Recently in dementia Category

by Jane* a home care worker

My local authority is about to start paying home care workers by the minute using an electronic call monitoring system (ECM). I use the service user's home phone to log in or out when entering and leaving their property.

The council claims that Actual Time Invoicing will save money by clawing back precious pennies from unscrupulous care workers who cut calls short. I offer no support to carers who reduce half-hour calls to 20 minutes by rushing. However, there are incidents when reducing visit times is necessary.

My priority on meeting a new service user is to gain their trust and make them feel comfortable with my presence in their home. Sometimes this is simple and they couldn¹t give two hoots about stripping down to their birthday suit to be washed.

It can take time, however, especially if the loss of their independence is still a shock. Recently I started visiting one gentleman who would only let me make his breakfast. After much coaxing he allowed me to wash his feet, then under his arms and now he has full body washes.

Building that relationship was intense work. Leaving when he wished me to and gradually increasing the length of the call was an incremental part of giving him the sense of control he needed. Under the new system I would not have been able to do this without my wages being penalised.

Logging in can be delayed simply because the client is using their phone when I arrive. Once, I walked into a woman's house to find her walking about with her knickers and skirt round her ankles ­ I didn't stop to log in before helping her.

If I finish putting someone to bed in 20 minutes, am I supposed to plonk myself on the sofa with the main carer until the end of the half hour? How fair is that on someone who hasn't had a moment to herself since 6am? What if the family decide to cook tea? After meds and helping the service user to the toilet do I sit at the table with them until the time is up? And what if I feel unsafe in a call? Am I to lose 15 minutes' pay because I put my safety first?

My team leader has told me that if I need to leave a call early she would chase up extra pay for me. I do not know how she will find time for this when she is already struggling with rotas and covering staff sickness.

Although the system could deter carers from cutting calls short it does not address the reasons why they do. Also, an unprofessional carer is unlikely to perform extra duties when forced to stay at a call until the end of the allocated time.

To reward carers according to the length of time spent in one place and not by the quality of our care is to underestimate the complexity of our work and diminish its importance.

*Jane (name changed) is a home care worker who wishes to remain anonymous

(Pic: julianlimjl on flickr)