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!

@bebanjo

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.

It's this that is the hardest to take for me - and the knowledge that it happens because it's mainly mainly profit driven.

I'm not asking for a massive wage, I'd be happy with enough to live on, have a decent life with a holiday now and again and not have to worry about having the heating on or work 50 hours a week to just scrape by.
I'd be happy with enough staff to enable me to spend time with people like I'm supposed to, not rush through everything because it's a choice between everyone getting the basics or half getting good care and half getting none.

I'd be happy with better training - and the staff ratio's to achieve the standard we're supposed to be reaching.

I'd be happy with not being made the scapegoat for systematic, provider, healthcare and government failures in social care and to be listened to when I raise concerns rather than fobbed off and then blamed.

And I'd be happy with a bit more respect from employers, from managers, from families, from the government, from society at large, from other HCPs (nurses can be awful towards care workers ime).

For starters these things need to change, followed by -
The 15 minutes at the start of every shift for handover (for every carer, every shift) - essential enough to demand you're there but not essential enough to pay for, the mandatory training that you have to legally do, yet don't get paid for, and some companies charge you for it, the mandatory uniforms - that you have to pay for yourself, the staying back to complete paperwork (because it's a legal requirement) yet you don't get paid - you've been too busy looking after the people you're meant to be looking after - because there aren't enough staff to meet the residents needs - and have to wait for the next shift so you can complete it so they can do the care, the short staffed shifts that are more and more common, numbers made up by cleaners, management and domestics on paper, but in reality you just work harder and faster - not giving the care you want and should be giving and the company pockets the last persons wage for that shift and then get the blame when something goes tits up and safeguarding get involved.

Social care (like the NHS, education etc) has been run on too little investment and an abundance of good will - what we're seeing is that good will is running out, we know we're having the piss taken out of us and so people are leaving, and after covid it's not so much that people don't want to give more, it's that there's nothing left to give, the tank is empty and on fumes.

There is a fundamental misunderstanding in this thread and indeed among most people of what adult social care spend their money on.

Is not the elderly. The majority of ASCs budget is spent on younger people with life long or acquired disabilities.

So yeah. All this talk of assisted suicide and ending life prolonging treatment to save money is fucking vile.

Improve pay ,treat staff with respect ,acknowledge how hard the carers work ,remember they are human beings ,take notice of their concerns, stop guilt tripping staff to work longer hours because the company loose staff so quickly due to all of the above!!
Remind the owners of care homes to stop being so GREEDY!

@Maverickess….agree with every word you have written!

@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.

Seriously? Some people can’t do it!

I might just be a ‘carer’ but I’m trained to give medication, including controlled drugs, give personal care and maintain dignity, learn safeguarding skills and end of life care. We shouldn’t get ‘too involved’ but that’s just impossible.

When your loved one is covered in faeces, vomiting and scared do you really want an unwilling carer who can’t do the job properly caring for them?

@makingmiracles

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.

I think you might work for the same company as me lol.

@DockOTheBay

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

This tbh not a popular opinion as PP said but given my family history (dementia) I have no desire to live a long lingering end where I wouldn't recognise the shell of a person that I've become.

Politicians are twitchy about it who wants to go out on a limb as killing granny?

It does need better wages and more career progression. I'd also agree trhat it needs to be brought back under local authourity control/ some sort of national care service. This idea that you don't pay travel time between clients and just over minimum wage for what is a difficult job is ridiculous.

What puts me off is the fact that it’s shift work. I’d like 3/4 days a week but set days. I like to know what I’m doing. Also I can imagine that’s a lot of pressure to do more hours all the time

Local authorities need to pay more- a lot more. They can't do this without increased funding from central government. There needs to be better conditions for carers, they need enough time to do their job, pensions, sick pay etc. It needs to be an attractive option as a job. It's hugely rewarding but unsustainable for many people. I went back to domicilary care work between jobs and my God it was hard. The clients were lovely and I am not at all “ick” about personal care- we are all human! But the time pressures, the rushing from one job to another, the amount of things you are expected to doing a short space of time. It was really unnecessarily hard work.

I am care manager

We have some amazing carers who are worth so much more than money we pay but it's not as simple as just pay them more . Most private care companies will have have contracts with the LA , they have a fixed amount of how much they will pay per hour and will do anything to cut a package down to save money . In some areas this is as low £15.50 per hour , take out the £8.91 add 20% for annual leave , pension contributions etc , mileage allowance, the wages of the people who are needed to coordinate the care ,general business over heads , training ( currently 40+ courses a year to stay compliant) it doesn't leave much left to increase the wage of the person actually out in the field doing the job .

