Carer hygiene and professional standards

[Dormit]

Should carers have a uniform, or at least wear appropriate clothing for care work in a client’s home? Are very long false nails acceptable for care work when there is food prep and manual handling?

Would you be happy if carers turned up in leggings and a crop top displaying a multitude of tattoos, had 1.5inch false nails and don’t think washing their hands is necessary?

Would you expect a meal to be presented nicely instead of slapped on a plate like they’re serving in a roadside greasy spoon? Whole tin of salmon mashed between two slices of unbuttered bread anyone? No drink, no napkin, no tray, no fruit, no crisps, no anything that the client usually has.

Then buggering off after 15 minutes instead of staying for the 30 minutes they are paid for.

These are the least of the issues to be honest and it’s all being investigated but yesterday’s experience was a new low.

I’ve been told my standards are too high by expecting them to wash their hands and do what they are paid to do. Im
ending up spending about 3 hours a week fixing their mistakes.

Couldn’t care less what they wear but washing hands and basic hygiene is a must and the whole food prep thing needs to be better. (My Mum had carers 4 times a day).

This is unacceptable. I work as a carer in my second job, and the standards you’ve described are not what I would expect from professional care.
We wear uniform, and even during very warm weather when cooler clothing was permitted, we were still expected to look smart and professional.
Hands should be washed as soon as you enter the client’s property. Gloves should be worn where appropriate and changed between personal care and food preparation.
If a client asks for a sandwich, it should be prepared properly and presented nicely, cut into manageable pieces if needed. If they don’t want it straight away, it should be covered appropriately rather than simply left out.
Staying for only 15 minutes when a longer visit has been commissioned is also unacceptable unless there is a genuine reason. We use an app to check in and out, so management and families can see exactly how long visits last.
I would definitely raise a formal complaint. I would also consider installing a camera if appropriate, as I’m increasingly seeing families use them to make sure vulnerable relatives are receiving the standard of care they should.

They should be sacked, washing hands is vital going from client to client. Giving inedible food is unacceptable.

What they wear is irrelevant as are tattoos and fingernails.

Washing their hands and staying the allotted time are not optional though.
Presentation of food is subjective. Have you provided a pack of serviettes and asked the carer to add one to the tray?

I’m tempted to install a camera in the kitchen but mum wouldn’t hear of it.
We have been through handwashing so many times. I’ve made a formal complaint and complained every time something has warranted it as requested by the manager. We’ve had meetings with the social worker and care agency and nothing changes. There’s a new manager now and things might change but I’m not very optimistic.
Mum hates it but I’m having to put post-it notes in various places to remind the carers what to do. There’s a couple of excellent ones but most are lacking any basic hygiene or common sense. Mum hates needing carers so it adds to her upset. Things like glasses and mugs not being washed properly so I get me out of the cupboard and have to rewash it. They’ve had to be told to use hot soapy water to wash up because they were just rinsing things under the tap. The commode is emptied but not cleaned.

I’m not too fussed on clothing but so think that elderly clients will be more likely to expect carers to dress appropriately and carry ID or at least a name badge. A lot have names that are unfamiliar to mum so seeing them written down would help her. Her hearing isn’t what it was and anyone with an accent she struggles to understand.

@DontGoChasinWaterfalls

We use an app to check in and out, so management and families can see exactly how long visits last.

I'm interested in how this app works exactly.

Mum has carers, they use this check/in out app, and I have access to the log online. However, there seems to be a loophole with it. For example, say they check-in at 8:03 for the morning visit which is supposed to be 30 minutes. Then they leave at 8.20 (I get notified of this via Mum's Ring Doorbell), but don't check out (I can see this via the log as it says "Visit incomplete"). At some time later in the day, the log updates to a full 30-minute visit, saying they left at 8.33. Is there some kind of autocomplete, or does someone have to action this? Is this a loophole?

Fingernails are definitely relevant - long nails are not appropriate for care work. They are unhygienic and also can damage frail skin during personal care.

Also clothing is relevant. Bare below the elbows to reduce infection risk, and appropriate dressing when caring for others as older people with dementia can be disinhibited.

I work as an HCA on a hospital ward, the HCAs with certain issues tend to be some of the new males & very young ones with little care experience - so I found one new guy who’d got a patient a bowl of water & was trying to wash her legs & feet without any soap.. I literally had to explain how to wash someone!! The weird thing is that this male HCA cares for his toddler part time at home & he himself always looks clean & doesn’t smell of BO, so basically was just not applying his knowledge to patients!
Some of the very young HCAs & student nurses don’t have a lot of common sense around washing patients either. So I try to teach them.
Handwashing & gelling hands is drummed into us but some still don’t understand the importance.
I also find that when our Hostess is not around, the male HCAs make me dish up the meals. Some people don’t give out plates or napkins with sandwiches! Or condiments with the meals.

So take all that and put it into a domiciliary care setting, where certain younger or male carers don’t have a more experienced carer watching them & you get situations like you are having OP.
Personally rather than asking the agency I would maybe be around during a visit & in a pleasant way prompt the carer(s) your parent is having to do things in the right way, I find also explaining the reasons for why certain things are done that way helpful. They will not change or learn otherwise. The agency won’t bother doing it.
But please don’t talk to the carers in a patronising manner or ‘tell them off’ - I’ve had that happen to me (undeserved I felt) & it just makes you resent the relative of the person you’re caring for.

