Panorama featured undercover reporting about the mis treatment of elderly people in their own homes by carers, that where working for large care providers, it featured an 80 year old man, being given a bed bath haveing his privates washed by a carer while she was useing a mobile phone to talk to her office.and not hands free.
Another chap was fed packets of Qvavers for weeks,because he did not have food in the house, residents where forgotten about, and left in soiled incontinence pads , similar to pampers for long periods, another lady had rectal bleeding and nursing care was not requested until the next day,the list goes on and on.

Al the people featured where bed or house bound.

Discuss

The mean-minded attitude of the current, and previous, governments means that local councils who purchase these services are forced to get the best value (generally cheapest) quote for the work.

The companies they appoint to the task employ underpaid carers who struggle to deliver a reasonable service against unacheivable targets. (You don’t do the job for the money!)

The government, national and local, should fund homecare properly.

The situation is going to get worse with the replacement of CSCI with the CQC which has a wider remit with less money and resources.

null

Heres a linky to the diary of one of the under cover carers.

http://news.bbc.co.uk/panorama/hi/front_page/newsid_7987000/7987882.stm

Its simply about money. a recent contract went in Scotland for £12 an hour. thats £12 an hour the council pay the private company. No way can anything but substandard care be provided for that. The company will have to cut corners in training and recruitment, wages will be low, its a national disgrace.

Don’t die old.

My old man did a bit of work with a local care home and was horrified about the agency staffs attitudes towards the elderly and has heard that it’s no better when they’re cared for by the same staff in their own homes.

To be honest, I can’t imagine how, as a human being, you’d consider it was reasonable to leave someone sitting in their own urine and faeces for an hour because you were on your break.

Atlaz – it aint quite so simple. Modern incontinence pads are designed to allow for up to 12 hrs use. If taking your break needs someone to wait for care no matter when the break is taken then either you have no break or someone waits.

If you abuse staff by not training them, not allowing them sufficient time to perform their tasks and so on then this sort of thing will happen. couple that with poor pay meaning that recruitment is difficult so you end up with either unsuitable people caring or no one then you have this sort of issue arising.

Its purely and simply down to lack of money.

If you want to prevent this sort of thing you have to pay more tax to pay for it. That carer was probably earning under £7 an hour *edit* and thus doing a 60 hr week to make a living wage

TJ – These were people who were normally capable of not making a mess of themselves but with a bug going around the home, they needed a little help to get to the loo in time and the agency “carer” was too busy eating lunch and talking to his mates on his mobile to help or even to help clean them up.

I don’t work in that sector but there are plenty of days where I don’t get lunch or breaks because I’m busy and, as I said, I fail to understand how one human being could justify leaving people in that sort of state to themselves, let alone other people.

The fact is, staff mostly try their best but a lot of people have no interest in helping the people they are supposed to be caring for. Don’t give me the hard luck stories, there are plenty of people in low paid jobs who bust a gut to do their jobs and don’t use low wages as an excuse to slack off. If you take the money, do the job, it’s that simple.

Tandem Jeremy, Modern incontinence pads are designed to allow for up to 12 hrs use.

And how as a non user of the product would you know that, ever tried, also how would the smell and the faeces soak into a pad, unless one had very loose craps.

All we can do is COMPLAIN AND COMPLAIN AGAIN, until the powers to be do something significant , because one thing is for sure were all getting older.

Thanks to Panorama for doing such a worthwhile job.

my partner was getting £6 per hour as a carer until recently, not exactly motivating, the amount of crap you have to deal with from management and from those being cared for is unreal.

2 carers looking after 21 people, 12hours shifts with no proper breaks. The breaks are scheduled but it is impossible to take them due to work load. Working for agency gets you more money but you find that the rest of the staff treat you like crap, expect you to know everything when you walk through the door, leave the crap for you to deal with, etc.

She was telling me about one set up, the amount of time allocated to each call included driving time and it was not possible to do all the calls in the given shift, pay was per shift, but no extra was paid.

I am sorry to say this is the norm, the pay is crap, the treatment of staff by management tends to be crap, there is no respect in society for “carers”, so what you tend to get is people who can do nothing else or those who genuinely care. To many os the former and not enough of the later.