We do have more complex packages but you try fighting the LA to pay anymore than the standard rate so you can pay the staff a little bit more to be bitten ,punched and general abused all day .

To be a good carer you need care , thought, tolerance and resilience and a bloody good sense of humour . We want to pay more , we want good staff retention , we want the industry to be recognised as a good carer choice and something to aim for , not as something that people do when they are not good enough for anything else .

For us it starts with the LA's paying a rate that allows us to pay what the staff are really worth and stop using the care providers as scape goats when something bad happens because they decided 15 minutes was all the service user needed 15 minutes was all they were willing to pay for .

Pay them more. Fairly simple.

@dipdye

Pay them more. Fairly simple.

But we don't want to pay more to provide care that's the problem

@DockOTheBay your assisted suicide 'solution' is chilling. All types and ages of people suddenly develop care needs...if this happens to you tomorrow would you tidily end your life? You just might want to continue!!

My young adult daughter has eorked in care whilst at uni. It was exhausting and stressful (she loved her clients...it was the racing around with no travel time that did her in, also being given 30 mins to make lunch for elderly who would then have to rush through their meal before she had to insist it was time for their shower so she could dash off to the next call)

@BettyBag

There is a fundamental misunderstanding in this thread and indeed among most people of what adult social care spend their money on.

Is not the elderly. The majority of ASCs budget is spent on younger people with life long or acquired disabilities.

So yeah. All this talk of assisted suicide and ending life prolonging treatment to save money is fucking vile.

There may be a fundamental misunderstanding about the pressures on finances on this thread but on your point about the discussions on assisted dying being 'fucking vile':

Many of us if not the majority have witnessed parents/grandparents as they become frail and elderly require more and more care. It is absolutely horrific to see, when someone you love is in constant pain and has no quality of life left at all, no dignity, cannot get out of bed, no control over anything that happens to them. Out of my four grandparents, only one had what I would call a 'good death'. Never needed care, could still do everything for himself, was a bit frail and tired but doing ok. And then one morning had a massive stroke and was gone by late afternoon. My other GP's on the other hand have had long, drawn out, painful deaths where they have lost all quality of life long before they actually died. One is still alive but in a care home, in constant pain with no ability to do anything for himself. His mind is unaffected but physically he cannot move out of bed at all now. He has said many times himself he just wants to go. I've also seen the mental and physical toll that caring for him took on my parent, prior to him going into care.

He is in his 90s- a pp mentioned about improving the quality of life rather than talking about assisted dying, but how do you improve quality of life for people who have lived well past life expectancy and are basically then suffering the horrible consequences of all the medical interventions that have got them there? It's great if people can live very long lives in better health these days- but I don't know why it's 'fucking vile' to discuss AD only for those who would CHOOSE this- nobody thinks it should be forced upon anyone. I rather think it's an absolute disgrace that it doesn't exist for people who would choose it rather than suffer constant pain, indignity and misery. After seeing what happened to my grandparents its absolutely what I would choose for myself.

Imv it's the oldies (include myself in this) who are desperate to hang on to their homes, to pass it on to their DCs. The dementia tax (thanks Corbyn) might have worked but T May lost a lot of seats over that and imv it was the oldies voting against it that caused that.
Likewise the deathtax in ? 2009.
How people can be so daft when they can see friends/ relatives etc moving into care homes for years of their lives at 1,000 a week.
So we end up with young people paying increased NI.
Another factor is keeping very poorly babies alive. I don't think all premature babies are kept alive in some countries. If they can't breath unaided they are allowed to pass away.
And you can't commit suicide once you have dementia, or I've never heard of it - you can't fly to Switzerland as you must have the faculty to demand that.

Going crazy 'protecting' our care home residents during Covid - forcing Care homes to keep residents shut up, wrapped in cotton wool because the inspectorate will lambast them/close them if anything happens eg resident falls out of bed.
Hence the miserable lives the residents live and I'm sure their condition detiorates due to acute boredom.
Other European countries seem to do better, perhaps they have more immigrant workers doing the work.

@JockTamsonsBairns

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.

