BASW pledges support to Leonard Cheshire Disability 15 minute care campaign
As new research from charity Leonard Cheshire Disability shows the public agree that the practice of restricting care visits to elderly and disabled people to just 15 minutes is unacceptable, BASW has pledged its support for the campaign and called on local authorities to reconsider current commissioning models.
BASW has previously said that 15 minute care is only satisfactory if the visit is to dispense medication or a quick check to see if somebody is alright. If intimate personal care is being delivered, more time is needed if the person is to be treated with care and dignity.
Commenting on the publication of the Ending 15-Minute Care research from Leonard Cheshire Disability, BASW manager Ruth Cartwright said: “Many people have an extremely high level of need. It is not enough to say that family, friends and neighbours should be helping. They are often already helping where they can, but many people would not want people who are close to them to have to see them being helped to use the toilet or be cleaned.
“The current model of commissioning services also needs to change. Home care services require enormous amounts of flexibility. Assessments of need can only ever be approximate. To say someone needs 15 minutes care in a morning to get them dressed (and of course everyone wants to be dressed between 8am and 9am) and not allow for things going wrong is a recipe for disaster.
“Employed carers are often exploited and encouraged to skimp on tasks by their employers. They are often paid below the minimum wage, not paid travel time or allowed realistic time to travel between clients so can be tempted to leave early. The majority of these staff are good and caring and frustrated by way they're expected to work.
“There are also so many examples of ridiculous contracts where anything up to 20 home care companies have a contract to cover an area.
“Huge inefficiencies have been built into the contracting system by home care workers criss-crossing each other, travelling large distances to get to service users who may have a worker from a different agency supporting someone next door.”
“The current system is close to collapse and we urge local authorities to heed this research and have sensible discussions about adequate funding so our most vulnerable people do not continue to endure perfunctory care and disrespect.”
So, what next?
1. The theoretical models of commissioning that are now operating in commissioning need to be examined. Are models being used that are not fit for purpose, such as models that see the purchase of home care as the same as purchasing paper clips?
2. Best practice models – which includes learning from the private sector as to how they manage supply and demand need to be looked at. This needs to include ethical commissioning because the key people who deliver home care are the front line staff and if the nature of the contracts are such that they don’t feel valued and supported then this has serious consequences for the delivery of quality care.
3. Providers need to be involved in developing commissioning, with local authority purchasers at the macro and micro level. They have very substantial experience built up over many years as to how to make home care work, or not work.
4. There needs to be engagement with people who receive home care services to rediscover the partnership model of home care that used to exist between the local authority and the individual. Put simply, many users of home care services understood that it was impossible for them to have everything that they wanted when they wanted, because there would be people who were in greater need than they were. The agreement being that when they had a greater need that they would get the help that they needed – an insurance model.
5. Home care workers need more say in solving the logistical problems. They used to work out with service users what would work and would share the difficulties that they had of not being able to be in two places at once. Now home care staff are treated as automata who have to do what they are told.