What to do about future of care in the UK?

[Flawedperfection]

I just wrote a v long post which I lost due to phone battery fading!

In a nutshell, what do we do when there are no longer any carers or anyone willing/able to care for our elderly and those in need of support?

I currently work for a care provider in a finance/admin role and it’s scary how: understaffed we and many other care providers in the area are; few people want to actually work in care and ;few younger people want to do it, and will only do so if threatened by sanctions etc.

In my company, most carers are aged between mid-40s and late 50s.

I previously worked in care on and off for much of my working life partly because (not going to lie) I couldn’t find anything else and was over or under qualified for other career paths. I know it’s crap in many ways: the pay, the hours and working conditions and the personal care is not for the squeamish (this was my issue!), but how do you get people to want to work in care?

Seriously, what do we do when the numbers fail to tally: many people in need, too few carers? Do people go off to hospitals long stay? But we also have a nursing recruitment crisis…

And before anyone suggests that I rejoin the carer ranks, as said I’ve done it before (for years), and it wasn’t for me. That’s kind of my point- no one really wants to do it!

I think many people would consider it IF it were better paid to be honest. I have friends who have always been interested but as they work in ‘professional’ roles it would involve cutting their income by 2/3- not feasible.
I’m a nurse and would love to be a carer but again its the pay.

I'm a carer in the community. I don't think I can continue to work because of the cost of petrol. I can't afford to work and I can't afford not to!

I don't think the business model (charge loads and pay peanuts) is sustainable or ethical.

If pay was realistic then people would do it gladly I think

I've no idea. Some sort of conscription? Every school leaver has to do 2 years of elderly care in order to be eligible for it when they're older?

An increase in pay and conditions would be an obvious draw, but not easy to achieve in an NHS setting.

Also unpopular opinion but make assisted suicide legal and allow people to sign to say they want AS if they get to a certain stage of e.g. dementia

Make it a requirement of claiming unemployment benefits that if roles like care are available then then you can't claim dole? I often see care roles advertised with flexible hours etc, people shouldn't be paid not to work.

First and foremost, I’d really struggle with personal care (mostly I think because I would hate having to have it myself). The awful pay would do nothing to help me overcome that.

I’m so sick of hearing carers being described as unskilled, too. It’s a highly skilled profession.

I'm a home carer and have been most of my adult life (I'm 49 now). I'll be leaving the sector for good in the next few months, which is with a very heavy heart because I genuinely love my job for the most part.
However, due to the chronic shortage of staff, I'm under constant pressure to work more and more, to the point that I'm currently out at work for around 70-80 hours a week. I'm not paid for all those hours though, so I can't even take comfort in being paid well. I work rurally, and I don't get paid for the time it takes me to travel between my calls. So, in a 15hr shift (7am til 10pm), I'm generally paid for 9 hours of work. Show me another sector that would tolerate that.
The cost of fuel is the final straw.
I'll be far better off (mentally, physically and financially) working in the tearoom down the bottom of my road.
I don't know of any of my colleagues who aren't planning similar.

I don’t agree that people should be made to do it, either by conscription or withholding benefits. Not everyone is up to be a carer. You have to be a special kind of person - in my opinion. They’re worth their weight in gold.
Bad carers are just as bad, if not worse than no carers!

I'm hoping that if I find myself in that situation in the future there will be robots, at least in care homes. I wont even go to hairdressers because I find people touching me so upsetting and the idea that there might be robots instead of people comforts me.

Set up a National Care Service on a par with the NHS. Get private equity firms out of the care sector so that all money from local authority funded care circulates back into the public sector and not private pockets. Ensure there is consistent pay banding and expenses paid to carers as there are many (most?) other public sector workers. Proper progression options for those who stick around in care and are good at it. That would all be a start.

• increase Carers Allowance and increase the earnings limit. There are people who would care for disabled/elderly family members themselves if it was financially viable.

