What tasks does your care provider do?

[FindingMeno]

I could really use the help of the collective brain of MN here!

The council funded care provider seems very specific about adhering to only the duties itemised on the care plan ( full 4 times a day package). At present these seem to only be changing pads, washing and giving medication.

More support is needed than this, and the visits end up being much shorter than the time slot allocated. I am trying to work out what reasonable expectations should be to ask to include on the care plan . Things like keeping the environment clean ( and what that means in practice), and ordering and collecting prescriptions etc.

If anyone can help me by listing the things their council provided care provider does, it would be enormously helpful.

Thank you!

Cleaning and prescription order/collection is not a carers job.
Their job is to provide physical care ie washing dressing feeding.

The tasks you're looking to cover need to be done by family or domestic help.

Thank you for replying.
That's interesting to hear.
Do you know what happens if no one else is able or willing to take on the tasks that contribute to a person's wellbeing, and private help isn't a financial possibility?
I am sure I have heard that carers will deal with prescriptions or is that just privately funded ones, do you know?

FILs council-provided carers will;

Help him wash, dress, brush teeth etc
Cook or reheat breakfast / lunch / dinner (simple things like porridge or scrambled eggs, ready meals or dishes provided by SIL), serve it to him, wash up after.
Give him his medication and make sure he’s taken it.
Help him get undressed / ready for bed.

They don’t do cleaning (except dishes). He has a cleaner 2 x week who does bed changes, cleans (small flat), does some laundry / ironing, and brings basic messages - bread, milk etc.

Ordering prescriptions is done by SIL. She also does lots of other household stuff - buys him clothes, sorts the rest of the laundry, tidies up, does shopping. She also orgsnises things like chiropodist, hairdresser, and all medical rdv including transport. It’s a lot even though I it’s less than she used to do.

Do you know what happens if no one else is able or willing to take on the tasks that contribute to a person's wellbeing, and private help isn't a financial possibility?

Well it depends on the reason why they can’t look after their own wellbeing, and their general situation. If they are unable to organise their own medication etc, if they need domestic help, and no one is willing to do or organise that then it’s a problem. What is the persons situation? Why do they need carers and how did it come about that carers were provided? What capacity does the person have at this stage? What’s their living situation? Their medical situation? Have family ever been involved - and if not, why not?

What age is the person and what is their income?
are they receiving attendance allowance as that what is should be getting used for I think, those tasks that don’t come under personal care.

Yes, Attendance Allowance (or Pension Age Disability Payment as it is now known in some parts of the UK) should help with paying for eg cleaner. Re. prescriptions, see if the pharmacy can deliver, many do.

https://www.gov.uk/attendance-allowance

My local pharmacy have a system where they can reorder repeat prescriptions (most medications, not all are covered). I believe they can deliver to the housebound. Would that be a possibility?

Not everyone has family unfortunately. People can be without relatives e.g if they were an only child and had no children of their own.

You’re correct. But it’s important to know the back story here. The OP is presumably involved in the situation to some extent, but it’s not clear if they are family or not. We don’t know if the elderly person has carers for physical or cognitive reasons - that’s quite important in terms of knowing the extent to which they can organise their own lives. We don’t know what situation has led up to the current one - has the EP been struggling on alone, had a crisis - if so, who noticed it and initiated the intervention that had led to them being set up with carers? Does anyone have POA? If the EP has family (the OP implies they do but none willing to be involved in care) why don’t they want to get involved?

In this case, an assessment has clearly been done which has led to the provision of carers. What did the assessment say about the other aspects of the EP life? Was anyone (OP or others?) outside social services involved in the decision to provide carers?

I would add to my list of questions:

What's written in the care plan about medication and how it is to be supplied / renewed? Does the care plan assume that the EP has the capacity to organise their own medication? Or have SS assumed that the OP or some family member will do it? Was the OP involved in drawing up the care plan?

My DM's carers would get her up and dressed, sat in her chair and give her breakfast and wash up after. They were not allowed to handle medication but if I put all her morning tablets in a box by the kettle they could pass them to her.

Re medications - the GP can request that the pharmacy make up a dossett / dosette box, which organises medications by day and time .

In MILs case this was delivered weekly by the chemist, but could be monthly ( MIL mislaid hers repeatedly)

Cleaning, washing, etc was organised privately, and paid for by MIL.

DH had POA and latterly organising that sort of thing fell to him (and me)

Without family, and without capacity, she would have been in a care home earlier.

We have someone who helps DM (not council funded), they are generally a support for her so make sure she eats lunch (maybe supervise her getting food ready), does some light cleaning, helps with laundry, checks medication, takes her for short walk to shops etc.

This is all very helpful, thank you.

To address some questions, paramedics raised concerns and the issues are physical ( mobility and inability to wash and dress), incontinence, and mild cognitive problems.
There is no POA and very few family, none of whom are prepared to take on the quite substantial caring role.
There is capacity but refusal to go into residential care.

And despite capacity, there's an inability to manage own personal admin such as medical appointments.

Need to get POA sorted before capacity lost

How did the paramedics get involved?

Have you seen the care plan OP? If council-provided carers have been put in place, then there will be a plan outlining what they are expected to do. Who initiated the care assessment? Was the family involved or informed? Did anyone ask about medication / general housekeeping when the care plan was being drawn up?

So if it's an elderly person, living alone, who has come to the notice of medical / social services, and ss have deemed it necessary to have carers come in 4 times a day, and they are only tasked with changing pads, washing and giving medication, then they have presumably either decided that they EP is capable of organising everything else OR they have assumed that someone else (OP, family) will be taking this on. If only the EP was involved in the care assessment, then they may have told SS that they only need specific help, may have said that their family will help. Who knows?

I'm sorry for all the questions OP, but these situations are so individualised. Ultimately responsibility lies with the local authority BUT if the EP has capacity to decide how they want to live and / or has lied about family support, then they won't proactively seek go beyond that.

Get prescriptions ordered abd delivered via the chemist, complete waste of time doing otherwise.

You need to get the care plan reviewed.

Funding rules are strict - whether it’s for services directly commissioned by the council, or commissioned by the service user via direct payments.

Services that fall outside of the agreed care plan should not be covered by funds supplied as a result of a Care Act Assessment resulting in a care plan.

Hi again O

I've re-read your OP and it looks like the care plan is in the process of being written?

In any case, the arrangement for FILs medication is that his surgery / Dr sends his prescription directly to a local chemist which offers a medication packaging and delivery service. They make up and send a month's worth of meds at a time. Each morning / lunchtime / evening set is packaged individually, and labelled with the date and time that it's due. The pharmacy also arranges for delivery to FIL home (he's able to answer the door). The carer then just has to open the correct package and give the tabs to FIL. SIL had to set this up with the Dr in the first instance, but I think it has worked quite smoothly since then. Any time his medication changes, the surgery informs the pharmacy directly and they send the appropriate meds. Not every surgery does this and where we are it seems like it's a specific arrangement between the surgery and the pharmacy - so someone needs to check whether the EPs surgery offers this service and how it can be set up.

My mum's carer's will give her her medication (it was the reason I insisted on twice a day visits) but I have to submit a monthly prescription to her GP surgery, who pass it to the adjacent pharmacy who deliver it.

The morning carer will wash and dress her, make breakfast - usually porridge and a cup of tea, bring in the milk when delivered, put dirty clothes in the washing machine and start it if requested, wash any dishes. The late afternoon one gives her her medication, draws curtains, turns down the bed for her and will make her a hot drink for her.