The crisis in care

A care worker speaks about the terrible reality of the government’s attacks on homecare

In a July 2014 survey published by the Association of Directors of Adult Social Services, it was calculated that another £266m was  being taken out of services in 2014-15, making a total real-terms cut in spending since 2010 of 12%, while demand for services has risen by 14%.

At the same time, rampant privatisation of home care was seeing a rise in zero hours contracts and a parallel decline in the quality of care.

Rochelle Monte, a care worker for 20 years and a member of UNISON’s Newcastle Mental Health Trust Branch, speaks from the frontline about the crisis confronting her profession and the people who depend on it.

“Employers and politicians talk about targets, budgets and statistics. I don’t understand them. What I understand is people and care.

I want to tell you about a lovely man called George. He has very complex care needs. And for a while he had a very good care worker who supported his needs well.

George was confident in his carer’s ability. But over time, she was given fewer hours and was struggling to provide for her family. She dared to challenge the quality of care with her employer. And then she left.

A different care worker every day

I then picked up extra calls to George. There was no continuity. He had different care workers daily. Sometimes they didn’t turn up at all and he’d be left in bed for up to 20 hours. More often than not, they’d forget to open the curtains or turn the TV on.

I was so concerned that I started to drive past his house at 10.30 every morning. If the blinds were closed I would call up the care company and ask uuif I could go in and check on him.

After a few weeks I was told this was none of my business and that I couldn’t go to see him anymore.

I felt the fight being kicked out of me that day. What more could I do?

Just a few weeks later it became my business. Someone called in sick and I got the call. It was January. When I arrived at lunchtime it was snowing. But there was no heating in George’s home.

What I saw will stay with me forever. As I walked in, he was shaking. He was wearing just a T-shirt. Here was a doubly incontinent man, left alone and wet in the dark and cold, just waiting for someone to help.

I was angry, annoyed with the person who left him there, with the company who failed to listen to my concerns, with the whole system which means that this level of care has become accepted by many.

But mostly I was annoyed with myself. I had allowed that organisation to knock the fight out of me.

I’ve worked in homecare for 20 years. I started in 1995, with a local authority. I started to see a decline in the standard of care from 2008, when I started full-time with a private commissioned provider; this has only got worse, since the majority of care is now outsourced.

Selling people to the lowest bidder

Through privatization, local authorities are parceling up people and selling them to the lowest bidder – absolving themselves of responsibility for the quality of the care provided. Private companies are driving down the costs. Zero hours contracts and the absence of the minimum wage make the job unattractive and experienced care workers can no longer afford to stay. So now it’s somehow become acceptable to employ people with little experience to replace them.

Training standards are appalling. You have a few days of office-based training, then people have four to eight hours shadowing another member of staff before they’re let loose.

Older and vulnerable People have more complex needs than ever before. People are staying at home longer, for a start. Then you have life-threatening conditions, MS, palliative care, mental health problems, learning disabilities. But it’s acceptable to walk into their homes and provide care without any knowledge, understanding or skills.

Zero hours seems to sum up the experience of the majority of homecare providers. Over the past year, I’ve heard lots of people talking about it. On top of that, a lot of these companies don’t pay expenses, they don’t pay for travel. Sometimes you have 20 minutes between calls, which may be five miles away. When that happens you have to steal valuable time from one or other of the people in your care.

Terms and conditions actually do impact on the quality of care. I’ve met many people who feel let down by the care system, who are receiving undignified care, who never know who is coming through their door next.

After what happened to George, I made a promise to myself that I would fight to make sure that never happened again. I only hope that by sharing my experience I can get the support of other people to help me keep that promise.

This article first appeared in the Autumn 2014 issue of U magazine.