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!

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

Let me tell you a story about my cousin Pete (not his real name, obviously).

Pete is in his late 20s, has been on the 'dole' since leaving school, and - by your reckoning - should be forced into care work as a condition of receiving that money?

Pete has a learning disability, not enough to get him declared unfit for work but enough so that he leads a chaotic life and struggles to make good choices. As a result of various circumstances he is a bit of a dick, he gets into bother with the police over shitty decisions he makes, his girlfriend regularly chucks him out so he's often drifting from sofa to sofa. Oh and he has a drug habit. Most of his dole goes up his nose or is burned up and sucked down into his lungs. The rest mainly goes on booze. He's tried various rehab and therapy programmes over the years, family have tried to get him help, his probation officer after he was lifted for burglary tried to get him into a rehab programme all to no avail. He's semi-functional apparently and, thabks to all those vote-winning cuts to services, that means he's too functional to qualify for help. He regularly self-harms in a big way, including stepping in front of cars, climbing up on bridges, and utilising power tools in ways they were not designed to be used. He's not bad enough to be sectioned though because he shows remorse for his actions afterwards and says he doesn't really want to die, besides which there are no beds.

He is exactly who you want looking after your elderly grandad, isn't he?

Then you have my FIL. He has one foot, one functional kidney, diabetes, blind in one eye, Hugh blood pressure, angina - basically it would take me all day to list his conditions. He lost his job during lockdown when the company went busy and was living off his savings which have dwindled so has had to make a claim to the DWP. They found him fit for work so he's expected to find a job. He is two years from retirement and has all those health problems so basically has no chance.

Should he be pushed into care work as a condition of getting his UC?

I did care work in my early 20's as was only job i could get quickly with no experience. I worked in community care and then a care home for dementia residents.

Honestly, i fucking hated it. Some people/jobs were ok. But the personal care was rank 🤢 and the dementia home really got me constantly anxious about ageing and having no decent life if i lived to 80+.

The hours in care home were 12hr shifts, and only 2 half hour breaks. No staff room so you either ate your lunch outside or in your car, or whilst having the residents pawing at you constantly while you sat in main room with them.

I had 2 young children, so spending all day being a carer to elderly people who were like children then coming home to my actual children, absolutely drained me mentally!!

The pay was dismal. The working conditions dismal.

One time i was 6 months pregnant and a resident said oh look your pregnant, then went to punch me in my stomach!! She was not normally very violent but was annoyed she wasn't allowed to go outside that day.

They would continuously take on people who should have been in a nursing home not a care home, so our job became so so difficult as we were not staffed and set up to look after people with massive physical disabilities.

In the community i had some lovely families i helped but also some really horrible ones who looked down their noses at us. Some got annoyed when they asked me to do extra things that i couldn't do due to being pregnant - tasks involving lifting/bending that were not on the jobs list for my visit. They were able bodied people who could have done it themselves for their relative but just didn't want to! I also saw a lot of questionable behaviour from relatives of the person i was caring for - as in them setting themselves up to inherit and clearly had no real feelings
towards their nan/uncle/mum/dad.

Community care you are just in your car, so have to pack lunch in such a way you can keep it fresh until you have enough time to have a break.

Some of the carers i met were amazing and it was their passion. But some clearly didn't want to be there and i would not want my loved ones being cared for by someone who didn't have the right caring and patient personality to be a carer.

I would never do care work again, I'd happily be a cleaner, stack shelves, whatever - but never care again.

What I can't understand is why we continue to keep people alive at any cost-even when they have next to zero quality of life.
I mean if we took our dog to the vets in a similar state we would be told the kindest thing would be to put them to sleep.
I see so many posts on here from people who say if I get so bad I would rather not be here so why not legalise assisted euthanasia. Of course it should all be done above board but it would save some people a pitiful and painful few years before they died or assist someone who basically has no quality of life whatsoever out of their misery.

And yes I know we are talking about humans and not animals but same basic principles.

@DockOTheBay

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.

Aside from the ethical issues, all that would happen there is that any school leaver who doesn't want to do it, ie most of them, will gladly sign away their right to care in decades time. Teenagers aren't very good at recognising their own mortality.

On the unemployment issue all claimants for universal credit or Jobseeker’s Allowance will have a claimant commitment. It’s agreed with the work coach. If you fail without good reason to apply for jobs or to take a job that is offered it/part can be stopped - sanction. So in a sense jobcentre staff can make people apply. I hope they don’t make people that are obviously unsuitable apply or care homes are careful who they accept.

Why don't you quit your finance/admin role and move to the care side of the business? Not being facetious, it's just often this question is asked by people who don't work as a carer and would never consider it.

@DockOTheBay

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.

What an awful idea.

It terrifies me how many people suggest that assisted suicide is the solution. We should be improving patients' quality of life, not killing them off

If AS is introduced, then strict legal safeguards would be watered down over time, people would feel guilty for being alive in poor health, relatives with an eye on their inheritance would say that "Dad always said he would wish to die if he had alzheimer's"

Back to OP's question, raising wages would make the role more attractive

It needs adequate government funding. The only route to that is to get rid of the Tories.

Yanbu. The Tories claimed to have "solved social care once and for all" by implementing the upcoming NI rise. The media seem to have forgotten all about it but I don't see how anything will change. Its very worrying.

