FOIs show 73% of councils still commissioning 15 minute homecare visits

Freedom of Information (FOI) requests for UNISON, the UK’s largest union, reveal that 73% of councils in England, Wales and Scotland still commission 15-minute home care visits to elderly and vulnerable people. Regional figures show that 88% of Scottish councils commission these short visits, compared to 83% in Wales, and 69% in England. Figures are available for each of the 160 councils across the UK who have responded – see attached spreadsheet.
In the government’s own words, 15 minute home care appointments ‘risk stripping people of their dignity and jeopardising their human rights’. However, the government has failed to stop their use, and the coalition’s unprecedented cuts to council budgets are hitting social care hard, piling yet more pressure onto an already overstretched system.   
Home carers repeatedly raise concerns that elderly people are suffering because 15 minutes is not enough to provide even the most basic care. Frail elderly people cannot move quickly, making it impossible to carry out the range of tasks that often have to be completed in 15 minutes – feeding, bathing, administering medicines and getting people up or into bed. People with dementia find the rush of such a short visit particularly distressing.
Care workers are also deeply concerned that they do not have time to talk to people in their care. This is especially worrying given that home carers can be the only source of social contact in an elderly person’s day. The impacts of loneliness on health and wellbeing are well documented. The rush of a 15 minute call also makes the risk of mistakes with medication higher, say care workers.
UNISON is calling on the government to ban 15 minute care slots, and for councils to sign up to its Ethical Home Care Charter, which sets out basic standards for home care. The charter also provides guidance for councils to use in the commissioning process – 80% of homecare is provided by the private sector and paid for by councils.
Heather Wakefield, UNISON head of local government, said:
“Our home care system is in crisis. Every day, elderly and vulnerable people suffer because they are not getting the care they need and deserve. 15 minute visits exemplify the inadequacy of the current care on the cheap system.
“Imagine trying to provide personal care to an incontinent 94 year old with dementia, clearing up any mess they have made, feeding them and giving them medicines, all in just 15 minutes. There is no time left to have a conversation, let alone provide some compassionate care before rushing out. No wonder home carers tell us they are depressed about the standard of care they are forced to provide, and the impact on elderly and vulnerable people.
“The government has acknowledged the damage that 15 minutes care visits can do, but it has failed to stop their use. In fact, drastic cuts to council budgets have only made matters worse. It is time to act and ban their use across the UK, and for the government to end the scandal of the elderly care crisis in this country.”   
The union is also raising concerns about the huge number of provider councils use to run homecare services. North Yorkshire, Kent & Birmingham, for example, all commission from more than 150 providers, making it impossible for such councils to have close insight into each contract.
This fragmentation also fuels uncertainty amongst providers as to how many hours they will be contracted for, and they then employ staff on zero-hours. These contracts give low paid workers no idea how many hours of work they will get, fuelling already high staff turnover in the sector. This impacts on continuity of care, and can mean elderly people have different people coming in each day, something they often find distressing.  
Quotes from home carers into fifteen minute care slots:
“15 minute slots should be done away with, you cannot give any level of care in 15 minutes. Some of these people don’t have any family and a care worker is the only person they see, but you have to practically run in and run out again.”
“15 minute visits aren’t even long enough to fill out the care plan, 10 minutes with client, 5 minutes paper work, clients are suffering because of this. 15 minute visits are wrong on all levels.”
“Lady registered blind, also disabled with rheumatoid arthritis and can’t hold any weight. She has to let her tray drop to the floor. Not got time to stay with her whilst she eats.”
“We are told constantly that if we have not completed what we need to in the allotted time then we must leave, however I cannot leave a client like this and I am consistently late to calls.”
“I have worked as a homecare worker for 15 years. Things have to change but not at the expense of clients. It’s appalling the level of care they receive now. No home cooked meals, no time to chat. More clients getting 15 minute visits. As you don’t have time mistakes are going to be made. Dementia clients are rushed, which is the worst thing you can do. It’s depressing and upsetting.”
“It’s far too rushed now. I worry I will miss something by not having the time to listen to what my elderly ladies say. They don’t think at the same pace as we do and often forget. In the past, by taking the time to listen I’ve discovered care needs that would otherwise have been missed.”

“A lot of the elderly people I care for are old and lonely, they are not only in need of physical support, but they are in need of company and someone to talk to. The time given to these people are the bare minimum, no time to chat just in and out.”
“I think that they need to go out and assess the poor clients that we are taking care of as time allocated is not sufficient, so we wind up taking longer and not claiming for it as you have to justify as to why. These folk don’t see anyone almost all day and as a back shift worker we are whizzing in and making their tea in 15 mins. Not exactly a great deal of time.”

Please contact the Press Office for UNISON’s Time to Care Report and Ethical Care Charter and the FOI results spreadsheet.