Catch-82

We’ve been working alongside clients in the care sector for nearly three years now. During that time, we’ve immersed ourselves in the ‘industry’, as agencies do, and find ourselves knowing rather a lot about one of the most fascinating – and soon, relevant – issues facing our society.

If you know anything about care at home, it’s probably what you’ve gleaned from some of the horror stories that periodically appear in the press. About care workers abusing those in their care. About zero-hours contracts and staff shortages. About the terrible conditions in which the oldest and most vulnerable in our society find themselves. Whether that ‘care’ is provided by the state or a private company is immaterial for those on the receiving end.

What you won’t hear about is the carer who – upon discovering once again that those relatives in charge of the financial affairs of an elderly, Alzheimers-afflicted gentleman for whom she cares had left him with literally nothing to eat or drink in his flat – will regularly go out and buy him provisions from her own pocket so that she can make him lunch, only to find the cupboards bare again the next day. Or the care team at a branch in the midlands who ignored medical advice to consign a paralysed man to hospital, provided him with intensive, specialist care and rehabilitation and now see him out and about in his specially adapted car; able to drive, walk with a frame and wave to them as he goes by. That’s care at its best.

There are carers who don’t go to these lengths; who join the profession because of its scandalously low barriers to entry and who don’t lift a finger unless they have to, but I would suggest that these people are a product of a system that singularly fails to reward the amazing individuals we encountered with wages and conditions that reflect the vital, life-affirming and in many cases life-saving work they do.

Here are some facts for you:

Those elderly people who move into residential care homes are 80% more likely to die within 12 months than those who remain in their own homes.

By 2030, one in five people in the UK will be aged 65 or over.

That’s why care at home is so important today, and will be even more important in the future. And, fortunately or unfortunately depending on your ideological bent, that’s why much of it will be delivered by private companies.

Hopefully, most of the people reading this blog will grow old. Some of you will grow old in the UK. In which case I am delighted to report that while working with the good people at Allied Healthcare, we discovered a management team determined to improve the provision of home care in the UK. Allied have offered guaranteed hours contracts to all their care workers, rather than consigning their care workers to zero-hours contracts. They described to us how they intended to recruit only the very best, most conscientious care workers, by offering better pay, conditions and training. They retained us to produce an advertising campaign that, by demonstrating the company’s commitment to keeping elderly people in their own homes, would actually save lives, and would help recruit better care workers.

At the same time, we produced a raft of materials for the local authorities who award care contracts in order to persuade them that Allied should be their first choice. We spoke to care workers, care managers and customers (and filmed some of them) and were moved to tears by their stories, and by the relationships we found between those in care and the care workers who arrive on their doorstep every day to wash them, clean them, talk to them, administer their medication…care for them.

You can see some of that work here:

Victor Tony ad

The revolution in care was underway; the campaign was ready to roll. And then…

Catch-82.

To supply a superior level of care costs money. Guaranteed hours contracts cost money. Improving care workers’ training and conditions costs money. And guess what? Local authorities will generally award care contracts to the lowest bidder. Because, in austerity Britain, money is the one thing LAs don’t have. Of course, in an ideal world, all health provision – including homecare for those in need – would be covered by the NHS. But that’s the subject for another blog piece…

So on the one hand, government is instructing care companies to improve care. On the other, they’re not giving LAs enough money to pay for that care. Which means the care companies using unskilled labour on zero-hours contracts and failing to train their care workers are rewarded with LA contracts while they deliver substandard care, and the companies trying to break that circle can’t make money from the contracts they’re bidding for. Who loses? The elderly. Catch-82.

As a result, many providers are only able to bid for selected new LA contracts as the numbers just don’t add up. And our mums, dads and grandparents are left facing a future in which the standard of care they receive is dependant on the off chance that their care worker might exhibit the humbling levels of commitment, conscience and humanity I described earlier.

Whatever happens, if you’re poor and growing old in the UK, good luck. You’ll need it.

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