If you want decent care 2 things need to change, first people need to respect carers and secondly there needs to be enough money to live on.

Project – I am a nurse specialising in care of the elderly – I do know about these things.

If you don’t work in the sector then you really don’t understand. if there was a D&V bug going around then it would have been continuous. As in a never ending cycle of wash and change folk. I have been there and done it. There comes a point where you simply have to stop. Its bloody hard work – physically and mentally. More draining than farm work or building site labouring – both of which I have done. So whenever they stopped at all someone would have had to wait.

Are you seriously suggesting the staff should have worked flat out without stopping at all for 12 hrs?

I say again – the main thing that will make a difference is more money – lots of it. I did once work it out but its IIRC about £30 per week from every taxpayer to bring elderly care up to standard.

Don’t get me wrong – I am not condoning poor care – merely pointing out why it happens. Underpaid, undervalued and undertrained staff put under huge pressure. They get burnt out and dehumanise the patients.

good quality care is incredibly expensive. the state pays for those with no money £480 a week for nursing care in a care home. That simply is not enough. I wanted to open my own care home – I calculated that to do things reasonably well including giving the staff decent terms and conditions so I could pick and choose the staff would cost around £600 per week per resident. the only home I have worked in that I consider “good” in care terms and ran at a profit charged £900 – £1200 a week a resident. that ran at about 7% return on capital profit. ie 7p profit per year for every pound invested

TJ, It does pain me, but I think I feel for your situation.
To many people want decent care & decent pensions, but are unwilling to pay significant taxes to pay for it.
Anyway. I won’t dwell on the bad points, but I do admire anyone who works for the NHS, or are employed by contractors that cream the profit for others hard work, but such is the way of sub contracting/tendering.

Good on you.

I watched the programme with interest given the fact that I work as a Social Worker for one of the local authorities featured. The issues raised in the programme were not overly surprising to be honest and, as TJ says, it really is about resources and money.

I was surprised that Social Work was not mentioned in the programme given that the care plans – ie, the tasks and care that the carers were carrying out – are devised following a community care assessment. The care companies don’t make up the care plans – following assessment we call the companies to discuss the care package required. We always try and use the council’s own care first – this is an obligation – but invariably we have to use the private companies as the council have no availability. I firmly believe that the council carers are better mainly because they’re better paid and better trained. Care plans are meant to be reviewed shortly after inception and then periodically thereafter but unfortunately, again mainly due to resources, this doesn’t always happen.

I have lost count of the number of times service users or their relatives have phoned me to say their carer has failed to turn up. We ask a lot of the care companies and it’s fair to say the carers must be run ragged at times. With the coordinators trying to squeeze everyone in it’s not surprising that people are missed out by accident. Some service users are fearful of complaining about the care they receive for fear that it’s taken away or they suffer other repercussions. Again, frequent reviews can help identify problems here but as I mentioned earlier it’s not always possible to do this.

The situation will remain the same unfortunately with everyone being asked to make ‘efficiency savings’ (cuts) each year. If a political party went to the electorate and said ‘we can sort this out and provide better care, but we’ll need to raise taxes significantly’ they would have no chance of getting elected. In addition with the rapidly ageing population the situation ain’t gonna get any better fast…… ;-(

Tandem Jeremy as a nurse specialising in the care of older people, then you are earning considerably more than a care assistant, and as it is you job, you should be doing the best for your patients, if you cant do your best due to so called efficency saveings etc, you should make a formal complaint, as should everyone else involved, we are talking about frail elderley people here not tins of beans in Tescos, some day it may be you or your family and your mind set will soon change, i know it must be physically demanding, but so are a lot of physical jobs, thats what you get paid for and why you stay in the job, sadly i know from very personal experience, the problems with so called care providers care users and care plans, all seem to ignore the person, who is a liveing breathing person all for the sake of cash.

Oh and i worked in occupational therapy for 6 years, then worked in another job for the nhs for 2 years, also had input in 6 care homes and theyre all the same, money saving to increase profits or to cut budgets.

Project – I pick and choose my battles and I don’t accept substandard care when I have the authority to do anything about it. I have raised concerns and I have quit jobs rather than accept it.

There is virtually no profit in private care these days.