@notanothertakeaway

It terrifies me how many people suggest that assisted suicide is the solution. We should be improving patients' quality of life, not killing them off

If AS is introduced, then strict legal safeguards would be watered down over time, people would feel guilty for being alive in poor health, relatives with an eye on their inheritance would say that "Dad always said he would wish to die if he had alzheimer's"

Back to OP's question, raising wages would make the role more attractive

And it's very telling that people would rather talk about that than how to improve it now. It's certainly an option for the future, but as we don't have it and are actively keeping people alive with a range of illnesses that reduce quality of life, it's not going to solve the crisis happening now, right now and affecting people right now. We need to change things now, but people would much rather talk about popping off to Sweden than increasing pay and conditions for care staff doing this job - and then wonder why they feel undervalued.

Care wages don't pay the rent.

Hi @hugr, if you’d read my original post, you’d have seen that I did once work in care, and it was admittedly not for me. I wrote this with that point in mind: that people don’t really want to work in care (and sadly, I understand why!)…

The only way to improve recruitment is to pay more, and then charge the elderly more for services.

Or recruit from abroad, and hope they'll accept lower pay.

Or raise the threshold for support. If you've got family within a certain distance, they have to do it.

Or raise taxes. Or reallocate tax money from elsewhere.

Probably a combination.

I know some people who love being carers. So if we made the job viable for them, they would do it. Raising pay for sure, and improving working conditions - I guess the latter is a catch-22 though, because I suppose while staffing remains an issue, whoever does work as a carer is going to be overworked in a stressful job...

I have no idea whether, if the working conditions were attractive enough, there would be enough people wanting to do it.

I find it both devastating and outrageous that cost of care is being brought up as a reasonable argument for assisted dying...there is a real debate to be had for and against this but REALLY finances are the worst possible grounds.

The well aged are increasing too....equivalent people who required care at 75 due to ill health when I was a young adult are now travelling the world, healthy aging is much more common BUT the increased age of the upper end of the demographic mean that frailty plus ill health plus the numbers born have caused a care and NHS crisis,

Poor funding and work force planning over the last 20 years, the embracing of the program of austerity by all parties have left us in this spot compounded by brexit and a pandemic (predicted for years by the way).

The only way out is financial commitment, proper wages and conditions, respect for the work done and workforce planning and recruitment.

Sadly I don't see any appetite for this
even Jeremy *unt thinks we have missed the boat......

I think people need to watch panorama episode “crisis in care-follow the money” on bbc iplayer and then it will become clear why carers are not paid a fair wage.

13 yrs ago I was working for an agency, one of the few who paid well, we got £9.18 an hr, £12.50 on weekends and £18 on bank holidays, £35 a night sleep in rate. Most agencies were invoicing clients for £30+ out of which the carers got around £6-8 (can’t remember what min wage was back then) and the £24ish pounds over was profit for the agencies.

I had a decade break from work due to childcare responsibilities but went back in may 2020, I work for an organisation now not an agency and am paid £9.50 an hr. The responsibility I have for that pay is insane, I arrange drs appointments, hospital visits, district nurse care, change catheters, apply dressings, personal care, I’m dysphasia trained by SLT, I administer medication, I thin and thicken foods and drinks to safely drink, I do housework, shopping, I’m responsible for their finances and spending, record keeping, medication ordering…….all for £9.50 an hour.

My organisation wants people 7am -10pm in the daytimes, however they are so short staffed they accept me coming in between school hours-because a carer is better than none/short staffed. I do occasional weekends although when I started I only did weekends for 1yr, we do not get additional pay for weekends or bank holidays.

The care system needs an overhaul, to be based heavily around investment is shit and a lot of providers will do the bare minimum to get bodies in rooms without much thought for residents or staff.

Forgot to add we have to do a lot of training as well, especially around eating and drinking, Gdpr, fire safety, food safety, epilepsy training and medication training. A lot of which has to be updated every year.

As supply dwindles the purchaser has to increase what they pay.

Those in private arrangements pay more or get by with less, the state has to chose to cover less or pay more.

As a society we have decided wealth stored in property should be protected unlike any other asset type. Sooner or later this will have to be reconsidered.

I used to do it and loved it. My hours were 7am-11am and then 4pm-9pm.

Impossible now as a single parent. Zero willingness to be flexible on account of the company. It wasn't so much about the pay but the hours. 5 minutes to do a 20 minute journey was standard too.

Shame as I loved it.

Iv been in care for 18 months, I’m leaving next week.
We had a team meeting last week, I said I want to be issued with 3 uniforms a year, we get one when we join and then have to pay £15 each for more. Can we be paid for meetings, can we be paid for training.
No, no and no, they know they can do this as they have employed a company to see if it’s legal.

Can’t believe you have to pay for another uniform, @bebanjo- atrocious. The tight gits ought to get their priorities in order. And they don’t pay you for mileage? Wtaf??

My MIL hires private carers they might have 2-3 clients in total, rather than ones that have multiple jobs a day. They get paid pretty well, I think its £20 - £25 per hour.

I think the pay is what lets it down. It's horrifically badly paid and known for it. Carers deserve much, much more.