British local councils cut home care visits for elderly and disabled

By Joan Smith

3 December 2013

The Leonard Cheshire Disability (LCD) charity has revealed that nearly three quarters of health care home visits to the elderly and vulnerable in the UK only last 15 minutes. Over the last five years, the number of these shorter visits has increased by 15 percent.

Such short care visits, which include washing and dressing, serve only to confuse and upset people with mental health and physical problems and affect their ability to live independent lives. Unmet physical, emotional and mental needs of the people inevitably lead to increased unnecessary hospital admissions.

LCD chief executive Clare Pelham said that a survey it conducted “resonates with our experience, where quite often the feedback is that the individual care worker is lovely but they are under such time pressure that the overall experience for people receiving care is not a positive one. Everyone knows this is happening, everyone agrees that it is not acceptable, but the councils commissioning care and the government are quite consciously looking the other way.”

The crisis in home visits is a direct result of drastic cuts to communities and local government budget, £2.6 billion of which has been in social care budgets.

After coming to power in 2010, the Conservative/Liberal-Democrat coalition imposed 33 percent “efficiency savings” on local councils to be implemented by 2015. Earlier this year, they announced another 15 percent budget cut for 2015-2016. As a result, the wages and conditions of council workers have been slashed and services reduced, shut down or privatised, including home care, day centres and what remains of council-run care homes. Many councils are on the verge of bankruptcy.

In 2012, more than 50 councils revealed there was a “medium-term” collapse in their ability to keep paying for care. There was a fall in spending on elderly peoples’ home care in 102 of 152 English local authorities of £148 million. The number of older people who received local authority-funded home care support was reduced to 224,745, from 244,080 in 2010-2011.

Today, by and large, local councils buy services from private care providers who have eclipsed the publicly run services over the last three decades. They are buying an increasing number of 15-minute care visit packages, totally indifferent to the actual needs of individual patients.

These private care companies, whose sole aim is making profits, are able to provide relatively cheaper care by cutting corners and massively exploiting their workers, who are forced to squeeze in as many care visits in a day as possible, jeopardising the safety of both their patients and their employees.

Some 220,000 care workers are reported to receive less than the national minimum wage. Two thirds of the home care workforce are on zero-hour contracts and have no financial or job security.

A report by the Unison trade union reveals some of the incredibly bad working conditions in the sector. It reports that 79 percent of care workers are given work schedules that are crammed with appointments, forcing them to rush their work or leave clients early to get to their next appointment. Over half of respondents reported that their terms and conditions had worsened over the last year. The report explained, “Only 56 percent received between the minimum wage (£6.08) and £8 per hour and 57.8 percent were not paid for their travelling time between visits.

“41.1 percent have not been given specialist training for dealing with their clients medical needs, only 43 percent saw other employees on a daily basis and 36.7 percent reported they were often allocated different clients affecting care continuity and the ability of clients to form relationships with their care workers.

“Although all respondents reported clearly defined ways of reporting concerns about their clients’ wellbeing, 52.3 percent reported that these concerns were only sometimes acted upon.”

These horrifying conditions faced by workers, elderly and the vulnerable would not have been possible without the tacit collaboration of the unions, including Unison, which has overseen the privatisation of huge swathes of public services over the years, without lifting a finger in opposition.

The LCD charity is calling for a minimum of 30 minutes for each visit, but it has met with opposition from national and local government. A local council spokesman declared it would mean “more expense and the need for more resources.”

Katie Hall, chair of the Local Government Association’s Community Wellbeing Board, said, “[C]ouncils need an extra £400 million each year just to maintain services at current levels. Instead of that they are seeing a 42 percent cut in funding from central government.”

The government professed support for the LCD charity’s report, saying it “fully agrees” with its findings and that “it is not fair” to patients or health care workers. But it went on to say that ministers would not be able to support the charity’s campaign. Instead, it called on LCD to support its Care Bill, currently going through Parliament. The Bill is using recent cases of abuse and neglect to “reform” care and support for vulnerable adults.

LCD said that taking into account the debates and amendments to the Bill so far, all the indications are that it would not stop “inappropriate” 15-minute care visits and in fact could make the situation “worse” because of proposals to reduce the powers of the Care Quality Commission (CQC). In a report earlier this year, the CQC described how an inspection of the care provided by 250 home care providers to more than 26,000 people across England found that more than a quarter failed to meet basic national standards of care.

LCD managing director of campaigns and engagement Jane Harris said, “We are deeply disappointed that the government has pressed ahead with reducing the powers of CQC to review how care is commissioned...the CQC will no longer be able to conduct regular reviews of how local authorities commission care.”