I don’t think long nails are hygienic, we’re not allowed them in hospital, but I would just let that one go.
The outfit and tattoos are not relevant to be honest.

To encourage handwashing, you could place hand gel with pump tops in various places.

When I worked in reablement - very similar to care, but the aim is to support people towards independence rather than doing things for them - the log-in/out system involved a bar code on a piece of card that was supposed to stay with the client’s records in their home. The worker would scan the code when they went in, that registered what time they arrived, and again as they were leaving the property, so it was not possible to tamper with arrival/departure times.

On the whole, it was a good system, unless someone (usually the client or a family member) forgot what it was and threw it away, or on one memorable occasion got worried it was a device planted in their home to spy on them and cut it into a million pieces.

Hygiene is obviously important but I think the inform thing can depend on the client. I think my Mother would be more receptive to a carer in uniform as she would feel they were more professional and had status. Conversely casual comfortable clothes could put other clients more at ease but that doesn’t include an outfit you’d wear if you were pole dancing.

Clothes don’t care tattoos don’t care

try putting hand sanitiser around?
nails not great.

timing not ok

Im not sure about some of your post. 30 minutes is not very long to russell up a lunch. Maybe state ideas and leave a list.

Can you just ask for another carer?

It takes 5 minutes to make a sandwich or some crackers. They are only ever there 15 minutes at the most.
It’s a small house. There’s handwash and little towels specifically for the carers that are pointed out to them. They can use the kitchen sink or the bathroom to wash their hands. They just don’t bother. They usually come in with gloves already on so they’ve touched their car door, the key safe, keys, the gate and the door with those gloves. I’m a qualified nurse and did food hygiene when younger so hand hygiene is something that’s been drummed into me since being a teenager. Long nails were not permitted due to amount of bacteria nails harbour. I appreciate that some people don’t care much about hand hygiene, or other hygiene either going off some threads on here!

There is a pile of napkins and a selection of trays to choose from.

our local authority pays a private organisation to provide care. both have separate meetings with their elderly clients. what you say happens at yours would be unacceptable here.

if they did that to my mum i’d be looking into private care from someone decent. that’s awful.

Couldn't give a shit about what they wear or their nails.

Hands should be washed before prepping food obviously!
I don't butter bread for a salmon sandwich either
A drink should be provided and they should stay the correct amount of time
I would be speaking to them

Nails are massively relevant as long nails are an injury and hygiene risk.

Had awful experiences of carers. Dads stayed 2 minutes as dad said he was ok and had eaten....he hadn't. He couldn't get out of bed for two days and carers just shouted through letter box . Neighbours rang me in work . Worked and lived an hours drive away. Found him in bedroom . No food no water. Pee in every object he could reach. Gp refused to come out so called 999. He went into care home after that.
With mum..they lives separately.. out of date food cooked . No meds given (that was one of reasons she had carers) things went "missing"
When I came back from holiday found a bucket of water with skin on top that stunk. Mum had obviously not been eating. Social worker came out noticed how bad things were and was admitted to emergency care. The place mum lived in was sheltered accommodation and the warden worse than useless and a right cow. I reported her several times to no avail.

Unfortunately slap-dash seems the norm. In fairness, my parents had a couple of excellent carers but also others that weren't aware that baked beans should be heated. Giving my Mum very obviously mouldy bread was another highlight. And another couple who literally stayed 2 minutes for a half an hour call. I had cameras set up so I could see what went on. All wore gloves but not always uniform.
The theory of carers is good - the reality somewhat different.

I don't think carers generally wear a uniform. Clean clothing, short nails and gloves are vital. Not staying the full half hour not acceptable. Not washing hands... I would use a different agency. Appalling.

Can you request a direct payment and employ a PA?
No agency carers then

I’m her PA but can’t be there every day for meals.

If they do wear unifirm they have most likely paid them out of own pocket.

It's a low paid work and it's hard work. The work conditions are awful.

Nobody really wants to do it for a living.

Standard of carers won't change before people are educated bette and better paid for the job.

The carers are via social services. This is the third care agency they’ve tried and this has been the best one. The old manager just told me that they were trying their best to get the carers to do what they are supposed to do but with no luck. Surely you sack them if they can’t do the job?!

I have experience of both sides- my mom has a carer & my daughter works as one. Mom had a re-enablement package after a long stay in hospital and it was awful. Language & differences in culture were definitely a problem, nearly every carer didn’t speak English as a first language & struggled with prepping food how she liked it. They would often sit in the car for part of the 30 mins & come back in to scan the code! We ending up complaining about the agency after mom was burnt by them handing her a hot plate & her ending up back in hospital. She luckily has a lovely carer now who comes in every morning.
My daughter works for a more exclusive agency, where clients pay a lot more per hour for care. The app they have lists everything that needs to be done for each client within that time frame & if there’s time over she always asks them if they need anything else or just stays for a chat.
It’s unfortunate that the majority of carers aren’t in the job to help people. If you want a better service you need to pay a lot more.

Most of the things are a problem but tattoos are not going to affect the care of a client. I am funny about tattoos and don't particularly like them but it's certainly not my business if someone else has them and it doesn't affect how someone is cared for. The other things should be raised and evidence logged if the concerns are not addressed.