Underfunding social care and carers

[Sodd]

While funding has increased in other areas, social care funding has been rock bottom the last 13 years (despite regulations and demand being at their highest). There is no real plan for staff retention. Local authorities fail to cover the cost of care packages, which in turn puts care workers on the minimum wage despite high levels of responsibility, safeguarding responsibilities, medication responsibilities, report writing, key working and risk of harm while working.

https://www.theguardian.com/society/2023/apr/04/halving-social-care-workforce-funding-in-england-an-insult-ministers-told?CMP=Share_iOSApp_Other

I think some of this is down to demographics. And is an issue much of the world over. I think itll be even worse when I'm old, I'm in my 50s now.
As for funding, I think a 2% death tax should be imposed on every estate when someone over pension age dies. Care should be free (although food and housing costs not) and this death tax should pay for it whether care needed or not. As for staffing, just allow more immigration and sign up for freedom of movement with the EU again. We massively shot ourselves in the foot with Brexit and took rights and opportunities away from our young people, FoM gives a little bit back.

We either need to properly fund health snd social care or we need to start seriously rethinking our attitudes to prolonging life

But not even Labour wants to rejoin the single union...

It's grotesque. There's few more important things than caring for people yet there seems to be no respect or regard for the carers or the people who are being cared for.

The situation is getting worse by the day and more support workers are so badly needed but I couldn't advise anyone to go into that line of work between the disgustingly low pay, increasing paperwork, the care is becoming ever more complex for many, it's bordering on a nursing job for some considering how many medical needs some have. I haven't worked in care for years now but I know many who still do and I find it disgusting that those who are dealing with many complex medical needs are paid no more than I was for looking after someone who only needed help with meals and medication.

The cuts to mental health and other related services are taking their toll too. I've heard of more assaults on carers than ever before and a support worker was killed by a resident in Stirling last month. A family Some are being expected to look after incredibly violent and aggressive individuals who even specialist units struggle with. Most carers are not equipped to deal with such challenging needs in a residential setting. It is not ok for carers or other residents/tenants to be traumatised and assaulted. It also means that the individuals aren't receiving adequate care, No this isn't an issue in every setting but it's increased considerably but the government clearly doesn't give a shit.

We have been specifically told by our council that they won't pay mileage for our carers!

Oh and @Luckydip1 I actually told social services I was taking my dad to A&E and leaving him there if they didn’t get him into respite care.
Id begged for weeks and each time he was assessed it was found that his needs were too much for the respite place, although it was fine for me to do it.
They did find him a suitable place on the exact day I’d given them as the date for his A&E drop off.
I couldn’t go on much longer but social services actually asked me to move in with him.

Again this is not true in all cases. We have been told by the council that they will only fund minimum wage, no mileage, despite needing to drive our son to clubs, and only work for a couple of hours a week. He also requires a carer who can change nappies and cope if he tries to run off! No wonder we can't find anyone to employ! We have resorted to using less hours and giving higher wages as it is just not reasonable to expect anyone to work for minimum wage in these conditions.

There are lots of issues with family care.
From people not having families, to families having to work to feed and house themselves, to families not having the skill or ability level to provide the right time of care.

But another issue us respite. Paid carers work shifts, get breaks and have annual leave. Kin carers end up doing 24 hour shifts, 7 days a week for 52 weeks a year. I think more people would tackle being a carer for a relative if they got 2 days a week off, some uninterrupted nights off and could go away for a few weeks at a time. My uncle is a carer to his relative. Its been really difficult to get any respite at all. The social care contracts are all or nothing, there is nothing ad hoc or just one regukat day. He has found a charity that will come in and do lunch on an ad hoc basus so he can go out for lunch occassionally. It still cost £28 and is limited (he supplies the food)

People looking after their family members tends to result in inadequate care of the person requiring care and means that the mental and physical health of the person(s) caring suffers. I've been a carer for family members 3x now. The second time almost literally drove me insane. I suffered

I've looked after people that whole teams struggled with, including people with dementia. How the hell are family members supposed to look after someone without all of the necessary equipment and training when a whole team of carers struggles? It's just not feasible.

I despise the romanticisation of the way that people in other countries, often developing nation, are lauded for supposedly looking after their family members. A quick Google reveals what a major problem elderly abandonment is in many countries because just like here, families cannot cope.

@YourUserNameMustBeAtLeast3Characters - are you sure about that? It definitely wasn’t the case last time I worked in this sector and that was in 2020.

It is a huge problem, because frankly care work is a horrible job. I ended up taking it on a part time basis because of all sorts of complex factors and it was horrendous. You could easily be out from 530 in the morning to gone 10 at night because of the way it was structured. So you’d have the morning ‘run’ - which was maybe 6am-10am and took forever during term time, then maybe an hour before starting the lunch time run which could be 11-2. Then you’d start your tea run at 3 and finish at 5, and then the night run could start at around half six and end at 10 at night (or later.) More and more service users would be added onto your rota - I think I had fourteen people on the bed run at one point.

