To be furious with the way social care is(n't) run in this country?

[shallIswim]

I know I know I should have gotten angry about this before it affected me but... Mother has had severe stroke and is marooned in a community hospital in the back of beyond because there are no carers. None. Not in the community, not in nursing homes. The hospital is embarrassed. I'm quietly seething that a woman who has paid taxes all her life (forgive the cliche) has been left like this. There are no physios in the hospital so she is getting no rehab. I don't blame the hospital or any of the care agencies or companies. But I am raging with impotence.
Father is being cared for full time at home by a good private agency (we are paying) but even they cannot supply anyone.
The lady in the neighbouring bed to mother is way better than she is but has been waiting since early July for a care package to go home to.
What kind of place are we living in?
I do blame Brexit in part but don't want this to be a debate abut Brexit.
What can we do? It's AWFUL and inhumane

That’s the point though planets.
People for Eastern Europe are being paid a reasonable amount in relation to the rate of pay in their own country so they will do it. They know that it’s temporary and they can build up a pot for home some day possibly where the money can go further.
How can UK based health professionals compete with that. There is no incentive to put the pay up while cheap foreign Labour is freely available.

I think we are saying the same thing @Carycy - I just have to smile wryly at the nice lefty people who voted to remain all outraged that the Eastern Europeans have left so there’s no available labour to treat like dirt!

Ha yes. Agree Planets. It smacks of hypocrisy. There is a reason UK nationals don’t want to do it. It doesn’t pay the bills. Therein lies the problem.
Also find myself getting mildly annoyed at people who have only ever done “naice” office jobs whinging. Everyone should get their hands dirty at least once in their life.
Maybe we should all have a year after school A-levels, where we have an option of community helping jobs to choose from inc care work, kind of like subscription. That might solve the problem long term. No one would ever go for it. Too much like hard work.

I think a major part of the problem lies in the fact that care agencies take a significant amount of the fees paid for care, whilst paying pathetic rates to their staff. My dad, who has dementia and physical disabilities but still lives at home, was paying most of his Attendance Allowance for one carer visit per day.

Then, one of the agency carers broke away and set up on her own, recruiting a small team of women already trained and experienced to work with her. Dad now gets 4 visits a day (which he needs) for the amount he was paying the agency plus 50% again. These are proper, half hour visits, during which they get him the relevant meal, ensure he is clean (get him in the shower, etc), put his washing on and later hang it out, keep the kitchen clean, do him a weekly shop - and the lead carer sorts out his meds with the pharmacy, harasses the GP surgery when necessary, got the council to fit him a new shower when the old one broke - and lots more.

The ideal is to try to get care privately organised - that's what I think.

It smacks of hypocrisy. There is a reason UK nationals don’t want to do it. It doesn’t pay the bills. Therein lies the problem.

Many national wc people do this job and do it without decent working conditions.
It is naive to believe only immigrants do the job. Probably why no-one cares to fix it.

The pressure put on community carers by "managers" who sit in the office and make thier timetables is immense. 15 minute slots to wash, dress, serve meals, help with medications then 5 minutes to get to the next. Of course that is barring that on arrival extra care is needed or ambulance support. Some days the carers who come to clients homes are the only social interaction these people have and often ask them to stay for 5 minutes longer which carers are not allowed to do.
Yes to all of this. One friend transferred from community to NHS hospital care, she was heartbroken knowing she hadn't 2 extra minutes to chat with the clients, some hadn't spoken to anyone all day.
Private companies creaming the profits.
She was spending an extra hour every day.

I don’t think think immigrants only do the job. Like I said I did it for a while. I just think the thinking that they can solve the problem keeps the wages low and the conditions poor. It also doesn’t help that it is seen as female work as well, which also keeps the wages low. It is physically demanding work and most traditionally male physical work attracts a reasonable premium because it it “tough man’s work.”

@Planetsandstars

I think we are saying the same thing *@Carycy* - I just have to smile wryly at the nice lefty people who voted to remain all outraged that the Eastern Europeans have left so there’s no available labour to treat like dirt!

We didn’t like having them here to ‘treat them like diet’. We liked having them here because they added things to Britain, made it less inward-looking. They left because they were made to feel unwelcome by brexity twats. This country has lost a lot by ending free movement.

@SoreusBacchus

What kind of place are we living in?

A place where we pay very low tax, keep trying to pay less, and yet expect to get an awful lot for those pitiful taxes, is where.

Exactly. OP (like many people) says her mum has paid tax all her life. Well, yes, that's the normal way. Problem is most of us don't pay nearly enough tax - or legally avoid it by diverting tax into pensions.

