Live-in care workers are keeping people out of residential homes while offering more to clients than traditional domiciliary services, writes Anabel Unity Sale
Helping people who need social care support to live in their own homes rather than in residential care is high on the government’s agenda. But sometimes conventional domiciliary care is not enough.
One organisation filling this gap is Bath-based Agincare. In 2003, 10 years after the domiciliary care agency launched, it started providing clients with a live-in care service. The concept is simple: live-in care allows a person with low, medium or high dependency needs to continue living in their own home by having access to round-the-clock care workers.
Agincare services director Raina Summerson says the idea developed after clients with high levels of need requested more support. “We thought it was a good idea to provide continuity to meet the specialist needs of clients and to prevent people going into care homes,” she says. “We wanted to expand our service provision and keep people in it.”
The service proved so successful it launched as subsidiary Agincare Live-in Care in 2004. “Staff were excited at the concept because it meant they could continue to work with clients even when they needed 24-hour care,” says Summerson.
Agincare has 85 care workers on its books serving 63 clients, 40% of whom are over 65. Half of all commissions for the live-in care service come directly from individuals who either self-fund or use direct payments other referrals come from primary care trusts and local authorities.
Agincare provides a care worker who lives in the person’s home offering one-to-one support 24 hours a day, seven days a week. This support ranges from companionship to helping service users attend university and fulfilling social needs to high-end personal care. Staff work a 24-hour shift with one two-hour break and work two weeks on, two weeks off. They have their own bedroom in the home.
The benefits of providing such a service are profound, says Summerson. Clients can keep choice and control over their lives, maintain their identity and remain in touch with their existing support networks. It is also an approach favoured by workers themselves. “We get feedback from staff who say it gives them a huge amount of job satisfaction to help people stay where they want to be, at home,” she says.
Such a close way of working, in which the care worker and client live together for long periods, is not without its problems. Summerson says the company emphasises the importance of maintaining professional boundaries and privacy for care workers and clients alike during its specialist five-day induction course for staff. Clients are instructed on what they can and cannot expect from a live-in carer.
“We have to reiterate to service users what they can’t do, for example, they can’t give workers gifts or take them on holiday without prior arrangement,” Summerson says.
Di Hains has an Agincare live-in care worker. The 64-year-old broke her back in two places four years ago and is now paralysed from the waist down. After spending two-and-a-half years in hospital and then living in a care home, Hains was discharged in March 2007. Her local adult services agreed to co-fund a live-in carer and referred her to Agincare, which arranged for Sarah Mapuranga to support her.
Initially, having a live-in carer was difficult for Hains, who felt frustrated that she had lost some of her mobility, and it took a lot of work and understanding between the pair to develop their successful relationship. “It was strange because Sarah and I didn’t know each other and it took time to work out. I was apprehensive about closing the door and it just being me and her,” Hains says.
Now she praises Mapuranga for rebuilding her confidence and encouraging her to be independent. “Before this I would never ring the gas or electric companies [with a query or complaint] but she’s taught me how to do it. Being able to do things again after a disability makes such a difference.”
For Mapuranga her work with Hains is equally constructive. She says dealing with one client is less stressful and it gives them the space and time to work out any difficulties. “The best thing with us is that we understand each other.”
Top tips for live-in workers
● Be professional but also recognise you are in someone’s home.
● Do not make assumptions about a client just because you live in their home.
● Communicate effectively with the client, their family and any practitioners involved in their lives and care plan.
● Share relevant information with other live-in care workers.
Published under the headline ‘Home Comforts’ in the 13 November 2008 edition of Community Care