Councils still insisting on 15 minute homecare visits

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Three quarters (74 per cent) of local authorities in England are still limiting homecare visits for their elderly, ill and disabled residents to just 15 minutes, says UNISON in a report.

The report – entitled Suffering Alone at Home – is based on an online survey of 1,100 homecare workers and data obtained from a Freedom of Information request (FoI) to the 152 local authorities in England that commission social care visits.

The UNISON survey findings mirror those of the FoI request to local councils. Three quarters (74 per cent) of homecare workers who responded felt they did not have enough time to provide dignified care for the elderly and disabled people they visited. Worryingly says UNISON, 61 per cent said visits of just a quarter of an hour meant they frequently had to rush the care of people who were over 90 years old.

A similar report by UNISON in 2014 showed that the same proportion of councils (74 per cent) were regularly using 15 minute visits. Given the harsh financial climate in which local authorities are operating, UNISON says it is not surprised that there has been no change in the numbers, and fears the situation will only get worse.

The 2015 survey findings show more than half the homecare workers (57 per cent) have been asked to provide personal care in 15 minutes or less with an elderly person they have never met before.

The limited time allocated means the majority of workers (85 per cent) said they regularly didn’t even have time for a conversation during some homecare visits. One third (32 per cent) said they have no time to address people’s personal hygiene needs such as washing, and a quarter (24 per cent) have no time to take people to the toilet.

Half (49 per cent) said a quarter of an hour wasn’t long enough to prepare a nutritional meal, and the same proportion said the shortness of the visit meant there was no time to assess any change in the person’s health.

Homecare workers found the limited time they are able to spend with each person distressing because the majority (82 per cent) of the people they saw on their rounds suffered from dementia and more than three quarters (78 per cent) had mobility issues. More than half (53 per cent) were stroke victims, had mental health issues (51 per cent) and 42 per cent had Parkinson’s disease. Some may have multiple conditions.

Homecare workers also said that more than a third (37 per cent) of the people they saw have hardly ever had visits from friends or relatives, which is why they felt it was important to be able to spend time in each person’s home.

UNISON General Secretary Dave Prentis said: “It is heartbreaking and distressing that many elderly and disabled people are not being cared for in a humane and dignified manner. Homecare workers have shared their harrowing stories with a strong sense of sadness, guilt, anger, and ultimately disgust, at a broken homecare system.

“Eye-watering cuts imposed by the government mean councils are still booking the shortest possible visits to care for vulnerable, frail and isolated elderly people. Homecare workers are often the only face some people see all day, and they are a lifeline – only they can call for help and ensure that the housebound people they care for are fed, washed and well.

“Although the government is going to allow local authorities to raise council tax to fund social care, the crisis is so great that any extra cash will barely touch the sides. It will also be of little help to deprived areas – where the need for home care visits is greater.

“With the challenge of an ageing population living longer, care planning and adequate funding for social care should be a government priority and it clearly is not. Ministers should stop passing the social care buck to councils, and dig deep to find the cash from Treasury coffers to provide dignified care for the elderly. Rushed 15 minute homecare visits should have no place in a modern, caring society.”

Notes to editors:
Suffering Alone at Home is available here

English region Percentage of councils using 15 minute visits
Eastern 100%
East Midlands 89%
West Midlands 86%
North East 83%
North West 82%
South East 79%
Yorkshire and Humberside 73%
South West 69%
Greater London 45%


– UNISON published 15 minutes of shame in 2015, a report featuring the accounts of homecare workers and the difficulties they face. 
– Official guidance published last September by the National Institute for Health and Care Excellence advised against visits shorter than half an hour. It said that homecare visits shoud be long enough for homecare workers to complete their work without compromising the quality of their work or the dignity of the person.
Survey quotes from homecare workers:

  • “I had a user who was receiving end of life care, the lady had terrible diarrhoea, was covered in faeces. I found myself extremely stressed as I had very little time to give the lady the care she deserved and comfort her husband who was in tears.”
  • “I have 15 minutes to take someone to the toilet, wash their hands, prepare a nutritional meal and try to have a conversation.”
  • “I used to care for a lady of 103 years old. I was given 15 minutes at night to change her into nightwear and make a drink. She was so alert and friendly and always offered me a drink but I never had time. I hated it.”
  • “I had to visit a lady who is 102 years old for a shower, help her get dressed, make food, tidy her kitchen, give her medication, and put her bins out in 20 minutes. It’s humiliating as we haven’t got time to have a chat.”
  • “It’s disrespectful – these people have lived through wars to become reliant on help. It feels like you’re abusing them.”
  • “A lady of 92 has dementia and depression. Her clothes smell of urine as she is becoming incontinent. We are not allowed to help her with laundry as we are not allocated time. The council has even tried to cut our time down to 10 minutes.”
  • “It makes me feel angry, ashamed and embarrassed. We are under constant pressure to do more and more in less and less time. Service users feel let down.”
  • The online survey was emailed to a random sample of 2,210 homecare workers and promoted on social media. A total of 1,102 responded.
    – The FoI request was issued on 21 August 2015 with the question: “Does your council commission homecare visits of 15 minutes (or less)?” A total of 152 councils responded. The regional breakdown is available from the press office.

    UNISON’s ethical care charterwas developed after a nationwide survey revealed a system in crisis, with a committed but poorly paid and treated workforce. The over-riding objective behind the charter is to establish a minimum baseline for the safety, quality and dignity of care by ensuring employment conditions which a) do not routinely shortchange clients and b) ensure the recruitment and retention of a more stable workforce through more sustainable pay, conditions and training levels.
  • The regional league table showing the percentage of councils using 15 minute visits is below.

UNISON media contacts:

Fatima Ayad T: 0207 121 5255 M: 07508 080383 E: f.ayad@unison.co.uk

Liz Chinchen T: 0207 121 5463 M: 07778 158175 E: l.chinchen@unison.co.uk

Alan Weaver T: 020 7121 5555 M: 07939 143310 E: a.weaver@unison.co.uk