Forum

15minute care visits

Hiya!

Just seen an article on BBC news re care.

It was about some care visits lasting just 15 minutes. It referred to clients sometimes having to choose between having a cup of tea or a trip to the loo!

Has it come to this? The government say 15 mins calls should stop, as it isnt long enough.

Well the agencies which deliver care, say not enough money is paid to clients to pay for longer visits.

I know my morning carer often runs over the 1.25 hourly visit. That time is to cover, getting me up, onto the commode, into the shower, washed, dried, dressed and attending to my spc wound, which needs careful attention.

1.25 hr may sound a lot…in my former life, I could have done all that (no wound care) in 15 minutes.

Us less able folk simply cannot rush…ANYTHING…I often get flummoxed if I try to rush.

There was a chap featured who has MS. His name is Richard Stapeley. Are you a memeber here, Richard?

What`s your experiences of care everyone?

luv POllx

Hiya Poll. Hope you are doing ok.

I saw that article Poll.

Having worked in the NHS for 12 years my experience is cut back after cut back after cut back. Doctors, nurses, social workers, healthcare assistants etc etc leaving and not being replaced. How the poor carers can cram everything into a 15min visit is beyond me. And they earn a pittance too.

I hear they are asking for voluntary redundancies now (believe it or not). Absolutely ridiculous. The workers aren’t coping at the moment with the amount of work they have to get through, let alone with less staff. Yet another government blunder in my eyes.

Sorry to rant but this has been a grudge of mine for 5 years now.

Shazzie xx

Blimey, that is crazy… I’m relatively ‘able’ at the moment but that still means lots of planning. So I have no idea how 15 mins is enough.

To leave the house in the morning means straight in the bathroom for a wash then the faffing about that is getting dressed - it takes me ages (seriously, I have managed to fall over so many times just putting my knickers on) so there’s a lot of sitting down, standing up and sitting down again and I generally lay out my clothes the night before. I have ditched anything with buttons that are too difficult and lots of my work clothes are now of the button free variety.

I have loved the warmer weather in that respect, as am now cursing about socks and zipping up boots etc.

My husband will usually have brought tea up by this point as I can’t carry it up. Make-up is now mascara only and hair is brushed and put in a pony tail is anything scary has happened to it overnight!

And then I have to go to the loo and this can take between 2 and 10 mins depending if my bladder is ignoring me or not - there’s no way I can chance a 45min car journey without going!

So I’ve managed to cut down my getting ready from half an hour to about 15 mins by cutting out full make-up etc, but net efffect is actually zero, it takes me 30 mins now from rising to readying myself to leave the house…on a really good day I might have a pee before I wash and not fall/trip whist getting dressed and actually manage to do it quite quickly - I have absolutely no flaming idea how that could be quicker with someone else helping… and I haven’t even told you what my evenings are like!

Poll, I think it’s crazy. I think you get my drift, we run everything in our house now on convenience. M&S/tesco are my heroes as it means my poor hubby doesn’t have to do everything from scratch as I usually have to sit pretty still by evening!

Sonia x

Not something I’ve experienced, as yet, but living alone with a degenerative disease, as I do, it does make me worry deeply about what the next ten or twenty years may hold.

I would prefer assistance to remain in my own home, over institutional care, but if that might mean as little as 15 minutes contact from someone who doesn’t give a damn - partly because they’ve never had time to know me as a person - I’d probably be better off somewhere permanently staffed. Then you read all these horror stories about abuse in care homes, and at home - physical and emotional, and stealing money and the like. I’m left wondering if anywhere is safe, for an elderly or disabled person. Short of having the place wired up with webcams! But then I’d need one of the younger generation to monitor them for me. I only have my nephews, whom I rarely see. Not sure they’ll be interested in some batty old disabled auntie, when they’re grown-up and have families of their own.

Tina

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I’m with you there Tina. Very worrying.

If they can’t cope now then how the hell are they gonna cope in 10 - 20yrs time.

