Just 3% of home care providers offer staff more than the statutory minimum in sick pay, a survey on the sector's workforce has found.
The Homecare Association reported that 97% of organisations responding to its 2025 workforce survey paid staff statutory sick pay (SSP) if they had to take leave for sickness. Under this, employers give staff £118.75 per week from the fourth day of their absence for up to 28 weeks, so long as they earn at least £125 per week.
Providers reported that government plans to extend access to SSP, under the Employment Rights Bill, would increase their costs significantly.
This adds to concerns that the social care sector will be adequately resourced to deliver on the bill's package of new rights for workers.
Last week, sector leaders warned that the £500m in government earmarked for the sector's first "fair pay agreement", in 2028-29, was inadequate, while the Homecare Association survey also raised concerns about the deliverability of the bill's measures to curb the use of zero hours contracts, which are widespread in domiciliary services.
Minimum level of sick pay offered by almost all providers
The survey was carried out in June and July 2025 and received responses from 450 providers employing over 135,000 care workers.The Homecare Association said its finding that 97% of respondents paid no more than SSP when staff were off sick reflected the fact that most providers worked to contracts that paid significantly less than the true cost of care. It has calculated that there is currently a £1.6bn gap between council home care fees and the minimum price required by providers in England to operate sustainably.
Under the Employment Rights Bill, SSP will be payable from the first day of absence, not the fourth, and the current £125 earnings limit will be removed, with staff paid the lower of £118.75 per week or 80% of their average weekly earnings.
Four in five (81%) survey respondents said they expected that offering SSP from day one would increase their costs by at least 10p per hour of care delivered, with a third predicting that it would increase costs by 26p per hour.
At the same time, over half (54%) said at least 10% more of their staff would be eligible to claim SSP due to the removal of the earnings limit, while nine in 10 providers predicted that the reforms would lead to an increase in the amount of sick leave taken.
Sick pay reforms 'require funding boost'
The association said that, while positive for workers' rights and infection control, the SSP changes would "bring significant extra costs to providers", meaning most would continue to offer the statutory minimum and struggle to absorb the expected increase in absence rates without additional funding.However, the government has not earmarked any funding for the sector to implement the SSP changes as yet.
The association added that, should providers not be resourced to offer more generous levels of sick pay than the minimum, staff would would have to "choose between their health and their income" and there would be implications for the safety of care provided.
Reforms to zero hours contracts
The Employment Rights Bill will also require employers to offer guaranteed hours to staff on zero hours contracts or on contracts under which they are offered a minimum number of hours, with the guarantee being based on the hours they actually worked over a preceding "reference period", likely to be 12 weeks.The bill allows for the government to make regulations requiring employers to offer the guaranteed hours at regular times and also stipulates that employers must pay staff for shifts that are cancelled or rescheduled at short notice
While 3.4% of the workforce was employed on a zero hours contract as of April-June 2025 (source: Office for National Statistics), this was true of 43% of domiciliary care workers as of March 2024 (source: Skills for Care).
Most respondents to the Homecare Association survey (78%) said they offered zero hours contracts, while 66% offered guaranteed hours contracts, with most providers reporting that care workers chose one or the other based on their preferences.
The survey found that providers often changed care workers' schedules, with 40% doing this weekly or several times a month and a further 16% doing so daily or multiple times a week. Reasons for shift cancellations or short-notice changes included hospital admissions, deaths of people being supported, sickness absence, traffic and travel disruption or unexpected changes in the person's condition.
Providers not compensated for cancellations or hospital admissions
Three-quarters (77%) of providers said they always paid staff if a shift was cancelled. However, while 87% of providers said they were paid by self-funders for cancelled visits, just 43% of those working with councils said they were compensated by authorities, with 29% of those working with the NHS saying the same of health commissioners.Similarly, 59% of respondents said they were not paid by councils to hold a care package open while the person was in hospital, with 75% saying this was true of NHS commissioners.
The Homecare Association said providers often could not absorb the losses from these commissioning practices, which had a knock-on effect on staff in the shape of fewer paid hours, worse work-life balance and reduced morale.
Critique of commissioning practices
It added that the prevalence of zero hours contracts in home care was largely the result of councils and NHS bodies contracting with large numbers of providers to whom they did not offer guaranteed hours.While larger providers often had sufficient work in an area to be able to offer their staff guaranteed hours, this was much more challenging for small, start-up or specialist providers, it added.
"If a person changes care provider moves into a care home, goes to hospital or passes away, then a small or specialist care provider may not immediately have replacement work that matches that careworker’s specialist skills and availability," the association's survey report said. "This means it is challenging to offer guaranteed hours."
Recruitment and retention situation remains challenging
The survey also highlighted ongoing recruitment and retention issues in the sector, despite Skills for Care figures showing a reduction in the home care vacancy rate in England from 13.1% to 10.1% from 2022-25.Twenty five per cent of respondents said more care leavers were leaving than was the case in 2024, compared with 16% who said the same in response to the Homecare Association's equivalent survey last year.
The survey found that the biggest recruitment and retention challenge was having wage levels lower than other sectors, an issue highlighted by 51% of respondents, with 37% citing the sector's unsociable or irregular hours as a barrier.
Four in five providers said they needed to offer at least £13 an hour to attract care workers, with the most common rate, cited by 40% of respondents, being £13.00-£13.99 an hour. This is above the current national living wage (NLW) of £12.21 an hour.
Concerns over staff not being paid for travel time
However, the Homecare Association warned that staff were often just paid for the care they delivered, not the hours they worked, with travel or waiting time not compensated, which is only legal if the pay rate including travel time is at least the NLW.The association said this practice was driven by "zero-hour time-and-task commissioning" by the NHS and local authorities.
Under the planned fair pay agreements, a new Adult Social Care Negotiating Body, consisting of unions and employer representatives, would deliver annual settlements covering the pay and conditions of adult social care staff, signed off by ministers and funded through government payments to councils.
Fair pay agreement 'risks being unfunded mandate'
The association said that the agreements had the potential to be "transformative" in improving pay and conditions and thereby boosting retention and reducing workforce shortages.However, the £500m allocated for 2028-29 has been calculated as being worth about 20p per hour by think tank the Health Foundation if spread evenly across the workforce and only spent on pay.
Though the negotiating body will be required to ensure its proposals are affordable with an "envelope" based on the amount of funding allocated to councils for this purpose, sector leaders warned that councils and providers risked being underfunded to deliver on the agreements.
In its report, the Homecare Association said that "without sustainable funding and fair commissioning practices", the agreements risked becoming "an unfunded mandate that care providers simply can’t deliver".
It called on the government to ring-fence adult social care budgets and invest at least £1.6bn to address "historic underfunding in home care" and also legislate to create a national contract for care, with sustainable minimum fee rates that commissioners would be required to pay.