And many people are incensed that their (or their parents') home should be used to pay for care in old age. "They worked all their lives to pay for their house" they protest. No, they worked to put a roof over their heads and had the good fortune to benefit from house price inflation. Now use it to pay for care. I plan to.

Not having a pop at you, OP, btw. Must be awful to see your mum in this situation 💐

Because you can still earn a fucking fortune and far more than most people can dream of, but you have to contribute more to the pot.

1. The top 5% already pay 31% of all direct tax revenue so they do contribute more to the pot. I imagine as a demographic, they also take the least out as well.

1. Increasing taxes for higher earners is always the answer to everything on these threads, today it’s social care however it’s also meant to fix:

• the NHS
• Welfare
• Childcare
• Housing
• Education
• Pensions
• Police / public order & safety
• Defence (see Afghanistan threads)
• Environment
• Transport
• Overseas aid (see Afghanistan threads)

& so on.

Also don’t forget that tax money goes towards other things that we don’t really consider like:

• National debt interest
• Government administration
• Business / Industry
• Culture

So the question is, how much more tax are higher earners meant to pay to cover ALL of these things to a standard that people are happy with?

What interests me is that over half of the adult social care budget is spent on people aged 65+ (they make up 18% of the population) with 65% of this spending going to people with physical needs yet as an age demographic, they are most likely to vote Conservative.

So to those saying higher earners need to pay more tax, the age demographic who needs & benefits from social care the most are also the ones voting for lower taxes & wealth retention.

@NellDodds well no, you can't be having a pop at me because I have said clearly that as far as i'm concerned high tax is fine if it results in an improvement. I also don't give a monkeys that my inheritance is being spent at an alarming pace on first Dad's full time care, and now Mum's. I quite agree that the value of assets should count. But if all that is case, I'd blimmin like the system to work.

We didn’t like having them here to ‘treat them like diet [sic]’. We liked having them here because they added things to Britain, made it less inward-looking. They left because they were made to feel unwelcome by brexity twats. This country has lost a lot by ending free movement.

We foreigners were used to keep wages low, though. I worked as a carer on and off from 2004 to 2019. I felt really bad for the British carers by the end; they earned poverty wages, their agency co-ordinators were really vile to them and they hadn't the option of leaving the UK as I did.

@Planetsandstars

Can’t believe the people claiming Brexit is the problem.

Do you realise you’re effectively saying ‘well, we’ve run out of polish and Lithuanian and Romanian people to treat like shit, so what did you expect?’

Votes remain by the way but seriously

But it's true! We have lost people prepared to do the job. Which yes, means people prepared to be treated like shit.

And it's not just wages. Not everyone is suited to care work. It's a skilled job but unlike other skilled jobs it's massively under valued.

To fix it we need a huge rise in tax to fund better training, qualifications and registration of care and care workers and better pay and conditions. But it take a very long time to turn around.

@christinarossetti19

The social care system has been becoming increasingly broken over the last few decades.

Most dom care used by be provided directly by local authorities, so staff had contracts, annual leave, salaried positions, paid training etc etc.

It's now nearly all or possibly even all now provided by care agencies who can only win tenders by undercutting other providers.

Hence the piss poor pay, not being paid for travel time, having to pay for own training and travel, zero hours contracts etc etc.

Recruitment and retention has been a nightmare for years and is only becoming increasingly so.

It's horrendous and no, money won't insulate you from its effects if there aren't enough carers.

So true.

It's not every authority - where my sister works they have carers employed by the LA, it's salaried £19k per year plus holiday s and the better working conditions that comes with being in a local authority, decent sick pay, fair rotas etc. She's worked for agencies before and care homes and says the LA is the best employer by far.

Yes, I do think this systemic shift over the last 15 year or so, fuelled largely by cuts to local authorities is the root of the situation that we had now.

Dom care used to be an interesting, fulfilling if not well paid job. Carers build up relationships with their clients and had time for a chat. (Mainly) women took of these jobs when their children were small and stayed because they were decently treated and grew very fond of their clients. They were able to do so because they lived in social housing with low rents or had low mortgages when the property market was saner.

It's very sad to see what has happened to dom care over these years. Both the clients and carers tbh.

This is the demographic time bomb we have known was coming for years. We have too many old people to provide enough care for, while leaving enough people available in the labour force for other things. We also can't afford to have it provided.

This is why in so many countries, care of the elderly is managed within families a lot, it is too costly for it to be provided as a paid service.

When people are prepared to pay more for it, more people will be willing to work doing it. Carework is paid a pittance, the time & cost of travel to visit people at home makes it extremely hard to offer it at decent rates)

Every care company I've spoken to to try to source help have said the same thing: acute shortage due to Brexit

Coaltit
We appreciated your contribution to our workforce but you are right.