It was honestly one of the most miserable periods of my life. Christmas Day, Easter Sunday, summer holidays, winter evenings, Sunday mornings. Just shit. And you did have to deal with shit, but I didn’t mind that so much as the smoke (so many people smoked) and some of the conditions people lived in were 🤢 and aggression and rudeness and having to charge through peoples calls at the speed of light.

I’ve painted a very bleak picture there and sometimes you’d get a nice run with another carer who was nice and you’d have a laugh. But mostly it was just horrible. It beats me why anyone would do it. Bringing carers over from the EU might solve the problem insomuch as there are people available to do the work but it’s still shit pay and appalling conditions and surely that’s what the left, in its original form anyway, should be addressing.

My friend was saying that he has not had a single carer from the UK for his dad through the care agency, every single one is from Africa, they work over here to send money home for their families.

As a nation we have allowed this scandal to happen, we have to demand better!

This is the elephant in the room. A lot people say they wouldn't want to continue living if they had eg dementia, but there isn't another option. Even things like not treating any other illness they get (rather than outright euthanasia) isn't possible (as far as I know?) even if that was the patient's wish. We are only going to get more and more people living to old age with medical advances too. Already a lot of people make it to their 80s and 90s who would have died in their 60s 40 years ago (due to advancements in treatments for things like heart disease, cancer etc).

Didn't they raise our council tax for this reason?

Sounds like breach of contract to me.

You can write an advance directive limiting treatment such as antibiotics if you have Alzheimer's.

Yes most carers who come through the agencies in my area are Nigerian though there are a few other nationalities too. There's still a lot of White British carers but they tend to be employed directly rather than through an agency.

By the way I am not advocating some sort of Logan Run scenario. More saying that we need to consider whether we should be prolonging suffering especially where dementia is concerned. People suffer through years that a pet wouldn't be put through.

How, though? The only way is to pay a hell of a lot more, and it would have to be considerable, not a pound or two. Something that would make it a desirable job. And that would be insanely expensive. It may well work out cheaper than the alternative, but it would come at a cost. And the truth is, it isn’t a vote winner.

They did, I remember that was meant to be for social care, I don't know what happened to that...

I notice a focus on elderly care here and that is an increasing issue with dementia becoming increasingly common but there are also many, many people who are not elderly who also require care.

Well we consented to have it raised so this wouldn't happen.

@Butterwicky

It is possible to decline treatment but not always easy

And most people (despite what they say when healthy) and certainly most families don't actually want to decline treatment when it comes to it.

Care work absneeds to pay more

As does most carers allowance

Sort out social care and you sort out a lot of the difficulties the NHS is experiencing. Not only in terms of the bedblocking that you tend to think about - but in terms of repeat referrals for support because of horrendous staff turnover and teams like mine coming in and getting things in place and working well... and then the staff all turnover and the work done gets lost and we start again.

I work in adult learning disabilities - and the number of my caseload that are repeat referrals because "oh I've never seen that document" and "oh no one's using Makaton here now - I think Debbie used to use it but she left ages ago" where we had got things into a good place for people and then the staff had all moved on and it had all just become something in a folder on a shelf somewhere. The settings we work with where they're in the more rural areas.... they can't recruit because the staff can't afford to travel out to work there - so they're now agency-staff central and no one really gets to know the residents.

Utmost utmost respect for the staff and the managers trying to hold it all together - the joy in some of the good group homes is absolutely amazing (although trying to have "serious" meetings with a room of care staff dressed up as Christmas Elves goes down in my memories as one I was never prepared for at university) - but the mess the sector is in at the moment leads to some crappy conditions for some lovely staff and residents.

We're also dealing with trying to support challenging behaviour - because the homes can't fill enough posts or get the funding to provide meaningful activities... if you're not a person who can cope with hours watching TV (I get you - I'm exactly like this) and that is all you're getting all day is wheeled into a communal lounge so one carer can keep an eye on multiple of you, with periodic cups of tea passed to you... you are likely to get bored out of your skull, pissed off that your other residents want to watch This Morning and that's how a load of the challenging behaviour starts off - can think of one of my users for whom about 90% of the challenging behaviour has been over telly choices! They are bored, they want a bit of staff attention, the staff don't have the time or the time in-post to really build up relationships with the residents (and tune in if they have hard to understand speech)... so the way that some have learnt to get attention - is to lash out, act up, stir the pot among other residents for some amusement... it's horrendous.

There's some gems out there though - some places I go to visit it's a nightmare booking in because they are out EVERYWHERE and doing so much stuff! There've been times I've asked if I can book a return visit because it sounds like something fun is going on and I just would quite like a crack at it!

It's complicated where I work because it is a HUGE county with rural areas and also areas where property was cheap, unemployment high - so care providers moved in to buy up bigger old houses and convert them and there's a LOT of care homes around.

I'm speaking from the perspective of learning disabilities as that's my personal area (and I love it) - although there are issues within my sector regarding aging populations with LD developing dementia and there not really being anywhere that's a good fit in terms of services there either.