TJ, do you also pick & choose who you feel worthy of a response?
shortbread_fanylion’s post was worthy, why no reply?

Jeremy im not haveing a go at you, but the system, the dehumanising system,and the profit margins that are made, by some companies, who provide poor care, yet take the money.

Money is available to pay MP,S for expenses, and to support an ailing non productive banking industry, not to mention the car industry, that is draining millions , also all the failed major companies that the government is now paying redundancy to all the staff, there is or was money there to pay for decent care, sadly its been wasted .

TJ – are you private sector or NHS?

BBSB – I work for both curently and have done for years – sometimes simultaneously sometimes not

Project – I tell you again – there is very little profit to be made from care – unless you are at the top end of the market. The sort of stuff that was shown on that programme and that we are discussing makes virtually no profits. 5% margins are common

The sorts of costs we are talking about are huge – the money simply is not there without significant taxation rises.

Jeremy you need a better accountant then,

£450 pounds per week multiplied by 40 residents=£18,000 per week, multiply by 52 weeks and we have 936,000 pounds per year, then add in premium payments etc, and were on a good little turnover.

I see you do indeed pick & choose in your response’s, I’ll draw my own conclusions from that.

On the programe it was nt stated if the people where self funding paying for their own care, or funded by the local council.
If they where self funded,then the companies could/should be prosecuted for fraud , filling in the wrong and false times worked.
Usually instant dismisal in most companies.

that £18k would need to pay for 4 members of care staff on site 24/7, it would pay for a cook, cleaner, food, mortgage, bills, rates, etc….. then the owners will want a return

it disappears very quickly

I didn’t see the programme but am currently dealing with the real thing. Have looked at both County Council run homes and privately owned homes who accept Adult Services clients.

What I would really like is for those people who are anti-euthanasia to have a look around these homes, tell me what they see, would they like to “live” like that? What about the dignity of someone who has served their country in World War II and is left slumped in a chair with no stimulation?

It was like being in a freak show, very distressing. I sincerely hope I can make an informed decision of when I have had enough of this world. I came away with a huge feeling of guilt – how can you do this to people you love?

Until such time as we accept our taxes will have to increase to fund our longer lives, the situation will not change.

Project.

Given a 60 bed nursing home on state funding the income is around 1.4 million pa assuming 100% occupancy. Normally 95% occupancy is as good as you get so so £i.3 million

You have prescribed staffing levels. to provide this staff at the current miserable rates of pay is around £800 000 pa. leaving £500 000,

fuel bills are very high – around £150 000 pa. = £350 000 left.

Then you have to buy the building – it will cost around £1 500 000 to build a 60 bed home plus the cost of the land say £2 000 000 in total. A commercial mortgage on this is over £100 000 pa = £250 000 left.

Your equipment costs are around £500 000 total capital cost and you replace about 10% of this a year – annual costs over £50 000 pa. – £200 000 left.

Food – around £50 000 pa – £150 000 left.

Manager and admins staff – £35 000. £115 000 left. Thas not much of your £1 300 000. You only need to have occupancy rate drop below 90% and you are in deficit and I have only detailed the major expenditures

There are obviously significant other costs as well – folk not in the business do not realise how high costs are. for example you have to have a bath or shower to every 6 residents The baths used cost around £5000 each and are replaced every 5 yrs max. Beds cost around £1500 each. Matresses £300 each with a life of yrs

A well run home on state funding will be lcky to make 5% return on capital or 5% margin. Most of the nursing home conglomerates are in big financial trouble.

TJ – those figures make interesting reading. IME the care homes for Adult Services clients are full and there is a waiting list.

I do appreciate how labour-intensive this is.

Ballpark / back of fag packet figures only – but in the right sort of area.
You cannot get 100% occupancy – when a resident dies it takes around a week to get a new one in. the 60 bed home would expect 20 or 30 deaths a year so that is what 1 or 2 % vacancy.

Yep, in my part of the world the County Council owned ones are full. We are talking nursing care for dementia though.

CG, emotional yes, but really, do you not think you would not want to see your time out?
I have a very elderly ‘friend’ & I can only say that as the help she requires presents a bigger burden on the rest of us, the more I want her to hit the ton.
She came from an age that most of us don’t know/respect, dignity comes first.