I worked summers at a low skill employment. At the outset the workforce was local British,on permanent contracts, normal hours etc, lots of men & women with kids. When more eastern European countries joined the EU, steadily the local workforce was replaced by most polish & Romanian workers. The locals were pushed out by changing the hours from 8am-4pm, to a double shift 6am to 2pm, 2PM-10pm, only offering zero hours at rock bottom pay to new staff as old retired. The incoming EU staff accepted it because they were mostly in their 20s, living in extremely cheap HMOs with low rent. I made friends with 2 of them, they were bed shifting with another couple who worked nights, flipping the mattress over, they brought food & cigarettes in suitcases to save as much cash as possible. They were IT graduates and told me after 3 years working here they would have saved enough to buy a small house outright back home. The local labour force simply couldnt compete, what was offered wasnt enough to live here as a family long term but was great on a short term basis if you had a cheaper country to return to.

I have been saying fir years, long before Brexit was even a twinkle in Farages eye, that we have to have joined up medical and social care. Why don't we have half-way homes for people who no longer need to be in hospital but aren't ready to go home? Because it would mean massive investment and there's no money. The electorate always say they're happy to pay more tax to be spent on NHS services but then moan if they have to pay more tax.
When my friend retired, she did voluntary work at a speech therapy centre for stroke patients. A qualified therapist wrote care packages, and the volunteers did the exercises with the patients. She loved it and the patients got help they needed. The NHS trust then said that the therapist didn't have time to write the care plans so the whole place closed down. How does any of that make sense?
Unless a govt, of any colour, actually has the guts to tackle this, I don't see how care will survive in this country. And yes, we have more care than most. But we're the sixth biggest economy in the world, surely we can expect more than, hey, we're better than Ethiopia!

There was a news story yesterday about North Yorkshire having 1000 vacancies for carers. My sister in law used to be a carer. It seems like a poorly paid, stressful job with very little effort made to attract or retain staff.

I was furious when Labour derided a perfectly reasonable plan by Theresa May when to deal with social care as the 'dementia tax'.

If someone wants or needs someone else to care for an elderly parent, why shouldn't the parent's assets above a certain reasonable level be used to pay for their care. If you want your parent's assets intact, then you have to earn it by looking after them yourself as citizens in very many other countries do.

@SlipSlop
I would say two points to your post.

1. If your parent has long-term chronic conditions and needs permanent medication and nurse visits for injections, and stays in hospital etc, that would all be paid for by the NHS. No one suggests they should pay towards their costs of medication, or treatment of medical conditions, etc. If however they are fit and well and don't need any of that but they have dementia and they need assistance, then they get no money out of the NHS. They must fund everything themselves. That seems iniquitous.

1. My mother has dementia and my dad left her with a good income but not much savings. We pay for everything for her and we do loads for her ourselves. But there is absolutely no help from SS or any of the charities where we can look for advice and availability of services. Even though we're willing to pay, our council provides nothing anymore. There's just no support or advice anywhere. And don't even get me started on Age UK, Alzheimer society etc. They are just useless. But to be fair, why should it fall on charities? The problem is only going to get worse and there seems to be no planning for it at all.

And as annoyed as I am at the present govt, I don't want to make this party political because there are no ideas on either side of the political divide.

And as annoyed as I am at the present govt, I don't want to make this party political because there are no ideas on either side of the political divide.

I posted an idea up thread. I thought it was the best solution. I think it came from the LibDems. It was shouted down with howls of "it's not fair!'

Everybody who dies , past retirement age, pays a 1 or 2% death tax on their estate. This applies whether they needed care or not and raises more than enough to completely upgrade the system without further burdening the young.

And as for "worked all their life and paid tax" so what, that's what everyone does. The fact is the elderly generation didn't pay enough tax to cover their cost (not their fault, just the maths at the time) I don't think it's fair to make younger generations cover this shortfall while the older generation sit on huge housing wealth.
I'm older myself before anyone accuses me of just being jealous.

I'm in a similar position to the OP, dad in hospital waiting for discharge. They can pay after the initial reablement care but the carers just aren't there.
If anyone thinks agencies are creaming it in, they aren't. Insurance, NI and admin costs are huge and take up as big a chunk of the fee as wages. Those carers in the gield have to earn enough to pay the people who man the phones, sort the rotas and pay the bills etc. Then there are the costs of running the office. ILs agency charge them £22.50 and I would reckon the business owners probably see less than than £1 of that after costs. It's a low margin business. Same with care hones, that's why so many are going bust.
It's no good shouting that carers need to be better paid unless we are prepared to pay more ourselves, either directly or via taxes. There is no slack in the system for that money to be found at the moment.