Home care: Cuts and outsourcing equal abuse

Two Socialist Party members – a disabled activist and a support worker – explain the effects of cuts, outsourcing and ‘personalisation’ of care budgets.

In response to new CCTV film footage of an older disabled person being neglected, given to the BBC by her family, Lib Dem care minister Norman Lamb, said: “It’s just shocking and depressing because this is neglect in your own home.”

Any right-thinking person would share this sentiment and support his observation: “In a way you’re almost at your most vulnerable when it’s behind a closed door, it’s you and a care worker and potentially poor things, dreadful things can happen in those circumstances.”

Part of the CCTV footage shows Muriel Price, 83, from Blackpool, stuck in bed trying to contact her domiciliary care agency, family and neighbours after a care worker failed to turn up for an 8am visit.

For many years I was in a similar situation to Muriel where I did not have the funding for overnight support.

The most difficult part was managing retention of urine. I was not incontinent so had to adopt strategies such as limiting fluid intake two hours before bed.

Muriel, who now lives in residential care, should have had someone with her day and night.

While disabled people have an individual right to an assessment of need and services to meet that need, legal judgements from the 90s known as ‘Barry’ and ‘Kirklees’ allow councils to consider their financial resources when meeting need.

Under funding

Under the 1997-2010 New Labour governments existing rights withered, and under-funded councils were receptive to some very negative policy developments, even before the Con-Dems’ cuts.

The real downside is how these policies manifest themselves in people’s lives, even more so with the latest cuts and privatisation.

Muriel was expected to go to bed at 8pm for twelve hours with a number of visits by care workers during the morning, afternoon and evening.

Because of her incontinence she had to use ‘incontinence pads’. Manufacturers advise they should be changed when somebody soils themselves, not many hours later.

If urine and faeces are contained against the skin they quickly raise its alkalinity, sometimes giving rise to what is termed Incontinence Associated Dermatitis.

The practice of keeping people immobile in bed for half the day is also callous because it significantly raises the risk of a person getting a pressure sore, and once present this is very hard to get rid of and life-changing in a very negative way.

Muriel was able to reflect on her experience because she now lives in a residential care home.

For many thousands of disabled people who have lived independently for years this scenario would be the ultimate neglect and mistreatment, but this will be the reality for a growing number if the Independent Living Fund closes and the tens of billions of pounds needed to properly fund care in the community and personal assistance are not secured.

For this to happen, the ‘age of austerity’ must be stopped.

The Socialist Party calls for:

  • No cuts in benefits, jobs, pay and public services
  • Decent levels of care staffing with full training – falling short of this counts as abuse
  • No ‘zero hour’ contracts – a genuinely living wage, guaranteed hours and employment rights for all care workers
  • No privatisation or outsourcing of services. Take back in-house all privatised and ‘tertiary sector’ services
  • A living wage and provision of respite for all family carers
  • Provide free health and social care services to all who need them
  • Stop using children and family members as a substitute for professional services
  • A united anti-cuts movement involving disabled people and carers’ organisations, trade unions and the anti-cuts movement
  • For a 24-hour general strike as the next step in the campaign to defeat all the cuts
  • For a socialist society that puts the needs of the millions before the profits of the millionaires

Little charity shown towards tertiary-sector care users and workers

Up until a few weeks ago I worked as a support worker with disability charity Scope, founded in 1951 with the aim of improving the lives of people with Cerebral Palsy.

Since then the charity has developed to support people with different disabilities and complex needs.

Like many charities and not for profit organisations, Scope has been awarded contracts by local authorities to provide care and support in the community and some residential and education settings.

I applied to work there as Scope had a good reputation. But the interview informed me I’d have a zero-hour contract (sadly, not at all uncommon within social care), but I was reassured that there were plenty of hours to pick up.

The hourly rate was low, £6.40 an hour, but I needed to work and I was just starting out in care so I took the job.

On my first day I had an induction. I assumed this would take all day and I would receive some introductory training.

But the induction was moved from the morning to the afternoon. When I arrived, I was given forms to fill out with my bank details and a copy was taken of my P45. I then had my photograph taken for my ID badge, and that was it!

On my first three visits, I shadowed more experienced members of staff. But after this very short introduction I was left alone with some clients, with no manual handling, CPR or any other training.

It was a full four months before I received such training. Yet, just two months into the role, new recruits were shadowing me!

I wasn’t even being paid for every hour that I was in work as I could only claim back up to £4.50 a day to cover transport costs when more than one visit to clients took place.

So I could work for eleven hours but only be paid for nine. The only breaks I got within my working day were the travel time.

This time was tight, I would not even have time to pop to the toilet, let alone rest or have food.

Hours cut

To begin with, my weekly hours were fairly decent – 30 on average. But due to changes in the needs of clients and some moving to personal budgets, my hours were reduced drastically.

The local authority seemed to look for any excuse to reduce the money provided to pay for the clients’ care.

The clients’ were given a number of hours support a month, the local authority then decided that a month should be 28 days.

Most months have 30-31 days; any visits to clients’ that were scheduled to be in day 29-31 of a month were then cancelled.

This not only impacted the vulnerable clients, but I would lose up to three days’ pay a month.

Whenever I booked annual leave, I was asked to arrange with the client to give the owed hours at a later date, usually on one of my rest days.

Often there was no one available to cover for me, as we were always short staffed. When cover was arranged, it would often fall through at the last minute.

Scope’s current tag line is ‘Scope to…’ In my experience it has been ‘Scope to pay poor wages’, ‘Scope to give inadequate training’ and ‘Scope to not give employees a rest break’.

Scope is charged with caring for some of the most vulnerable people in society, yet they cannot even treat their employees fairly.