Government cuts make a mockery of new NICE homecare guidelines, says UNISON

New guidance from government advisors the National Institute for Health and Care Excellence (NICE) could see a real improvement in the standard of homecare delivered across the UK, but longer visits to people’s homes will be impossible while the government continues to slash local authority budgets,UNISON said today (Wednesday).

The new NICE guidelines echo large elements of UNISON’s Ethical Care Charter, which has been adopted by a number of councils in order to improve homecare standards for both care users and care workers.  The Charter means an end to 15-minute homecare visits, guarantees that people receivingcare in their homes will do so from the same group of workers, as well as better training standards so that staff are not sent out on the road until they know how to care for the people they’ll be visiting.

UNISON General Secretary Dave Prentis said: “Billions of pounds have been slashed from social care budgets since 2010. The result has been rushed 15 minute visits. This means homecare workers rarely have time to administer the level of care needed. And workers are being sent to people’s homes without sufficient training to carry out sometimes quite complicated medical tasks.

“Add to this terribly low – often illegal – rates of pay, where homecare providers are breaking the law and failing to pay the minimum wage because they don’t pay their staff for the time they spend travelling between their various visits. The sector has a workforce so demoralised that most don’t stay around for long. This huge turnover of staff means that some elderly peoplenever get to see the same care worker twice. This is the miserable reality of homecare in 21st century Britain.

“Our homecare system is collapsing, and it is being increasingly propped up on the back of hard-pushed and exploited homecare workers. Only urgent steps by the government to fund the social care system properly will give NICE’s new standards any chance of ever becoming a reality.”

UNISON wants the government to clamp down on the widespread practice of homecare workers not being paid for their travel time, which results in over 200,000 care workers being paid below the national minimum wage rates.

The appalling reality of 15 minute homecare visits was laid bare in a recent UNISON’s report 15 Minutes of Shame where one homecare worker recounted:

“On my run there are a number of 15 minute visits. One is to a man in his mid-nineties who is very frail and slow to move, especially in the morning. I have been given 15 minutes to go into his house, wake him up, assist him to the bathroom, give him a shower, help him get him dry and dressed, and thenmake his breakfast, and make sure he takes his medication. My organiser hasbeen told this takes around 30-45 minutes. Her reply was that other workers can do it in this time.”

And another UNISON report from earlier this year – Save care Now – focusing on the standards of training received by homecare workers found that staff are increasingly being asked to perform intimate procedures that would previously have only been carried out by registered nurses. Changing catheter bags, peg feeding, stoma care*, administering medication and looking after patients with dementia are just some of the difficult tasks that homecare workers carry out, even though many receive little or no training.

Of the homecare workers surveyed who regularly carry out the following tasks:

•    Almost six in ten (59 per cent) had received no training in how to attach or change a convene catheter.

•    More than half (52 per cent) had not been shown how to perform stoma care.

•    More than four in ten (45 per cent) had not received training in how to change a catheter bag.

•    More than a third (38 per cent) hadn’t been showed how to carry out peg feeding.

Almost a quarter of staff (24 per cent) administering medication hadreceived no training, despite some of them distributing drugs such as liquid morphine and insulin.

More than two thirds (69 per cent) said they cared for people who suffer from dementia. Despite this, more than a quarter (27 per cent) had received no training in how to work with people with this illness.