Helen Martin: The careless make a mockery of care

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LOCAL authorities in England are getting most of the blame following the Equality and Human Rights Commission’s year-long inquiry into home care of the elderly.

Although the inquiry didn’t cover Scotland, the situation is exactly the same here.

Care staff time is “bought” from agencies or funded in-house by local authorities, who also decree the amount of time a carer will spend on dressing, washing, feeding or doing whatever else is necessary for an old person. Sometimes that is as little as 15 minutes . . . for which a carer may be paid less than £3. Generally they don’t get paid more if they go over that time limit, and even if they did, there’s a long queue of other elderly clients waiting for attention.

It varies but many carers are not paid for the time they spend travelling between clients either. In short, these people – on whom we depend to provide basic care to our most vulnerable – are among the lowest paid and most exploited workers. Although some are kind, well-motivated and professional despite that, there’s no escaping the fact that when you pay peanuts, you don’t always get Einstein.

My mother had a home care service from a local authority in the west for a couple of years. The standard of worker was variable. One was brilliant. Another was consistently rude. Several were either completely uncaring or astonishingly stupid . . . it was difficult to tell which.

One assumed that because there wasn’t a ready meal in the fridge there was no food in the house. Even that wouldn’t have been so bad, had she not reached past the tins of stew, chicken in white sauce, mince, vegetables and potatoes in the cupboard in order to reach a box of instant cup-a-soup, which she stirred up and offered as mum’s main meal of the day.

Even her manager confessed it was a new low.

When microwave-ready “pingable” food was available, most seemed incapable of microwaving more than one thing to produce a balanced meal. Meat dishes would be presented without vegetables or potatoes, though these too were in packs that took only two minutes on “high”.

Sandwiches often consisted of a slice of corned beef slapped between two dry slices of bread.

Timing was bizarre. Mum went through a period of waiting until after 10am for breakfast, being left with a sandwich for lunch, tea anywhere between 4pm and 6.30pm, and bed as early as 7pm. She was therefore awake from 5am – with another five hours to spend alone and demented before breakfast!

This is what many social services departments call “helping elderly people to live independent lives” on the blithe assumption that we’ll all buy into it. I wanted good care for my mother, whose dementia and immobility was accelerating, and that certainly wasn’t to be found by keeping her isolated and imprisoned in her own home and dependant on people who can’t make a sandwich, let alone take responsibility for her drug regime.

Of course my mother, who was 91 at the time, wanted to stay in her own home. Who wouldn’t? But she would have been dead within a few months.

So for the last two years, despite social work reluctance (which, mercifully, I had the legal power to overrule), she has been happily ensconced in a nursing home near me and properly cared for by expert nurses and carers who are regularly inspected.

There’s a chef who makes balanced meals for all special dietary needs, her food and fluid intake is recorded, she has company and stimulation. She is “self-funding”, but even so, the statutory top-up from her local authority for her personal and 24-hour nursing care is many times what it paid for “home care visits” . . . on the cheap.

Some elderly people could live happily at home, with good and adequate support – if it was available. But I’ll stake my life on the statement that if all the elderly people who needed, or would benefit from living in, quality nursing or residential homes were encouraged to move there rather than being kept at home with fleeting and inadequate care visits, and if all home carers were qualified and reasonably paid, council budgets would simply collapse under the strain.

One way or another, our state and council elderly services are run on the cheap. It was inevitable that some organisation such as the Equality and Human Rights Commission would finally go public with revelations on scandalous home care standards that have prevailed for years.

Perhaps at long last we can now dispense with the myth that it’s always good for old people to be kept in their own homes, and at least admit that their needs, rather than council budgets, should set the pace.