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The Scandal of 15 Minute Homecare Visits
UNISON have recently been raising awareness about the scandal of 15 minute Homecare visits. Following a Freedom of Information request, it was disclosed to Unison that 73% of councils are still commissioning 15 minute visits despite the national outrage the practice inspires . And quite rightly so. How can any sort of quality service be delivered in 15 minutes?
I recall being asked to deliver a service to a husband and wife for thirty minutes. The contract was in the husband’s name but there were clear instructions that a service was to be delivered to his wife also. I had never seen two individuals on one contract before and queried this with the social worker. She confirmed that her Manager agreed to one contract for both of them. I queried what would happen if the husband went into hospital- would we still provide a service to the female? Because it would seem sensible if one of the service users goes into hospital I would assume that the package will continue for the other still at home.
I argued the point that we needed two contracts in order to deliver the requested service as our company would be very vulnerable if we were providing care to a service user without any formal agreement to support that service. The social worker reluctantly agreed.
What came back on the two contracts was shocking. The request was for two 15 minute calls, a total call time for both at 30 mins. Within the thirty minutes, the following tasks were requested- assistance with personal hygiene/care, meal preparation- heat meal & serve, prompt medication, and then wash up after the couple have eaten the meal. I would question whether any carer can complete all those tasks for both service users within 30 minutes. How quick do they think a carer can work? They are not superhuman.
And yet it’s not just the care tasks that need to be completed either. Gaining access to the property itself can be an issue. Knocking on the door and allowing time to answer, can take time. Finding a keysafe, entering the code and securing the keysafe again, can take time.
Then there is the administration aspect of a Carers role. They are required to read the Care Plans to make sure that changes have not been made since their last visit, check medication and details on blister packs. They should sign the daily report log, sign in a MAR chart if appropriate, and in some cases, ask the client to sign their timesheet. The majority of companies require their Carers to ‘log’ themselves in and out of each call, which can mean in some cases phoning a telephone number and entering a pin number.
These tasks are an important aspect of their role and yet they are time consuming, and can take between 5- 10 minutes. In a 15 minute call what time is there left for a quality service?
I recently visited a client who had a 15 minute call. The only task identified on the Care Plan was for medication prompting. The lady had dementia and I spent at least ten minutes explaining who I was and what I was doing visiting her. The lady was understandably anxious that a stranger had entered her home and was trying to give her medication. By the time I had made her a hot drink, calmed the lady down, and completed the paperwork I had been with her for 35 minutes. I left the property and realised I had forgot to log out of the call.....
I spoke to the Care Coordinator and asked her to review the times the regular carers stay and she advised she had twice requested an increase and both times the social worker had declined on the grounds that the visit was “only” a medication prompt.
For this particular lady, she receives two visits each day and both are 15 minutes in duration. Her brother is in his 80’s and lives down South. Our carers are the only people she sees and yet they are only there for 30 minutes every day – for the other 23.5 hours she is alone and has no other social contact. How depressingly sad.
You often hear Carers saying ‘I forgot...’ or ‘I didn’t have time...’ to complete all required tasks and it is such a shame the pressure they are under at times. Carers are being rushed and cannot ensure that they are providing a good quality service which is meeting all the needs of their service users. Rushing tasks leads to mistakes, and if mistakes concern medication then the consequences could be devastating.
Time management is a major issue but more importantly - you cannot, and should not rush your service delivery. The people that we provide care to are the most vulnerable people in our communities and they deserve a lot better then what they are currently getting. The standards of care are not what Providers or their workforce aspire to have.
UNISON’s Ethical Care Charter was established last November and sets out basic standards for Homecare and it’s commissioning, which councils have been asked to sign up to. Councils that sign up to the Charter are being publicised on their website.
UNISON’S Head of Local Government Heather Wakefield explains -
“Our Homecare system is in crisis. Every day, elderly and vulnerable people suffer because they are not getting the care they need and deserve.....The government has acknowledged the damage that 15 minute care visits can do, but it has failed to stop their use...It is time to act and ban their use across the UK, and for the government to end the scandal of the elderly care crisis in this country”
So I ask again- How can a dignified service be provided in such a short space of time? The answer is - it simply can’t be done. That’s why I am backing the Charter and urge others to do so too, to stop this scandal of 15 minute care visits.
Rosie Robinson – QCS Expert Contributor on Care