In Carers Week 2015 Beatrice Morgan asks if the level of social care that people are receiving in their homes is good enough for vulnerable members of society
In March 2015 the UK Home Care Association (UKHCA), reported that over 500,000 people in the UK receive social care services in their own home every week.
Private domiciliary care companies, often commissioned by local authorities, have taken on the role of providing services to some of the most vulnerable members of our society.
Service users may be visited several times over 24 hours and, depending on their needs, may be assisted with toileting, washing, getting dressed, taking medication and preparing food. For many, the care workers will be the only people they see in a normal day.
For those who have restricted mobility, they will likely have to wait for the arrival of the care worker to assist them to get out of bed, or out of a chair that they may have been sitting in for hours.
As well as assistance with daily tasks, it seems humane and entirely reasonable to expect that the care worker will have a little time to ask how the service user is feeling and to make sure they are comfortable, safe and secure.
However, often the way in which these services are provided make it difficult for the care worker to provide this level of care, despite their best intentions.
Many, according to Leonard Cheshire Disability two thirds, of local authorities are commissioning homecare visits that last for as little as fifteen minutes.
Care workers will usually have a number of service users to visit in one day and are often under pressure to move on to the next visit. Even if all fifteen minutes are spent attending to the service user, this is a very short time to provide care to someone who is frail and isolated.
In March 2015 Corporate Watch reported that MiHomecare, one of the UK’s biggest home care companies, was paying care workers in two of its branches in Wales less than the minimum wage when travel time between home visits was taken into account.
Home visits were often scheduled with no travel time in between, meaning that the carers had to leave appointments early. In May 2015 Corporate Watch revealed that MiHomecare care workers in Devon and Surrey were subject to the same practices.
As part of the same investigation, an ex-Mihomecare worker spoke out about her experience of the company. She explained that if a care worker was to find a service user collapsed on the floor, they were expected to call an ambulance and then to move on to the next visit, leaving the service user but ensuring that the door was left ajar for the paramedics when they arrived.
The issue is not simply one of domiciliary care companies treating their staff and their clients badly.
The local authorities commissioning the care also have their part to play.
According to the UKHCA the minimum price for home care commissioned by local authorities is £15.74 per hour. This enables providers to comply with their national minimum wage obligations (including for care worker’s travel time), at the same time as running a sustainable business.
The UKHCA found that only 28 UK councils (out of the 203 for which an average price could be established) were paying their local providers an average hourly rate at this level.
Worryingly, the average hourly rate paid by four councils was less than £11.01 per hour. This rate is so low that according to the UKHCA’s calculations it would be unlikely to cover the cost of the provider employing the care worker, let alone the cost of running the business.
So where does this leave the service users? Even with the best will in the world, care workers who have less than fifteen minutes to spend with a service user may well not have time to provide a level of care that meets their basic needs.
Without an acceptable level of care, health conditions deteriorate and accidents are more likely to occur, meaning that a referral to NHS services or even a hospital admission may be necessary.
There is no doubt that social care services and the NHS rely on one another. To avoid piling additional pressure on the NHS, domiciliary health services must be improved. If the funding problems in this area are not addressed, those who receive care at home will continue to be at risk of unnecessary pain and distress.