What is the issue?
Our homecare system is in crisis. It is causing avoidable suffering for people who need care, the families of people who need care, and homecare workers.
Elderly and disabled people rely on care
Over 500,000 adults in the UK rely on care workers from local councils to get them out of bed, make their food, wash them, dress them, brush their teeth, help them take their medication, help them with their often serious medical needs and keep them company. These care workers are there every day for people who are elderly, disabled, have mental health problems or who have had an accident or health problem and have been in hospital.
The problem is that councils have been outsourcing care services to private providers who are cutting corners. And vulnerable people who need care are losing out.
Too many homecare visits are short, rushed and undignified
Councils are increasingly using 15-minute visits. It is hard – and sometimes impossible – to provide care in this short time. People are not washed adequately, the sandwich for their lunch isn’t made, there’s no chance for a cup of tea and a chat. They’re left hungry, frustrated, lonely. In practice care workers often stay, unpaid, to finish their tasks, but this means they are then late for their next visit, which affects the next person who needs their support.
“Being given just 15 minutes to get someone ready for bed, give them medication, make a cup of tea etc. is not giving any quality time to a person who has probably been sitting alone in a chair all day.” – Anonymous homecare worker
“People are living longer and often have complex health and care needs which often can't be fitted into a 15-minute care call. It is a service that is meant to look after people but forgets people are individuals. The service makes no allowances for the time it might take to persuade somebody with dementia to let you complete their care tasks and it is not the type of job where you can leave if you run out of time. You can't leave somebody half dressed or without food just because they have run out of call time.” – Anonymous homecare worker
There is no continuity of care
If you had to have someone give you a bath, you’d prefer to meet him or her first wouldn’t you?
Many vulnerable people see a succession of strangers come into their lives and care for them intimately. This happens for two reasons. The first is that many care providers are cutting corners and simply don’t take the time to make sure people have regular carers. The second is that pay and conditions for care workers are so bad that the sector has extremely high turnover – according to a government report 30% of staff leave each year.
The widespread use of zero hours contracts for homecare workers makes this situation even worse, and it is especially damaging for the growing number of people suffering from dementia who receive homecare.
“I'm a homecarer and have been for about 15 years and the recent changes we are experiencing are causing great concern for our clients and ourselves…People with dementia etc should be given the best assistance we can by making sure there is a routine and familiar faces they can trust.” – Anonymous, homecare worker
Care workers' concerns are not listened to
Many care workers say that their concerns about the people they visit aren’t acted upon by care providers.
“I have seen many good workers leave frustrated at the poor pay and the way zero hours contracts are used by way of punishment and reward. If you turn down a shift, hours you were depending on can be taken and given to others, sometimes with only hours’ notice. I have seen how many use this as a way to simply force out staff who may have complained about quality of care. Is this acceptable? Duty of care means that we have to raise concerns, yet many are too scared of the implications financially if they do.” – Anonymous homecare worker
Care workers are not given enough training
Care workers carry out many tasks that are similar to nurses, supporting people at their most vulnerable moments. Yet many homecare workers feel they are not adequately trained to carry out a lot of the tasks expected of them, and that this is detrimental to the people they care for.
Stoma care is not an area we would normally cover but if a person has dementia we have to assist as they do not know what to do – Anonymous homecare worker
Care workers are not paid fairly
The UK’s own National Audit Office has reported that 220,000 care workers are routinely being illegally paid below the national minimum wage. This happens because they are often not paid for travel time (which there is a lot of between visits) and many have to pay for their own required uniforms and training.
This pushes homecare workers into poverty and forces many to leave their jobs, which means many skilled and experienced workers are leaving the profession.
Many people are being denied care entirely
Because of cut backs many people have had their care cut, and no longer receive any visits at all. A report by Age UK showed that 500,000 of the 1 million over-65s who struggle to wash do not receive any help, and 1 in 5 of the 240,000 who need help taking medication do not receive any help.
People deemed to have ‘moderate’ rather than ‘extreme’ needs, people who used to get help with tasks like washing and making their food, now do not.