Jesus wept. Really? Is this really how little you think of the role I do?
In a typical morning, I start at 7, changing a stoma bag and a fistula bag for a disabled woman, before dispensing 17 tablets for her.
45 minutes later, I'm at a very elderly man with advanced dementia, helping him to shower and have breakfast, and possibly change soiled bedding.
45 minutes after that, I take a woman shopping - a 48 year old woman with acute depression due to losing her husband and three children in an accident eight years ago.
Two hours later, I arrive at my next client, a 64 year old woman with stage 4 cancer. I help to gently wash her in bed, rub cream into her acutely ulcerated skin, and help her into fresh nightclothes. We talk - a lot, about her fears for her disabled son, and what will happen to him in the next weeks/months when she dies.
Then I'm at a double up call with another carer, this time at a 96 year old woman who requires hoisting to a commode, personal care given, and hoisted safely back to bed. She then needs fed with a soft food diet and thickened drinks, before possibly requiring hoisted to the commode again.

I do this 5 days a week from 7am until 10pm. To be a carer requires compassion, integrity, and a massive amount of commitment. All this for minimum wage.
So please don't sit there behind your keyboard and insult us by suggesting that any Tom, Dick or Harry can be forced into doing it.
Is that the standard that people really want for the most vulnerable members of our society?

You don’t get paid anywhere near enough x

It needs to be better paid and properly respected basically. Currently carers are treated like cheap nurses with none of the advantages, worse hours, lower pay, poor ongoing training, no perks/discounts, low pension etc by the employer and families often treat them poorly too

@MrsSkylerWhite

The problem is it is technically unskilled - ex mil is a carer, she's got no qualifications and her training consisted of shadowing another carer for the week plus some lifting training, she bragged how easy it was to get work. What carers need is the right personality and lots of common sense which can't be trained for

@bellatrixonabadday

As you pointed out many if not most people have witnessed this so it baffles me why you are telling me this as if it were new information that will chasten me.

The OP talks about poor care and a crumbling system and the answer is "kill the vulnerable". That's fucking vile. Along with my personal experience I have worked in this sector for years and the number of people expressing a wish to die rather than receive support is vanishingly small especially compared to the percentage of people offering this up as a solution in this thread.

My point about the misunderstanding of were the financial pressure is was to point out that even if we kill off the elderly it really wouldn't help that much and isnt the silver bullet people seem to think it is. Unless the suggestion of assisted suicide and refusal of medical care is intended for those younger people with life long disabilities.

The biggest issue we are facing in my rural area is that there are far more elderly here than young people to look after them, highest number of elderly in Scotland believe. The young here leave for better opportunities unless they want to work in healthcare or agriculture there is nothing here for them

@BettyBag well hats off to you for working in that sector because it is a job I couldn't do, for many reasons. The time I have spent in care homes with my grandparents is in part what has informed my own opinion that I would much, much rather choose to end my life when I feel there is no quality left to it. And maybe it is a generational thing- I'm in my 30s and most of my friends feel the same. Although my parents feel the same too.

Essentially the working conditions for carers is diabolical. I did full time home care work for years before I went back to uni. I was out from 6am to 11pm, so 15ish hours a day, 5/6 days a week but only being paid for 7 of those hours I was 'out'. I didn't get any time between calls to get from one village to the next in morning rush hour traffic and no support from management when that client complained every.single.time. I did a live in care package where I was supposed to get up at 3am to turn the gentleman. I was in the package for 24 hours a day 4, but you don't get paid for when you're sleeping or for getting up at 3am. So I was only paid for 8 hours a day, 4 days a week. I was there for 98 hours a week and came home with £256 a week, £800 a month for living and caring for someone 24 hours a day. Most carers don't get proper mileage paid, they don't get enough time between calls to get to the next one, they get harassed on days off to cover extra shifts, they get their rota changed at the very last minute. All these issues, and the list is endless, need addressing. I absolutely loved being a carer, I loved all my service users. I worked for a small local company, had regular families I went to help and it was at times the best job I've ever had. Care needs to be made into a real career though. It isn't just some crap job you can pick up if you have no skills, qualifications and don't know what to do. You need real passion for helping people. And the only way to find this is making it something to aspire to be, with excellent working conditions, qualifications and proper pay.

We pay people more to do the job. If it paid better people would be willing

@DockOTheBay

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

Literally that is the only answer to this in my opinion. I’ve already made that decision that the first sign of it I will be off

@Bringsexyback

How is it a solution?

Draw me a line from assisted suicide to better social care.