/ Health

Why isn’t elderly care at home meeting basic needs?

Elderly person looking out of window

A new report reveals that care for the elderly in their own homes is not up to standard. Not only are time slots too short, costs vary according to where you live. So why aren’t older people’s very basic needs being met?

People left in bed for 17 hours or more, left in filthy nightwear and not washed regularly by their carers: it sounds like Dickensian England.

Unfortunately, it’s the interim report from the Equality and Human Rights Commission, following an inquiry into care of older people in their own homes.

With over a million people receiving care and support at home (and 81% of that provided by the independent sector) it falls under the inspection remit of regulator the Care Quality Commission.

Home care vs. care homes

We recently investigated what was happening in care homes – sending actors to live as residents to experience what’s really happening – and found that the regulator had spotted problems earlier but failed to get them rectified.

When I started a conversation on how care homes are failing, your many and varied responses proved that there’s a huge disparity in the quality of care being given in homes. Many of you sang the praises of your relatives’ homes, while others felt extremely let down.

Why aren’t basic needs being met?

It’s worrying to think that the same is happening in people’s own homes, and – together with the squeeze on council funding – it begs the question of what cuts really mean for vulnerable people who are dependent on carers to meet their most basic needs. For example, the brief 15-minute visit slots mean that people are left with impossible choices – such as a cooked meal or a wash.

We’ve reported on the postcode lottery when it comes to getting and paying for this care – some provide it free, while others demand £20 an hour. Many councils won’t provide it at all unless your needs are ‘critical’ – but now the spotlight is on the quality you can expect.

Are stories of neglect and carers rushing between visits and speeding through tasks the tip of the iceberg? What do you think should be done to improve the quality of care in the home?

VP says:
21 June 2011

I’ve just had the first month review with social services re my mother’s home care package. I was apalled to find she’s got ready for bed at 6pm, so is sitting in her nightie and dressing gown (plus blankets) until bedtime. At the moment she is able to get to bed herself, but if she wasn’t I’m sure she’d be put to bed at 6pm.

It seems that people’s care is currently arranged to convenience the care provider, not the person. However, I can also see that to do the latter we’d probably need more care workers employed for shorter and more unsocial hours than they are now. How many people would be prepared to do that?

One of my relatives works as a home carer and it’s interesting to hear her side of things. She’s incredibly committed to her job and works really hard but isn’t paid anywhere near enough. She also gets really frustrated that she has to rush through her tasks in half an hour visits and complains that it’s not enough time to do everything she’d like to for her clients.

But I think it must all come down to money – they are a private care provider and I guess the cost of longer visits would be too high to make the business work. As I said, wages are low already. There needs to be more funding, but this is obviously scarce at the moment… it feels like a vicious circle.

Gerald says:
30 August 2011

Lets put all the blame on the private sector again, why dont we. I am amazed of the attitude of WHICH ? staff latelythey seem to blame everything on the private Sector when, if they were to do their own homework properly they could soon find out that the bulk of this service is either carried out directly by Social Services or it is sub contracted out by the SS, either way the SS is responcible for organising and financeing the “Care at Home System”, they also actively promote this system in preference to Care Homes.
If you or anyone really has an honest complaint with this system you should complain,vigourusly to your local Councillor as they are being led to believe that this service should be used to replace Care Homes. In my opinion it is the underfunding by Local Authorities of both services which is the reel problem NOT which Sector carries it out.

PMA says:
24 June 2011

I am just getting involved with this as my father has recently lost his wife of 35 years has just passed away and he has Parkinson’s and it is terrifying. I have tried to have him with me but as I work full time and cover about a thousand miles a week, it just doesn’t work. I cannot afford not to work and we all earn too much to get any benefits but it is the lack of help and advice that is worse. The Social Services where he lives are useless, they don’t have a Parkinson’s nurse and the local NHS trust is a local joke. We are looking at wardened accommodation currently but a care home is likely to follow before too long and that is the real worry with the current bout of reports and financial failings. When will the fools in Westminster realise that we all end up old and most will need help to some extent, and sort out the whole business? My father has always paid tax and NI as have I and now we need some payback, it’s not there. It is a shameful state of affairs and we are fast declining into 3rd world status because of poor management.