Shazzie x

I work for social services and we do half hours and one hour calls…some agencies have a 20mins travel,time in this too. For some this works for some it does. People that only need a medication prompt the half hour is plenty and in some cases we would like to ony have to commission 15mims as often if its only medication they are in and out within 10ins. We also have the problem that if people have savings they really don’t want longer calls than necessary as they’ll have to pay for it! However it does depend on the individual case as some people 15mins is def not enough and care should be about providing everything they need. So I do agree too. See the bad and good in all care and the way its provided! Xxx

Feel that I need to add to this discussion also. I did not see the article but will try and get to it. I am a social worker and am involved in arranging people’s care. The care that is organised is usually arranged in multiples of 15 min calls however Some agencies now do a minimal 30 min calls now. The 15 min calls that I have commissioned are for check calls, toileting and meals/med prompts etc. (singular events and not all together) if it was prompt with meals and toileting it would go up to 30 min for example. This commissioning and any changes would be with consultation with the person it involves. When the care package is put in place it is expected to meet the needs of the individuals. However in time people’s needs often change and the care package should change as well. (In theory) The care agency and the person who the package is intended for needs to let social care know that things have changed, if they need an increase in care. There are things such as direct payments where the local authority pay you to commission your own care. They may say, for example, that after the assessment you will be given £400 to organise your own care, and with that money you decide how it is spent. That may sound a lot but it is not when it comes to care and you may have to make compromises. But it is essential that a good assessment is done in the first instance taking into account all care needs to maximise the money that is agreed as being the direct payment. However the local authority is not an endless pit of money and there have been cuts and there are to be some more. There may be an amount of money they will be prepared to spend on an individual before they say the cannot provide this level of care in the community. But before they get to this other funding sources should have been looked at such as the NHS continuing care to see if they will contribute to the persons care. Increasingly local authorities are looking at more joint funding arrangements. Some people who have savings over a certain level have to pay ‘full cost’ and they choose to make do with a 15 min call as a way of preserving their savings. When we talk about savings we are not talking about collataral in a house. Certainly the careers are rushed, time slots on a rota going from house to house. If someone needs extra time on an occasion it makes them late for their next client etc etc. Some people will no doubt experience carers who they take a dislike to, or visa versa and there are people who experience theft etc and they are people out there who love their carers as if it was their daughters or sons, who regularly go the extra mile for them. There are people who would take advantage of others situation in all professions. There are safeguarding procedures for those unfortunate to experience them. Just going back to the first point made about having to decide about toileting and a cup of tea, I would suggest that this care time was not correct and needed changing. However it could also be about a person who needs assistance with toileting who would also like to sit with the carer and have a cup of tea. Maybe because the have not seen anyone all day, carer looks tired, they have no other visitors and no one to talk to etc etc. making sure that someone is hydrated during the day would be part of the care plan. Stopping for a chat may not be part of the carers roll, this would be met through community groups, befriending etc…you would expect that the care would talk throughout his or her intervention. I keep writing more and terrified of deleting it all by mistake. Social care, for the time that I have been working in there, 11 years, is changing all the time, assessment have changed and will continue to change. Care planning and commissioning also, assessment being self assessments, client focused, thinking outside of the box, walking in the clients shoes, task centered, person centered etc etc the list goes on. Good care starts with a good assessment, a good care agency and regular reviews. More assertiveness from the person who is using the service and or a amly member usually helps also. Yvette

Yvette couldn’t have said it better myself. I am a review assessment and support officer, what was once upon a time unqualified social workers or social work assistants. I do what you do and agree with your post alot. We have agencies that are a minimum 30mins however often some calls really do not need to be that and 15mins is plenty. I’m all for direct payments as it’s much more flexible too xxxx

Well said Yvette. I just hope when the time comes that I need care at home that I’m assessed properly. I thought I’d be lost when I had to stop working but realise that everything takes so much longer now, even a pee as I sometimes have to catheterise afterwards to empty properly and with constipation etc which is most common in people who are unwell or infirm 15 minutes are not really helpful all the time. Never mind showering, dressing etc, I wonder how I ever found time to work.

Take care

Min x

Thanks Yvette and Lisalou for what you do. We do appreciate you. Just wish you got more support.

Shazzie xx

Thankyou everyone for your interesting replies.

I have a few comments on certain replies;

Tina, just one comment on your reply;

you said care given by someone who doesnt give a damn``…whilst there will be some carers who are like that, I know a lot more who do care, deeply, about their clients. I`ve not taken your comment to heart, but just wanted to give my opinion hun.

Shazzie, as a dedicated NHS worker, you saw the cuts first hand and it cut you deeply to see this happening.

Yvette, your reply is well received, but may I tell you what happened when I asked for an increase in care hours?

A social worker came and I told her why I would like more care. She said she couldnt just put in my request without doing a full new assessment. She told me what the previous social worker had written about me…it was badly wrong and i was upset about what he`d written

eg.he said I only showered once a week…hell fire, if that was the case, I`d be stinking and lousy!

