correctly and on time.
We have no medical qualifications, only a cursory amount of mandatory training, the quality of which varies hugely from one employer to the next. Prescribed medication is medication that can be taken in the form of tablets, drops, liquid medicine, patches and creams. Domiciliary care workers administer all of these medications, including controlled drugs like Oramorph - a liquid form of morphine.
Our counterparts in the NHS are Healthcare Assistants (HCAs). Interestingly, HCAs are not allowed to give patients medication under any circumstance, but they are paid significantly more per hour than domiciliary care workers. Likewise, if we moved to work in a care home we also would not be allowed to administer medication. Not even a paracetamol! We know care workers in care homes are far from highly-paid, but at least they get paid for a full shift of work. That is not the case for domiciliary care workers.
Despite a landmark court case in 2020 ruling that gaps of up to one hour between care visits count as legally-payable working time, many domiciliary care providers still only pay staff for the time they spend at visits. Whether we drive, walk or use public transport, gaps between visits form a significant part of our working days. Data collected by Homecare Voices shows that - on average - domiciliary care workers lose out on 27% of the pay they are owed when gaps are unpaid. Sadly, this practice is not new and has been going on ever since local authorities started commissioning care out into the community to private domiciliary care companies.
Domiciliary care workers are burdened with very heavy responsibilities. If under intense time pressures we make an error when administering medication, this could cause serious harm to the person we're supporting, something for which we are personally liable. And yet, we are paid less per hour than most supermarket workers! Our data shows that whilst the average contracted rate of pay for homecare workers was £13.28 this financial year, the average true rate of pay was just £9.81 once unpaid gaps are taken into account. That’s way below the National Minimum Wage of £12.21.
We are working hard to raise awareness about what goes on behind the scenes in domiciliary care and will not stop until all employed domiciliary care workers receive shift-based pay, with zero-hours contracts available on an opt-in basis as opposed to being the default.
Last year we made this video which sheds more light on what medication administration often looks like in homecare:
Homecare Voices is a not-for-profit peer support network run by and for homecare workers. We host a secure online community with daily talking points and fortnightly online meetups. We also connect members of our community with ways to get involved in meaningful activities outside of work, such as participating in research and attending external events.
*Not their real name
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