Recently a relative needed home care visits. This was organised by social services but we were given a list of providers that we looked at but obviously didn’t know anything about them. We were told only 1 has someone in this area so we had no choice. They were supposed to do 3 visits a day,7am, 12.30pm and 7pm. They had a signing in sheet that made interesting reading every time we went to visit. Luckily my relative could still use the phone by the side of the bed and would phone to tell me ‘no-one has come yet,its 9.30am not up yet or had breakfast’. We then had to dash to help her,difficult when you live a distance away and you work. The sheet next time you visited would be filled in saying they had been when they clearly hadn’t! I started to fill in the sheet myself saying no one has been to then find the sheet was replaced with a new one so no one would see my comments. And yes i did try to phone the agency but they never answered the phone. Speaking to social services they said no one has complained before! Prob because relatives didn’t know visits were missed out. She was also supposed to have a half hour visit once a week for assisted bathing,this never happened in the 10 weeks she needed care.Fortunately she was soon well enough to cope on her own but I dread to think what some of these older people have to cope with from these so called caring agencies. Having recently had to go looking at care homes for my mom in law I was mortified at some of the states of the homes on the social services list. You could smell some of them before the staff opened the door. One staff member of a care home showed us a room with brown stains on the wallpaper 6″ from the top of the bed. When i asked what that was she replied’ dirty b****r used to wipe his poo on the wall’!. Is this room going to be redecorated? I asked.No was the reply.This care home had a ‘good’report! With the lack of interaction of the staff, (they were all sitting chatting in the dining room, while the residents were sat in 2 rooms watching tele,women in 1 room,men in another,no other activities around,2 old ladies asked if i could take them to the toilet ,they had been asking for someone to come to them and no one had,told staff and they said’ always asking to go those pair’) no activities planned, except we do their nails once a month, we didn’t take this placement at £450 per week! Don’t dispair though,we pay £525 a week for an excellent home with loads of staff on duty day and night, daily activities aimed at the residents interests, pots of tea when we visit and caring staff who make sure they find out all about mom in laws life so they can remind her about past events. There are good agencies and homes out there but you have to visit a lot of homes that you wouldn’t put your dog in before you find the ‘1’ for your relative.

Gerald says:
24 October 2011

The Councils are now offering only homes which they have bulldozed into excepting their reduced fees most Care Home Associations have refused the Councils fees for a number of years because on many occasions they have failed to keep up with basic inflation. This has left only homes with very minimal overheads on their list, some of these still manage to offer a good standard of service so as you say you have to shop around.
One can always look at the Councils own homes they are normally highly subsidised by the rate payer of course , this does not always result in a better standard however

A N Other says:
24 June 2011

We are at the stage where we are helping care for several elderly relatives on both sides of the family. My mother has had care since a serious illness 15 years ago, and it is clear how the package of care has decreased over that time-initially, the socialisation, cleaning and shopping was an important part of the care package. Usually, the same carer came three times a week, and built up a friendly, but professional relationship with my mother. Last year, my mother entered a care home. This was precipitated by a change in the care arrangements so that my mother was expected to cope with an allocation of vouchers which she used to ‘buy’ her care. This type of choice was way beyond my mother’s reasoning ability. She has since been in two care homes, which she finances herself. The first was a large busy home, which suited her, but the carers were young, often agency workers. To her credit, she coped with the indignity of being washed by young men the same age as her grandsons. She is now in a smaller home, where the physical care is excellent, but the atmosphere less stimulating.
Another relative had 15 minute daily visits to check on medication and any personal needs. This relative’s dementia was fairly benign, and she seemed to cope, although again when the authority changed agency provision, new relationships needed to be built, and understanding of the manifestation of the condition.
We are now trying to help another relative, who so far, has organised her own help or through Age UK. She is dreading the thought of another Winter on her own, and would like to enter a care home, but being in reasonable health, her finances do not allow this to be a viable option at present.
Whilst we have not experienced any of the horrific stories that are being published, I have realised that care in the home is not a viable option when there is almost 100% dependency for basic needs. Even if personal finances allowed, who would be willing to take on such a job? Shouldn’t a rich society be expecting that care homes were strictly regulated, with standards expected which promote elderly peoples’ feelings of security, happiness, and as much well-being as possible?

