Carers charging for 30 minutes but only working 15-20 minutes - is this normal for care?

[ImissSpangles]

I am not sure if this is a normal thing to expect from care or not.

Mum lives with my dad, she has dementia and is incontinent. Last year we employed a team of carers to help mum.

They are all self employed but work together as a team, so not an actual care company. In retrospect we absolutely should have gone with a company because things can often become a bit too fragmented for my liking, for example I have to pay everyone individually, they insist on being paid weekly, I would have preferred monthly but they don't want that. Tbh, we had to rush about finding these carers a year ago after mum had come out of a long hospital stay and the NHS discharge carers let us down. It was all frantic at the time and very stressful. Looking back at it all a care company would have been a much better fit.

Anyhow, the carers come three times a day, around 9.30am to get mum up, put on the loo and showered/dressed, then again after lunch for a toilet break and again at 7pm to put mum to bed. They come in pairs and charge £26 per hour and £20 per half hour. This is 7 days a week.

However, they will often only do 15-20 minutes during the afternoon and evening visit and will round their charge to the nearest half hour. I am usually at my parents for the afternoon visit and I have never known them to ever do a full half hour.

I have no idea if this is normal practice for carers? I asked on a Subreddit and was piled upon by some people saying that it's poor enough money as it is and the carers have to consider travel expenses etc. I am a self employed cleaner and when I tell my clients that I am doing an hour, I will do the full hour, I have also incorporated the cost of my travel into my fee as this isn't my clients concern (and my fee is a lot less than the carers).

Does anyone else have private carers for a parent and do they do this? Maybe it is normal, I honestly don't know?

The carers come several times a day, and have a list of things to attend to - a list put in place by the Social Work team - this includes some personal care, help with meals, some tasks around the house, some errands/tasks outside the house.

That's half of my issue, when they go to leave at the afternoon visit I will always ask them how many more do they have after mum and more often than not they say that's it for the afternoon, they are off home before the evening shift.

We did ask if they could come at 8.30-9pm but they have clients after mum so we had no choice but to go for 7pm.

We have a SS care assessment soon so I will see what they say and will go from there.

I did ask about live in care on my local FB group and a few commented they have live in carers for their LO at a cost of around £130 per day. My parents are paying around £800 per week for care as it is for care thats less than 3 hours per day.

I do believe SS are going to care needs assess us all (mum, dad, sister and I).

Do you know if they do the full half hour when you are not there?
How long do they do for the other visits?

If they are a self employed team rather than an agency, I would think they actually have got to know you all somewhat and genuinely care, so I'd probably have goodwill and lean towards the possibility that they sometimes overrun in the morning visits and that it probably evens out?

When I was working in care, it would be the morning visits that were most hectic and hard to get everything done in time, but tea time visits where family were there, the family would quite often just say that they didn't need us, or offer a cup of tea etc. I don't think it's like being a cleaner where there's always other bits to do.
What extra care work do you want them to do if their tasks are done and they are sitting with family?

They are self employed though, so they can choose if they want to finish at that time.
If the timings don't work for you anymore, then you might want to look at a larger care agency with more staff.

I would go through a company it really varies and interview as many as you can. We were really lucky when my DH needed care following hospital discharge. They were really clear that - carers should stay the full 30 mins, they could help around the house if all personal care was done, several even offered to make me a cup of tea if they had spare time and were around. Some of the carers were less diligent and did leave early, actually this was ok for us as it was only DH who needed care and I was on top of the house but the company were really clear with me that I could/should challenge them and give them work to do if they looked like leaving early. I felt like their lives were hard enough so let them go, but in your situation they should be helping both your elderly parents.

The morning is usually nearer to the hour, although dad says it is sometimes 45 mins so that doesn't bother us so much although they never go over the hour. Never at all during any of the visits have they ever gone over their time and if they do they would absolutely bill us for that.

