The National Institute for Health and Care Excellence has criticised what it refers to as “flying home care visits” by care workers, with some local authorities commissioning visits of 15 minutes and others as short as five minutes.
The problem is that most local authorities have outsourced care work to private companies. Those companies may be registered charities, but getting registration is not that difficult since a company only has to show that they are providing some kind of benefit to the wider community. As far as I can see from my own experience in this line of work, most such companies are money-making businesses just as Tesco and Asda are: they are in the care business and that is still business. It speaks volumes that clients are now called “customers” – people who buy a product and that product is a care package.
At the bottom of the food chain in the care business is the care worker. Local authorities assess a customer’s care needs and allocate the care package to a private provider, often the one that will do it most cheaply. If the assessment is that the customer’s needs would be met by a certain number of hours a day or a week, that’s the number of hours the care provider will be paid for – minus the company’s admin costs. In domiciliary care in the home, most care providers pay only for the time the carer is actually in the residence of the customer and not for travel time since most local authorities only pay for the care hours.
I have worked mostly in domiciliary care, where visits tend to be half an hour, but some are as short as 15 minutes. In a half-hour visit, I could be expected to help an older, disabled person out of bed, assist them in having a wash or a shower, help them to get dressed, prepare breakfast, administer medication, wash up and leave the residence tidy. For many of those people, the care worker is the only person they would see each day or even week – and half an hour does not give any time for sitting and chatting.
On a 15-minute visit, a care worker is usually expected to prepare a meal and administer medication. It’s a quick in-and-out, especially as there may be a few miles of unpaid travel to get there and a few miles to the next visit. I have even driven five miles to and from a client’s home for a five-minute visit. My time in that instance was worth £2 an hour.
Most care workers are in the job because they want to be doing something worthwhile. I have recently come across the term “emotional extortion” applied to care workers. Apparently this is how care workers are persuaded to do the work and carry on doing it, by being convinced that they are a special kind of person and that nobody does this work for the money.
We may be at the bottom of this care-business food chain, but we are special people. We are people who care about others and don’t care about being thrown a few peanuts as wages. But we also go to work to earn enough money to pay the bills and put food on the table ourselves. We are not eccentric millionaires.
Since most care packages are funded by local authorities, cuts in funding can only mean that care workers will continue to be expected to provide an adequate level of care within the shortest time the local authority considers to be possible, and in my view, this means that both “customer” and care worker are treated very badly.
Most care agencies have an ongoing problem with staff shortages due to the rapid turnover of staff. When supermarkets offer more for stacking shelves and pay for every hour that is worked, who can blame anyone for opting out of being that special person who works long hours for crumbs off the local authority’s table? I certainly don’t.