Energy bills , i suggested to one owner to switch off the floodlighting , not the outside light and also fit decent thermostats on the radiators, draught proofing on the external doors, low energy bulbs , etc, and the fuel bill went down by a quarter.

One has only to look at a csiw report and see that many care homes are under staffed, and are thus saveing on staff costs.
Ihave never seen a bath replaced, most of the beds used a\re ordinary divan beds about 70 quid, a lot of the furnishings are purely domestic as well.
matresses are usually domestic, an air ripple mattres is usually provided by nhs stores on long term loan.

Jeremy i seriously think youre being fed wrong details, or inflateing the costs to claim back tax.

Residents tend not to eat much so the food bill is usually lower, food is bought in bulk, not from waitrose.

I’ve just been through this whole process with my father-in-law who has recently died after wasting away with dementia.

To get him a decent home we were paying £800pw. He spent 7 years in it.

Just hope that when your parents hit the inability to look after themselves stage that you have enough resources because it ain’t going to be pretty otherwise.

People like TJ who work in the sector are heroes.

I won’t accept that epicyclo. It has been a good job for me – never out of work and usually respected. Pay is OK but I’ll never be rich. There is a lot of job satisfaction in it and its not a job you can do unless you enjoy it – at least at times.

Want to hear some good stories?

2unfit2ride – I don’t see why TJ should have to reply to my post, however worthy you deem it! It was just a general post about the programme and the issues raised. It wasnt intended to challenge or debate any of the points TJ made.

I did not think there was much disagreement between what shortbread said and what I said.

I was not defending the shortcomings in the care – merely trying to show how and why it happens.

Project, a couple of things about understaffing, Firstly the pay is crap so no one wants to do the job, secondly there is little to no respect from people, so no one wants to do the job.

No one wants to do the job and you get treated like crap, not so much understaffing by design but understaffed because there is an acute shortage of people willing to do a job that is about as hard as you can get.

A couple of times my partner has walked into a room, to be greeted by a corpse, but rather than have time to get over it, you need to ring the relatives, doctors etc, then go on to the next resident and deal with their questions and handle there emotions.

A could move onto the level of concern shown by out of hours doctors, hospitals etc, basically they are going to die so why bother.

Stay healthy when you’re old and be wealthy and have family!

Easy to say but who knows what will happen physically and mentally as we age.

Stay fit-physically and mentally.

Like i said one thing is for sure , things will get worse and it will affect everysingle one of us, either through family, freinds or working in care homes, now is the time to plan for the future or enjoy today for what it is, because the future will not be nice.

To put it another way, your parents have a really nice house, worth a lot of money, that you deep down know youll get when they pass away, then due to dementia, stroke or just physical weakeness they have to go into a care home, the council will make you sell there home , your inheritance to pay for the care and any top up fees, and say they live for 5 years, at 500 pounds per week, theres not going to be a lot left to inherit, also if theyve got savings they cant just give them away, they have to be used to pay home fees, until they are below a very low limit.
Not nice but thats whats happening every day, thats why the people on the Panorama programe are haveing home care as its cheaper, and funded by the individual with a contribution from the government.

Home care is not cheaper. If you require 24 hr care then its far cheaper to do it in an institutions thats why its done like that. 14 hrs carer in the day and 10 hr sleepover at night will cost you £2000 a week. £500 a week will buy you 6- 8 hrs a day of care an no night care at home.

Home care is only feasible if you only require very limited amount of care go beyond a certain amount of care and an institution is cheaper

As for funding home care – its done identically to institutional care.

Why should the home not be used? whether the home is sold or not make zero difference to the care the person receives – it will be in the same institution. the only people who would benefit if all care was government funded is the children of middle class parents – not the recipient of care.

You want it all state funded? Pay another £30 per week in tax for every taxpayer.

Like i said they found money for their expenses Mps that is, , money to fund the banks, and pay redundancy to all the people who lost their jobs when companies go bust, for a failing car industry to produce over priced cars, for all the welfare benefits, and finally for all the foreigners comeing here for free care.

Home care can be funded by the council and given to the person who needs the care to soppend on the care THEY NEED DECIDED BY THEMSELVES.
or depending on funds can even be self funded .