PMP says:
24 June 2011

My aunt is 99 with fairly severe dementia, arthritis, diabetes and double incontinence. She lives at hom with her daughter and myself. She has to be hoisted from her wheelchair to bed which her daughter can’t do safely, so an agency come 4 times a day. Most of the ladies are concientious but do not have time to do more than the basics. They should come at 8-12-4&8 to get her out of bed,wash and dress her, change her incontinence pads and put her to bed. Her daughter does the housework, cooking and washing. She had a problem with a carer who was very rough and almost broke her wrist but the agency sorted it our immediately and that lady never visits vulnerable clients. They usually come within 30 minutes of the time requested. But we wanted 9 o’clock at night and was told they didn’t work that late. If aunty has an incontinence accident they used to make an extra visit. Now she has to pay for that. Yesterday she messed herself all over the wheelchair and her clothes. Her daughter cannot get her out of the chair so she had to wait like that for an hour. If she messes the bed at night they won’t come out so she lies for hours in a dirty bed. Luckily these incidents don’t happen very often. If we complain one of the ladies get agressive and challenge us even accusing us of hurting aunty.Having said all of that, after reading other people’s comments we’re very lucky.

Gerald says:
7 December 2013

It is obvious to me that your Aunti needs to be reassessed urgently and that she needs care 24/7 .The only place she will get this level of care is in a care home.
If there are any concerns which either you or your Aunti have with regards to taking this action the simple answe is to arrange a one week respite in a local home which has a good reputation, I know, from experience this course of action often works.

Margaret says:
25 June 2011

To be fair the picture is not all gloomy so don’t be afraid to ask for help. We are both in late eighties and I was struggling but when my husband was in hospital help was OFFERED for when he came out. We had a free six week assessment, and then offered help in the morning to shower and dress my husband and a few minutes at night to prepare him for bed. The Carers are very good indeed and I appreciate what they do. They provide a welcome few minutes of outside company for me as well as I cannot leave my spouse for long. I have to pay part of the cost but it is nearly covered by Attendance Allowance. Although I understand there are about five independent companies in the area I was not offered choice of provider or times and a variety of different people come, not always exactly to the specified time due to traffic and previous commitments but they try. As I have previously worked in this field I am not at all sure that the private sector which has to make a profit, is as good as an integrated public service. Several cars and carers can be in one area at the same time and choice was never an issue. I can only see disadvantages and no advantages to the privatisation of this service. The Cares are poorly paid and have to run a car which in this rural area is a big cost, They even have to pay for their uniforms and stationery and mandatory training, such as it is, is in their own time. However I am lucky – no horror stories.

Gerald says:
30 August 2011

Which ” intgrated public sector are we referring to I wonder,is this they same one which has had many horror stories when dealing with Children is this the one which for years now the Public has deserted in droves please enlighten us

Gerald says:
21 January 2013

General Question

Has anyone had any help or assistance form either Help the Aged or Age Concern ??

Gerald says:
18 March 2014

Over the years I have been following various strands of conversations at WHICH? on care of the elderly most of whch has been concentrated on services supplied by the Private Sector and to say the least the coresspondance has been of a wide and varied nature.
Is this suprising I ask myself when you are dealing with such a complex matter, surely when one looks at the size and the service it is not suprising that one gets numerous and varying reports which reflect the numerous and varying people involved.There are no guidelines from WHICH? that can be used and in fact to expect the views of 4 out of work actors to reflect the views of thousands of elderly people who at , in most cases at the end of their lives is totally nieave