He also said I needed help 3 times a week with my post, as I found it difficult to deal with…good heavens! I never even mentioned my post…I can deal with it and if i couldnt my fully compus mentos hubby would do it.

Then the social worker said if I applied for extra help, I may get a reduction in what I already had. She left me feeling as if I would never dare ask for more help ever again!

This is a worrying situation, as my condition is still progressing and sometimes hubby is in so much pain from his RA, that we literally muddle along and get quite upset with each other.

I use Direct Payments to fund my care and value every single penny/minute of it. I have a daily morning carer, who is self employed. She gives me 1.25hr. a day. That leaves another 22.75 hours in a day for hubby to look after me. My toilet trips regularly last around 45 - 60 minutes. I also get 8 hours a week and a sleepover once a week, from 2 other carers. this gives my hubby a break from me.

Yvette, I know you and other social workers work damned hard to ensure us vulnerable folk are taken care off. The cuts will continue, whilst you do your best.

i know we are fortunate to get what we already get and I know there are people who struggle more than we do and get less help.

Just my own perception and I hope no-one is offended by my words.

luv Pollx

Totally agree with you Poll.

The colleagues I worked with before I took ill health retirement at 51 were absolute angels and worked way past their finish time to make sure everyone were seen. A lot of these colleagues were social workers and district nurses. I get regular visits from these people who are my friends and they keep me up to date with all the cuts and extra work that is thrown at them.

Sounds like you have had some bad social workers Poll. Bet you were blowing your top when you read all that stuff about you showering once a week and needing help with your post. What a load of rubbish.

Shazzie xx

Poll there’s a difference between workers and that social worker blackmailed you. I’ve increased packages massively sometimes if there’s a need and most competent workers would do the same. One of the priorities is carers and supporting them. Yrs cuts are bekbg made but that doesn’t mean people are left struggling well in ny work ut doesn’t. Xxxx

Yes it sounds like the previous social worker has not completed their assessment fully. if you have a shower every day like the most of us that is what should have been out down and assessed for. All assessment must be shared and if you disagree with what has been out down you need to say so. If indeed it has been shared with you. The finished assessment should be left with you. Some assessments are quite rigid, tick boxes for example and does not allow the writer to put down what is necessary, but that is not the person who the assessment is about fault. A social worker is usually in a difficult place between pleasing the local authority (working knowing of the budget cuts, how many call per day is the usual norm etc) and what is right for the person. Funding also has been more readily available for younger people. But an Act came in in October 2012(equality Act I think) which says that the same amount of funding should be available for younger and older 65 plus people. I don’t know what age group you are in. I don’t know what to say about what the social worker said, but saying that it is true. Some people can be assessed and their hours reduced, say for example if the carers were no longer helping them to dress etc and spend 45 min chatting, or their hours could be reduced for example from 45 min to 30 min as the lady was doing more for herself. But it should not be said, if it is said in a way to reduce the chance of an assessment being requested. However, if you feel that your situation has not go better and that you need more support you need to ask for it. The local authority have to also consider the carer, if this is your husband/partner. Have you had a continuing healthcare checklist, or a DST (decision support tool) speak to your district nurse if not. It may be that you could have another assessment which would look at the joint funding arrangement with the NHS and the local authority. This essentially could reduce the local authority bill and in which case may be able to increase your care even more. However the above is subject to your abilities being at a certain level. Abilities go into 13 domains and each are scored from no need to severe need. Things like continence, mobility, cognition, behaviour, skin integrity, medication, emotional health and psychological, nutrition, altered states of consciousness etc…I can’t remember any more.!! Anyway, if you ask for another assessment if I could help in any way jugs leg me know. X Yvette x

That is supposed to read JUST LET me know

Thankyou Yvette. If I do find the courage to ask for more help, I will keep your advice to hand.

luv Pollx

Hi Poll,

Just to clarify, I didn’t mean to tar ALL carers with the same brush. I know there are some good ones out there. But I should have made the link more explicitly between these very short, “flying” visits, and the problem of carers not caring. Caring only builds up when you know the person; you have some sort of relationship with them. If it’s increasingly the case that “care” is made up of these very fleeting visits, how can that relationship ever form? There isn’t time! Doesn’t it make it more likely the person will just be viewed as someone who needs to be washed and weed in the shortest possible time, and not as an individual, with a personality, likes and dislikes, and the right to dignity and respect? They might end up just as a task to be ticked - someone the carer has never really talked to, or got to know, because the allocated time doesn’t allow it.

Tina

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