Yesterday, I went to visit a service user that I’ve been working with for a good while. Mrs K has Alzheimer’s at a fairly advanced stage and has and continues to be well supported in her home.
She currently receives a care package via the local authority and is fortunate enough to have had the same care worker coming to see her for about 18 months. That’s quite rare. There is a relatively high turnover of care staff.
I have met her care worker numerous times and we’ve chatted at frequent intervals – not least because Mrs K can’t get to the door to answer it so I time my visits to periods I know the care worker will be there to ensure access.
Yesterday, we had a chat as we waited for Mrs K to join us. I knew she (the care worker) had switched agencies recently when the council had retendered it’s care services and the previous agency she had been with had lost its contract. She moved to another agency so as to maintain the caring role with Mrs K (and other service users that she sees). She also told me the new systems in place have cut her pay by about £1 an hour. She is not paid for travel and it is becoming difficult for her to maintain this way of working. It’s not quite minimum wage but it isn’t far off. And this is in central London.
There is a push toward quality care and dignity being provided for service users (quite rightly of course) but noone is willing to pay the price for quality care and dignity for care staff. The local authorities are pushing agencies to drive down the prices of contracts and the agencies, increasingly, are peopled by those who are more distant from the hands-on care role and to them, someone who has 15 years experience is simply more expensive than someone who is new to the job.
This, for me, is the problem of delivering quality care. Quality care costs. Noone wants to admit it. There is no reward for loyalty or delivering high quality to the users of services. There are simply more checks and controls. Care staff have to ‘clock in’ and ‘clock out’ of homes by phoning in. No payment is made at all for ‘no answer’ visits, despite the travel time being completed.
Simply, how can you expect people to deliver a service that should be based upon dignity if they are afforded no dignity themselves as employees. I know many care staff who struggle massively with their own consciences because they feel they cannot maintain the ways of working that are being asked of them but they feel a responsibility to the service users whom they can build relationships up with over time. It is the agencies that take advantage of this to maintain low pay and poor working conditions and the local authorities are often complicit by demanding ever lower costings.
At a time when funding for adult services is coming into focus, noone wants to accept the fact that a quality service that everyone deserves regardless of their ability to pay – will cost more.
But it will.