Afternoons are usually always 15-20 mins and I'm not there in the evenings but dad says it's usually 20 mins, they get mum on the commode in the bedroom (often don't bother taking mum to the bathroom), put mums nightie on and then into bed.

Dad did complain about them using the commode in their bedroom as it often stinks the room out, he was told if he wants them to take her to the bathroom they will have to charge the 45 mins - they live in a bungalow and the bathroom is two rooms away from the bedroom!

Of course but that was in question to someone saying they are probably overrun and needing to go straight to the next client which isn't the case most afternoons.

I am glad you are taking action. It sounds like you are unlucky compared to my experience - but it could be right that my sister insisted that we choose the company and not just leave it to the LA to select the company and bill us. It was work - and I live a 3 hour flight away - but we could make demands what was going on.

A thought about the shorter visits. They will have to spend time writing up their notes at every visit. My dad used to accuse them of “playing on their phones” whilst we knew otherwise.

Also if they are working on 15 minute intervals, do they have to leave in time to start the next client? Ours worked in five minute intervals - but for every time they may have left early there was another session that they were kept late due to mums needs. I knew when the carer told me that the previous lady had soiled her bed and needed a shower that she was being truthful. She knew how to manage her time by the end of the day.

One suggestion is to get cameras. Tell the carers that you have them - you are doing it to make sure parents are safe (like falls). You can then monitor who is coming in the house and for how long.

i hope you get a good outcome

I think the difference between cleaning and caring is that cleaners usually do at least 2-3 hours per job, so the paid hours to travel time ratio is better, whereas carers are booked for several half hour slots a day with travel time in between, so they have to use some of the paid time for travel otherwise they'd be commuting unpaid for several hours per day and only being paid for a few half-hour slots.

Could you have a friendly word with them. Say they are doing a great job but you've noticed that the afternoon slt in particular seems to have been scaled down to about 10 mins for which you are paying £20. Ask if there are travel issues, and say your dad would appreciate them staying for the full half hour, as it means he gets a short break in the middle of the day, maybe a cup of tea or time to get a breath of fresh air.

Oh the afternoon using the commode sounds a bit much. At least your dad tried to complain. You cannot use a camera to monitor bedroom and bathroom. We had a corridor camera - and for a bungalow, bedtime visit was only half an hour ( unless your mum is difficult to change).

We got a booklet from Social care with a (long) list of companies that were with our area. We ended up going with a company that a neighbor used. Our initial experience was good. Staff changes with the managers caused us to be much less happy. They were not really listening to us - and given the money they were getting from us they should have. Mum is now in a residential setting because she was not safe wandering around the house - we saw this on the cameras

For the in-laws, we tried hourly, live-in (more expensive and bloody useless), with a so called top rated CQC company, even witnessed the poor NHS respite team... all were frankly awful and yes, I know how bloody difficult the job is having been the carer for both my parents, in very difficult circumstances. The whole industry (as that's what it is) needs a reboot, clear expectations and skilled staff. We were paying the live-in carers more than I earned, and we had cameras set up, with all being fully aware, as it was an early warning system which worked, highlighting the issues. If you are paying for care, then care it should be, travel is not care!

It’s very much depends if it’s a care visit or a support visit
yes they are 2 different things
this need to be made clear when you take on the carers
generally this is laid out on the initial visit before the company takes a client on

Please raise it with the care company. My partially sighted father in law was supposed to be having half an hour of care every evening, to help put him to bed. Usually he had already put himself to bed by the time they came, so it was more of a welfare check - they were then supposed to do the washing up or whatever needed doing in the house. He told us a couple of times that the carer hadn’t turned up, we weren’t sure if he was getting a bit confused. He got more and more adamant about it so we contacted the care company. They investigated and it turned out the carer was sitting out in his car for the half hour, not even entering the house!

I think the only way you’re going to resolve this is by having a conversation. It doesn’t have to be confrontational and you can use it as an opportunity to say how pleased you are with the kindness shown to your mum but that you are aware the carers are only staying for 15 -20 minutes so wondered if either her care needs have changed or perhaps a review of hours is needed .