At the moment Carers Allowance is £67.60 a week. To get this you must be caring for someone who meets the qualifying criteria (e.g., in receipt of high rate PIP/DLA) and you must be caring for them a minimum of 35hrs a week. You cannot be in full time education and you cannot be earning more than £128p/wk (roughly 14hrs p/wk at NMW). The care provided can be a mix of direct care such as cooking meals or helping with personal needs and indirect care such as doing their shopping or advocating for then with various services.

Taken over 35hrs that equates to £1.93 p/hr.

As many unpaid carers will tell you, it never stops at 35hrs and 24/7 is more in line with the reality of it. Taken over 24/7 it equates to just 40p an hour.

To make even worse it is a taxable benefit and so lowers the amount of other benefits and it doesn't count as a 'gateway' benefit so does not entitle you to things like free prescriptions or help with health costs such as dentistry or optical services (caring has a huge impact on the physical and mental health of carers).

• in line with the above, give incentives to employers to offer career breaks for the purpose of providing care to a family member in the same way they offer maternity/paternity/adoption leave. If someone's spouse, parents, child, or other direct relation becomes unwell/disabled and needs care then offer a minimum of six months paid leave with protected return to work and Statutory Care Pay for those who qualify (companies could then choose to offer enhanced packages in the same way they do maternity/paternity/adoption leave). Six months isn't going to resolve all of the care needs but it would allow the carer time to assess the support needed, look at the viability of various options, and so on without running themselves frazzled trying to juggle work, family, and caring (and let's face it, many of these people are women in their 40s/50s/60s). In other cases it would allow for people to provide end of life care to a loved one without having to also worry about work.

• change the idea that it is unskilled work. Offer Health and Social Care NVQs in sixth forms alongside apprenticeships in caring. Add caring to the curriculum for nursing and HCA courses so that alongside ward placements they also do placements in care home settings and community care roles

• pay carers properly with realistic pay scales for length of service and take steps to promote its value as a career. It should be brought under the same banner as health care assistants and nurses. Offer training, career and education progression for those who want it (e.g., experience as a carer counting towards entry criteria for nursing and HCA courses), and so on. Hell even a reality documentary like the ones that follow junior doctors around would help to show people the depth of the role.

Basically a lot of it boils down to money and no one is willing to spend the money to improve things.

@Cherryade8

Make it a requirement of claiming unemployment benefits that if roles like care are available then then you can't claim dole? I often see care roles advertised with flexible hours etc, people shouldn't be paid not to work.

And this attitude, in a nutshell, is what's wrong with social care.

I assume that you would want excellent care delivered? That you want standards met and exceeded?

You don't achieve that by forcing people to do a job that deals with human beings that rely on others for their basic needs, you do that by investing in the people that want to do it, training them, respecting them, paying them a decent wage, not bullying them into extra work for free or trading on their compassion to get it, paying them the least that's allowed legally and blaming them for everything that goes wrong.

The attitude that it's a job that anyone can do is the problem, there's very little stopping anyone being in a care role and doing the job, but in order to do it well, to a standard most people want and to ensure people are cared for well, you need people that have or can develop a certain skill set and continue to improve on that.

We're supposed to value everyone, including the most vulnerable in society, and that should include ensuring they are cared for by people who are invested in them, it doesn't though, as long as you're upright and have a pulse, you'll pretty much do.

Cherryade8
Make it a requirement of claiming unemployment benefits that if roles like care are available then then you can't claim dole? I often see care roles advertised with flexible hours etc, people shouldn't be paid not to work“

Really bush. Caring is a skilled profession. You honestly think anyone is capable of it?
I don’t want care when I’m old. certainly don’t want care delivered by someone forced into it who.

Really Bush?

Rubbish, obviously.

I would not want to see people being forced to do it for benefits. It would be a safeguarding catastrophe. Shitting hell.

Is flexible code for “we have no fucking idea what your shifts will be from one week to the next?”.

I enquired about a role at my local care home. Not my ideal job, but an honourable job and a way to give back to the community.

I’m a LP to primary age children. Now if they’d said EVERY Thursday night, I could’ve somehow found a way - but it was going to be a rolling shift pattern - and that’s NEVER going to work for a LP with school-aged children.

