We’re lucky. Really lucky. We have a wonderful local carer (take a bow Lorna!) who comes in every weekday morning to get Dad breakfasted, washed, dressed and up and about. Dad enjoys her company and it’s time out for me. Winners all round.
Lorna is paid through the Self-Directed Support Scheme (SDS). Under SDS our family is given money by the local Council Social Work Department (or Health and Social Care Partnership as it is now) to employ our own carer. The carer can be of our own choosing and for the hours that we want (within our designated budget). It’s designed to be flexible, responsive to the individual’s needs and to put the individual and their family in control. In principle, it’s a sound idea – but there’s one major flaw.
Carers like Lorna are as rare as hen’s teeth.
At least, they are here in Aberdeenshire. There are no doubt many factors at stake here, but one stands out for me. Let me illustrate with a typical advert I saw last week in our local paper.
Personal Assistants Wanted
To help elderly lady in in her own home with personal care and mealtimes.
Weekdays: 9.00am – 10.30am
5.00pm – 6.30pm
Weekends: 9.00 am – 10.30am
5.00pm – 6.30pm
10.30pm – 11.30pm (flexible).
Even with two or three Personal Assistants to share it out, that’s one might awkward shift pattern. You could easily be travelling back and forth to the same house two or three times a day. That might just work for you if you live five minutes down the road, but in rural Aberdeenshire that’s not terribly likely.
To make matters worse, carers here don’t get any allowance for travel time or expenses (at least, our carer doesn’t, so I’m assuming that applies Council-wide). This makes travelling back and forth to the same work site more than once a day financially difficult, as well as personally inconvenient.
I believe some councils in Scotland help carers with travel, but surely that should be standard across the board? I’m pretty sure other community-based healthcare workers (such as GPs or community nurses) get help with travel expenses - local and national politicians certainly do. So why should carers, who don’t exactly get paid a fortune to start with, be expected to pay it out of their own pocket?
Add that on to the responsibilities of lone working and I’m not so much surprised that they struggle to find good carers; I’m surprised they get anybody.
You can come up with the most wonderful scheme and put in place all the systems you like, but if you can’t find the carers then frankly, it’s screwed.
But Council’s can’t afford it, I hear you cry. There’s no arguing that the current social care bill is eye wateringly large (approx. £3bn was spent by Scottish Social Services Departments on social care in 2010/11 according to Audit Scotland). It’s pretty certain that sum has increased since then and is only set to increase further with our ageing demographic.
But we have to recognise that not fixing our social care system (however we choose to fund it, and that’s a whole other blog post or twelve) also carries big costs.
Lack of decent available care puts considerable strain on individuals and their family carers, leading to it’s own health problems and more calls on NHS services. It leaves more people stuck in hospital beds, unable to return home (or even to a care home), which racks up huge costs. And it puts strain onto care managers and care providers, who are trying to meet demand whilst managing the costs of recruiting and training a workforce with a high staff turnover.
I think being a carer is a massively important and worthwhile job, but when I look at the conditions that home carers have to work under, I’m pretty sure I wouldn’t do it. Fortunately for us, our wonderful Lorna doesn’t think the same.
It’s just a pity there aren’t enough Lornas to go round.