Thousands of isolated, vulnerable people living at home face “falling through the cracks” in the next two months unless the government steps in to protect them, the body representing their carers has warned. The United Kingdom Homecare Association said financial pressures resulting from the coronavirus crisis, including the spiralling price of personal protective equipment, could force a significant number of the UK’s 8,000 home care providers to close within weeks. Some providers of home care – already widely acknowledged to be the most fragile part of the social care system – have warned that vulnerable adults could face being abandoned to die alone at home. “The lessons learned too late in the residential care system are not yet being applied in the home care system, which suffers many similar problems and looks after far more people,” said Colin Angel, the policy director for the professional association of home care providers from the independent, voluntary, not-for-profit and statutory sectors. “Home care is the forgotten cousin of the already second-class social care sector, both in terms of lack of attention and understanding from government,” he said. About 97% of the UK’s home care is provided by independent providers. These providers make more than 1m visits a day to vulnerable people in their homes. But there is no centralised record of the numbers who rely on their support and very limited oversight of their financial stability. Raina Summerson, the chief executive of Agincare, one of the largest care groups in England, said: “All home care providers will do everything they can to keep care going. But we are already working on extremely tight margins and, with a lack of funding and sky-high costs of PPE, there will be providers who go bust. “Overnight, local authorities will have the responsibility of picking up care for bankrupt providers but will not have resources to do so. It could well mean people left without care and, in the worst-case scenarios, falling through the cracks and dying alone at home.” Self-isolation and staff sickness means that home care providers are also having to rely on expensive agency staff during the crisis. At the same time, many have had clients cancelling their contracts because they are scared of infection. Gill Heppell, the founder of the Nottingham-based home care provider PerCurra, said the cost of PPE was exorbitant while supply was short. “Masks now cost £11.95 each – and you have to buy 1,000. I am never going to need 1,000, and I hope I won’t need them at all,” she said. “We usually buy two five-litre tubs of hand sanitiser for £30. One tub now costs £100. Gloves usually cost £1.90 for 100. Now they are £20. “Most of these are single-use items. One care worker can get through dozens of pairs of gloves a day. Home care providers won’t survive in this environment. I have real concerns what will happen if government doesn’t get this right.” Angel said the lack of oversight increased the risk that if a small or medium-sized home care provider were forced to close, the people it cared for would not be picked up by the local authority in time. “Home care providers suffer a number of problems, the most important being financial,” he said. “Most councils in England have not yet paid out any of the £1.6bn that government has made available to them. At the same time, we’re getting reports from some providers that they’re not going to be able to pay their staff in the next payroll. “There are going to be a number of home care providers who will go to the wall in the next month or two because of the exponential increase in costs and an increase in the number of visits cancelled by councils and by people who fund their own care. That’s the fear we’re hearing now in the sector.” He added: “If there are a number of closures of providers in the same area, the local authority might well fail to identify everyone in need quickly enough to step in in time. Vulnerable people will fall through the cracks and not get the care they need.” Ian Hudspeth, the chair of the Local Government Association’s community wellbeing board, said: “There are many and growing calls on the £1.6bn funding and additional resources will be needed to allow councils to continue to support social care and other services.” A Department of Health and Social Care spokesperson said: “Our adult social care action plan sets out how we are protecting workers by ramping up testing across the system for care workers and their families and we’re ensuring millions of additional PPE items reach those on the frontline with local resilience forums identifying those most in need of more. “The secretary of state has written to local authorities, outlining how the £1.6bn funding for local authorities should support adult social care providers and workers. To ensure this additional funding is making a difference, we are asking local authorities to provide information about the distribution of this funding to providers.” Coronavirus and volunteering: how can I help in the UK?