I’m disabled I’ve used agency’s. Some carers are great others have been dreadful. You don’t want someone in your home because job centre says so. The attitudes, the looks, the gagging at personal care. Would you want someone to get your washed dressed like that every day?

I’ve seen amazing carers 20y experience great skills get all hard clients. Because yes they are great with people with dementia or other disabilities that can be challenging. You know what they got paid same someone who done it for 6months and since so awful you only asked them to do bare mim just so they would leave.

We need at least levels like NHS or bands that you can level up as you can experience and skills. Some places have senior carers on 50p on hour more than a new person. We don’t value nursing or people skills. If it’s a proper job you need to be able work up. Sadly in care this often means “working in the office” on a much higher rate.

We need accept we can’t ask people to pay decent wage for care and the state will have to make up the difference. The new care cap coming will not help me as I have no savings or assets but still use benefit income and take massive chunk. So once I reach £86000 I’d still be paying same as before. It’s not clear how hike NI will be used despite all Facebook posts I see about investments in care.

@Cherryade8

Make it a requirement of claiming unemployment benefits that if roles like care are available then then you can't claim dole? I often see care roles advertised with flexible hours etc, people shouldn't be paid not to work.

Yes because what people needing care need is people completely unsuitable to do the role and who don't want to be there. 🙄😡

Seriously it's attitudes like this that are the reason we are in this mess!

Yep, boils down to too little £ and too many severely disabled elderly with too many decades of care needs each.

Trouble is, in terms of £ investment, zero return is at least the best option.

Part of the cause is medicine - the NHS is bloody good at staving death off, useless at keeping you functioning. There’s more to life than a heartbeat, yet that’s all a lot of a care users have got.

@Cherryade8

Make it a requirement of claiming unemployment benefits that if roles like care are available then then you can't claim dole? I often see care roles advertised with flexible hours etc, people shouldn't be paid not to work.

Would you want a child to be looked after by somebody forced to do it? No you wouldn't, so why is it ok for the elderly?

I used to work in care but left due to the long hours (between 10 and 15 hours a day most days), the impossible time constraints, woeful pay and complete lack of work/life balance. My shifts were 6 days on 1 day off, 4 das on ,2 days off. It was not sustainable and something had to give so I left and won't be returning to it anytime soon. Plus the increased cost of fuel means that even the 45p a mile allowance wouldn't cover the costs of travel to each client.

Flexible hours doesn't mean flexible to suit the carer. It means they can be on shift any time any day 24/7/365.
Shifts are almost always minimum 12 hours. 24 hour sleep over shifts aren't paid for the "sleep" hours, but the carer cannot leave, or often even sleep soundly.
Would you work 9am - 9am for 14 x £9 ? Handing out medications and completing the paperwork, cleaning, personal care and cleaning every bodily fluid you can think of, be bitten/kicked/slapped/verbally abused?
Spend hours studying, because care is NOT unskilled, and requires various certificates to be passed.
Work say 50 hours overtime, but told you can have time off in lieu "soon" rather than be paid overtime?
Hold someone's hand as they die, then lay them out, then be the one to call their family and tell them ?

Health interventions aimed at extending people's healthy years as opposed to just adding more years of disability onto the end of life, and generally increasing the health of the population as a whole. Covid really showed just how shockingly unhealthy we are as a country.

Pay pay pay for carers.

Make assisted suicide legal.

What a shame the industry is losing you, @JockTamsonsBairns- you sound amazing. I wish I could’ve been more like you!

It's terrifying. I work in the NHS now but started my career in care, it was looking after these people that made me want to pursue a career in the NHS because I really enjoyed many aspects of it.

The trust where I work is currently on black alert because of a lack of care when patients go home, they simply cannot discharge patients because there is no one to look after them! No patients out = no patients in.

I think it would be good if it was a pre requisite of doing nursing training for all students to have done at least a year of care work prior to starting training. This would also sort the problem of many nurses coming through training who are too focused on the paperwork side of things rather than actually caring for the patients.

Other than that, apart from massively increasing pay and improving working conditions to make care work a more attractive option, I don't know what the answer is. The current system is absolutely fucked.