Dire situation in UK social care for the elderly
1 December 2016
Age UK and the Alzheimer’s Society, charities supporting older people, have published reports describing the way older people are cared for as “shameful” and “scandalous.”
Figures suggest that the number of older people not getting necessary help from the authorities now stands at 1.2 million, rising by 48 percent since 2010. Age UK found that since 2010, there are 383,000 people aged 65 or over living with some level of unmet need.
Care in the UK is funded by individuals themselves or local councils, but there are increasing numbers of people reliant on family and friends to support them.
The 1.2 million seniors with insufficient assistance includes 696,500 who receive no help from paid carers, friends or family. A further 487,400 receive some help but not enough, due to help only being available at particular times of the day or their carers only being able to manage some tasks and not others.
Those older people who reported having unmet needs included 291,400 people who have difficulty with three or more essential tasks, including getting out of bed, going to the toilet, dressing and washing. Of this figure, 52,700 people receive no help at all. Overall, local authorities agreed to help just under half of the 6.6 million people who approached them for help.
Where care in the home was provided, there were serious problems identified as to the way patients with dementia were treated. Families of those cared for reported examples of poor care, including loved ones being left in dirty clothes for days at a time, not being given medication and residents going missing from homes due to lack of security.
Staff said they had not been given enough training to enable them to deal with people with complex needs.
The Care Quality Commission, the official inspection body that investigates standards of care, warned a month ago that the sector was at “tipping point.”
The lack of care is having a direct effect on public hospitals, which are experiencing more and more elderly people arriving at local accident and emergency departments needing help.
The day-to-day impact on people’s lives, including those who are carers, is mounting. The BBC identified 11 councils who had rejected more than 75 percent of applications for help. One example is that of Lorna Wheatley, from North Yorkshire, who has been trying to secure a nursing home place for her 82-year-old mother Celia. Speaking to the BBC, Wheatley said, “My mum can barely walk or look after herself, and the council says she only qualifies to live in sheltered housing. I’m terrified that without constant support, she could die.”
An Alzheimer’s Society investigation exposed serious shortfalls and a lack of training for home care staff working with people with dementia, leading to intolerable levels of stress for sufferers, family, carers and staff. The investigation utilised a survey of homecare workers and included a Freedom of Information (FOI) request sent to all local authorities in England. The survey included first-hand testimonies of 1,220 people directly affected by dementia.
The Alzheimer’s Society documented numerous failings in the system, including people not being provided with food or water, being left to sleep in wet or soiled bed sheets, not giving people baths or showers for weeks and people being left with infections that have led to emergency admissions to hospital.
Care workers are facing enormous pressures, with the adult social care budget cut by 40 percent since 2010.
The budget for training and the development of staff is usually the first to be cut. The FOI request showed that 71 percent of the local authorities that responded do not include money for training within their homecare contracts. Another 38 percent do not fund dementia training sessions for homecare providers.
The number of homecare workers who have had dementia training stands at 38 percent of the workforce, with 71 percent not receiving dementia training that is accredited. Fully 43 percent of homecare workers have asked for further dementia training, yet 54 percent of applications for training are turned down.
Linda Jackson, from Orpington in Kent, struggled to get good homecare for her father, Ken, who had Alzheimer’s disease. She said, “’Dad was challenging at times and I was told that some carers refused to come back and care for him. They simply didn’t know how to cope with his behaviour. He was distressed and worried, yet no one seemed equipped to look after him and give him the basic things he needed—food, medication, and comfort.”
She added, “Dad’s last year was a living hell and he was eventually sectioned under the Mental Health Act before dying six weeks later.”
Such accounts provide a shocking insight into the lives that many older people and their families endure each day, left struggling to manage tasks that are the most basic human functions and intrinsically connected to a person’s sense of dignity.
Those having to work with older people suffering with conditions such as dementia face enormous challenges in attempting to carry out their work. They are generally poorly paid and have to work 60 to 80 hours a week to make a living. A recent employment tribunal case, involving 17 care workers employed by the private contractor Sevacare in the north London borough of Haringey revealed that some of the staff were being paid £3.27 an hour. This is less than half the minimum wage. It is the largest-ever legal claim brought in the care sector. Sevacare, which last year raked in profits over more than £1 million, has contracts across England employing 5,500 care staff, providing care and support to 9,600 people a week.
According to the Unison trade union, some of those on £3.27 an hour were women, employed as live-in carers. They stayed for seven days a week at a time in the home of an elderly women with severe dementia. These carers were on duty 24 hours a day, sleeping on a bed next to the person they were looking after, attending to the woman’s needs throughout the night.
One carer likened the experience to being “in prison”, saying they were not allowed to leave the house all week. Workers were also not being paid for the time they spent travelling between home visits. One of the careers, Florence Wambulu, said she worked seven days a week in order to make sure she could pay her bills and look after her family. “They have to treat us like human beings, not just someone who is there to make money for them,” Wambulu said, adding, “We were working like slaves.”
Last year, whistle-blower Gillian Demet resigned from her job as a care worker at Sevacar because she was only allowed to spend 15 minutes at a time on visits with frail pensioners.
The care of older people in privately-run care homes, and their own homes, has been increasingly outsourced to the private sector under Conservative and Labour governments. Labour-run councils throughout the UK routinely offer contracts to private companies to provide care. The intolerable conditions outlined by the charities are inhumane. For those being cared for, and the workers tasked with looking after them. They are both exploited by a system that sees them, first and last, as a source of profit.