By Neil Taggart, Director of Operations, FitzRoy, national charity supporting people with learning disabilities to live they life they choose. www.fitzroy.org
If you arranged to meet a friend for 15 minutes, you might get to say hello and make a cup of tea. But you probably wouldn’t have time to finish the tea, let alone have a good old catch up before your coat was back on and you were both waving goodbye.
Time is relative of course, but local authorities seem to think a lot more can get done in 15 minutes – they think you can make the tea, tend to personal care needs and provide the essential human contact many people rely on.
Commissioning 15 minute care visits is on the rise and, while this is legal, it has dire consequences for both the care worker and the person they are supporting. Most people come into the caring profession because they want to do just that – care for people.
But 15 minute visits mean they are faced with an intolerable choice. Do they give the person they are supporting the basic care possible in the short time available and more often than not leave them with needs unmet? Or do they stay longer and provider better care and possibly lose their job because their next person complains if they are late?
To inflame the situation further, the carers are often not being paid for the time taken to get to each visit, which can sometimes be miles apart. This means it becomes impossible for them to earn enough in a day to even meet the national minimum wage standards.
The system is creating more problems than it is solving, for all parties. The job becomes about the task, not about the person. If the carer is measured only on how time-efficient they are, helping someone to eat will become about microwaving a meal and plonking it down in front of them.
For those relying on these visits, their carer might be the only person they see in 24 hours. If this is no more than 15 minutes, then meaningful human contact is all but eliminated.
Efficiency, effectiveness and economy – the duties that local authorities must achieve when they commission and provide services – are a useful way to measure our work. Through these principles we can see just how much we risk if we continue in this vein.
How effective is it to leave a vulnerable and disabled person unwashed, or perhaps soiled or hungry, and reduce their need for human contact to no more than 15 minutes?
How economic is it when a person’s health breaks down to the point that they need in-patient hospital or nursing home care at a vastly greater cost?
How efficient is it when home care providers have very high staff turnover because people can’t afford to work for the pittance they are paid?
‘The time bomb is ticking’
It doesn’t have to be like this and thankfully much of it still isn’t. Home care that is properly commissioned and based on an assessment of individual needs through partnership – commissioner, provider and service user together – leads to a positive evaluation of how long each visit needs to be.
Keeping this approach is essential, as it means all responsible providers will find the most efficient, effective and economic way of supporting people to have good quality of life.
Neglecting care workers must be stopped and we must provide everyone who relies on home care visits the dignity, attention and care they need and deserve. If local authorities don’t stop their short-term approach to commissioning we will leave many people more vulnerable, not less. The time bomb is ticking as we witness services that are becoming not just inhuman, but unsafe as well.