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Case study 1:

Home care assistant, Redcar and Cleveland social services

"I have worked as a home care assistant for 10 years. I work for 31 hours per week and I am paid £5.68 per hour.

My duties include visiting clients in their own homes with physical or mental disability or elderly. I am expected to use initiative and act in emergencies. I have to carry out caring and personal tasks that used to be the responsibility of the district nurse, but could be expected to be undertaken by a member of the family. I have to report any changes to the client especially behaviour, needs or circumstances. I have to encourage the use of special equipment including artificial limbs if authorised by my line manager. This can include fitting such appliances. If I thought it necessary I would contact the emergency services or the doctor. I administer medication in accordance with the department’s code and the family permission. I undertake domestic tasks to ensure a quality of life for the client which the client cannot do for themselves. I am responsible to the home care manager. In order to do the job I have to have police and department of health clearance.

In respect of my health and safety I do not know what infectious diseases clients might have such as MRSA, Aids or Hepatitis, and I have been given no specific immunisation to protect me in my job.

Personal care of the clients is part of my role. This can include bathing clients, dealing with catheter bags, colostomy bags, medical sheaths, helping nurses giving enemas, help clients with physio, apply ointments, deal with incontinency and commodes.

I am required to ensure that clients are fed their breakfasts, lunches, teas and suppers. I will also assist with clients in dressing and undressing themselves.

I also have to deal with clients with Alzheimers and dementia. This can often result in violence and abuse from the client. I have experienced verbal, sexual and physical abuse – all for £5.68 an hour.

In caring for the clients I am also required to collect pensions, ensure food requirements are adequate, pay their bills and do shopping for them. If they have family pets I can also be asked to attend to these for feeding and toileting. I also have to communicate and deal with clients’ families and friends and other agencies involved in their care.

I can be required to deal with the terminally ill, and I have been present and assisted when clients have been dying or died.

I am a keyholder for clients’ homes.

In order to do my job I have to have communication, literacy, numeracy and interpersonal skills. I have to complete all required recording arrangements including written information on each visit.

In recent years I have seen my job change considerably, and the personal care side is much more intense than it used to be. Because of the responsibility level and the rate of pay it has been very difficult to recruit new staff to the service. Provision is currently provided on the basis of 60 per cent private sector and 40 per cent local authority. The private sector is primarily dealing with the housework side of the job, and the local authority staff are dealing with the more intense personal service side.

Health and safety for the home carers is a particular issue. Each client is not assessed individually, but a generic risk assessment is undertaken which does not meet all the individual circumstances of the client or the safety of the carer, who often or mostly is working alone in a vulnerable situation. There is no protective clothing issued either.

In addition the job is made harder by a bullying management style that puts pressure on staff to cover for vacancies, maternity leave and sickness absence. All this adds to the stress of an already stressful job. The responsibility level is way above the rate of pay. Despite having been job evaluated over two years ago my pay has not been increased."

Case study 2 - Former home care assistant Durham social services

"I worked for years as a homecarer. I was paid £5.69 per hour.

Because I have two young children I can only work evenings so that my husband can look after the children when I am not there.

In order to do the home care job I had to travel in the Durham area, and as I do not drive this required me riding on my bike. It was not unusual for me to go to a client's house and work for half an hour, then have to go home to wait for half an hour before going to the next client for a 45 minute visit then back home again.  I rarely left the house to work a full shift. My last call would be at 10.30 pm. On an occasion I met another home carer so that we could put a client to bed at 10.30 pm, and she had been working from 7am that day.

As I could not work mornings the social services department would not give me a contract to guarantee me specific hours, most home carers contracts are for a guaranteed minimum of 12 hours. This meant that every week my hours would be different.

One week I earned only £17 because the work was not there.

I left the employment of Durham County to work for Tesco supermarket as a shelf stacker. I work 5pm to 10 pm 3 or 4 nights per week and I am paid £5 per hour, so I know exactly what I am working and what pay I will receive. The company is good to work for and they have given me training and an overall, and my work colleagues are nice too. I also have the option of working more if I wish. Given the uncertainty about my work and earnings and the level of responsibility that I had I considered that for an extra 69p per hour it was not worth it. Some clients could be very demanding, and some families had high expectations of what the home care service should be delivering.

While working as a home carer I enjoyed working with the clients and I received very good training.

The reasons that I left the home care job was that there was no guaranteed hours, no set times to work, the pay did not match the level of responsibility, and how I worked varied from week to week."