Obviously £26 an hour for two people doing such an important role is a pittance but presumably that’s what they charged for an hour, so I don’t think it’s unreasonable to expect you get an hour (Unless it’s like cleaners where you pay for an hours work and if you get two of them, they only stay for half an hour?)

Yes it’s frightening how many people are going to need care for 10+ years in the coming future. Life span is ever increasing but healthy lifespan is not. Much of the British public - I won’t speak on others as I don’t know - eat bad food, don’t exercise, are overweight, stressed, don’t sleep well, addicted to phones. A wave of unwell elderly is on its way.

Seems a stupid and inefficient way to work

DD1 used to have carers come to the house, for 8 hours a day Monday to Friday, which was what I wanted. IMO, part of their job was to get her meals, wash up, do her laundry, etc. Mostly, they had to keep her occupied in the mornings, by taking her for a bath, getting her dressed, reading with her, playing games with her, doing jigsaws, etc. Then the carer and I took her out every afternoon. They were funded first by SS and later the NHS. The carers didn’t have to rush off anywhere else.

The company expected them to ring in, on their arrival at our house, and ring in again, when they left, so overcharging was not possible. They also had fill in a form every day, about what they had been doing, which were collected from time to time.

I think this may be a better fit for us. If we could find a company which offers day care for several hours at a time they may be able to offer a more personalised care package and as you say, they wouldn't have to leave early to shoot off anywhere.

I have tried to edit my OP as I don't think it's clear to some but sadly I can't at this late stage.

So to clarify, there are currently no care companies involved at all, we have a team of carers who are all self employed but know each other and work together.

Mum has two carers working together (this was not our request, the carers explained at the beginning mum needed this) and their fees are the same - £26 per hour and £20 per 30 mins - that's each so for each 15-20 minute call we pay £40 and £52 for an hour. So the average weekly care cost to us is nearing £1000 (mum also goes to a day centre every Friday costing £120).

Care certainly doesn't come cheap.

We had exactly the same issue so installed a ring doorbell with us having access. I monitored over a 3 day period, they had charged for 510 minutes, booked on their app as being present for 373 minutes and as per the ring doorbell were actually there for 247 minutes. A shortfall of nearly 4 hours care over just 3 days. I sent this as a formal complaint to the care company and they thanked me for getting the ring doorbell installed and out a qr code in the flat that the carers had to scan. Once they knew I was documenting this they then stuck to their times properly. I hated doing it but was infuriated the first night to see that she had been washed, fed, put to bed and tablets in 8 minutes.

If dad does decide to keep these carers on I think we will need to install a Ring doorbell and monitor it closely.

Isn't it dreadful enough having to deal with elderly and unwell parents without having this extra load on top?

It was the norm with my experience,one of the reasons my mum went into a home.

It's not acceptable,if they're paid for half and hour then they should be there for that time,I don't care how rushed off their feet they are. If they're doing that all day then they're being paid for not a lot of work.

I was just about to suggest a Ring door bell,I expect the appearance of that alone might help without you having to say anything.

How did you vet these people? Do you have DBS checks on them all? Is there a care plan? 😬

I'm glad she is having a social services review soon. I'd would be asking them, IF you stopped the private 'carers' what provisions would be made. I know you didn't like the previous NHS, but she might be entitled to a different package now. Your dad might even get some support. A relative is having 4 visits a day, 2 carers each time and I don't think paying near the fees you are. And yes, carers often do other things not just shower and dress people. If they have time over, they could make them a cup of tea, heat a meal, brush her hair, help with feeding etc etc.

I've worked in a similar medical role and understand the pressure to get from A to B, and house to house, BUT, these people are self employed and working their own rota system. The fees seem extremely high IMO! I'm not saying carers shouldn't be paid a decent wage, but in most areas, its lucky to be above minimum wage. I'd be asking about them cutting the time short because its fraud.