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Echo probes council moves to measure care for the elderly and vulnerable by the minute
CARE of the elderly is being measured by the MINUTE in Hampshire in a bid to save millions of pounds, the Daily Echo can reveal.
Both the county council and Southampton City Council commission just 15 minutes of care for some frail pensioners still living at home, including dementia sufferers.
And in that brief time, carers may be required to feed disabled OAPs and take them to the toilet.
The county council has introduced a new electronic monitoring system which precisely times when agency carers start and end home visits.
It will allow per-minute billing for care when fully implemented and help save Tory council chiefs an estimated £3.2m a year by only paying companies for care that is actually delivered.
But the UK Homecare Association is alarmed and says the council’s attempts to save money could lead to “rushed and undignified” services.
And David Watt, chief executive of Southampton-based Nobilis Homecare, has claimed the home care system is now at “breaking point” in Hampshire.
Today the Daily Echo can also reveal: n How the county council has driven-down the price it pays for care.
n Carers are not paid much above the minimum wage of £6.08 per hour.
n Staff shortages have led to carers missing visits and distressed pensioners left home alone.
n The new electronic monitoring system – costing £400,000 a year – has been beset with problems and is delayed.
Currently the county council spends about £60m on home care for 9,600 elderly people. It, like Southampton, commissions private agencies to provide care.
Though it saved £4.9m in 2011-12 by paying less for care, county chiefs claim the “efficiency savings” have no impact on the elderly as they receive the same service for a lower price.
But our investigation raises questions about the ability of companies to pay much above the minimum wage and carers having to clock-watch rather than focus on the person needing care.
Mr Watt, a board member of Hampshire Domiciliary Care Providers Association, said: “The big issue for these providers is the council’s prices do not allow adequate pay and allowances for carers and they are now at a stage where recruitment and retention is a serious issue.”
He added: “I really do appreciate that councils are under budget pressures but quality care does not come at bargain basement prices.”
The home care agency is among those commissioned by Hampshire County Council to provide care for pensioners across the county.
As previously reported, inspectors voiced serious concerns about staff shortages, carers missing visits, distressed pensioners left alone, lack of training and supervision.
But the agency pointed the finger at Hampshire County Council – and its new contract.
In a statement the company said: “Difficulties include price reduction and the gradual reduction in the average length of visits.
All this has been exacerbated by the attempted implementation of an electronic monitoring without robust project planning.”
So why has the new system been introduced – and what do councils say?
Before it introduced the new contract, the county paid more than 200 companies a wide range of different hourly rates – and council bosses said there did not appear to be any strong link between the prices paid and quality of care.
In Winchester, rates ranged from £11.40 an hour to £23.58.
The council has capped the new rate at £15.80 while in Eastleigh, the figure is £14 and the Waterside £13.80.
The council also stopped paying higher rates for part-hour visits which helped cover travel between appointments and for weekend and bank holiday working.
Companies were asked to bid to be included on the council’s “panel of preferred providers” (PPP) with the threat of no work if they didn’t.
Critics say this forced many to slash their prices.
Most agencies don’t pay staff to work in shifts but only for contact hours with clients.
In addition, carers don’t usually get paid travelling time or any gaps between appointments. This can reduce earnings to below the statutory minimum wage.
Mr Watt said: “The zero or pitiful rates of mileage paid by some are also a big burden on care workers who have to fund travel costs out of these low wages.
“People get paid more to stack supermarket shelves.”
Meanwhile, it’s the council which assesses the care people need.
Hampshire and Southampton City Council commission 15-minute slots but other councils have a minimum half-hour period, for example Bristol and Gloucestershire.
In fact, a national report by the Equality and Human Rights Commission last summer found some people in the UK had to choose between being washed or being fed because visits from home helps are so brief.
Colin Angel, policy director of United Kingdom Homecare Association, said: “We are increasingly concerned about the shortening length of time that councils are purchasing care for people in their own homes. While attempting to save money, councils risk services becoming rushed and undignified for older and disabled people.”
But Hampshire County Council said only 14 per cent of visits it commissioned were 15 minutes and this figure had not increased on the previous year.
Most calls are 30 minutes or longer to provide personal care such as washing and dressing.
A council spokesman said: “For some people, 15 minutes is perfectly adequate, for example, when people just need reminding to take medication in the middle of the day.”
Labour-run Southampton City Council, which does not have an electronic monitoring system, was unable to provide figures for the percentage of homecare visits that were 15 minutes.
The council was asked but did not respond to a question on how any quality of care could be provided in a quarter of an hour.
Councillor Matthew Stevens, chief of adult services, said: “The city is working hard to provide the best quality care despite the cost squeeze on care put in place by the previous Tory administration.”
But Councillor Alan Dowden, Liberal Democrat opposition spokesman for adult social care on Hampshire County Council, is calling for county chiefs to extend the minimum period of care.
Cllr Dowden, who recently spent the day with a home care agency in Test Valley, said: “Many clients were happy with the care they received except some felt it was all too quick and rushed.
“Sometimes the carer is the only person an elderly person will see all day and most carers would like the opportunity to make them a cup of tea, sit and just chat for a few minutes.”
But Cllr Dowden said he supported electronic monitoring as it showed if visits had been missed, safeguarding the vulnerable.
The county picked up the bill for the system which cost on average £400,000 a year plus £100,000 start-up costs.
But there have been problems and Hampshire Domiciliary Care Providers Association has warned the council of major cash losses to independent providers and “possible bankcruptcies.”
Now the roll-out of the system has been delayed – and the council savings have not yet materialised.
The county council has defended driving down the cost of home care, saying all independent agencies it used had been evaluated to determine their suitability and prices had factored in training, minimum wage and travel.
Councillor Felicity Hindson, executive member for adult services, denied the elderly had been put at risk of neglect by the cost-cutting.
She said: “Hampshire County Council’s adult services department takes safeguarding very seriously and as such we have a panel of preferred providers to ensure that the care we commission is of the highest quality.”
Cllr Hindson said the council worked closely with the Care Quality Commission and companies to resolve any problems identified, providing support and training.
The Tory council chief added: “The new domiciliary care system is set to save £3.2m by reducing administration and through paying only for care that is actually delivered.
“It enables us to be sure that users have had a proper visit and will offer reassurance to families.”
Care of the elderly remains a huge challenge as councils grapple with the twin problems of an ageing population and the need to cut public expenditure.
Indeed the number of people aged 75-plus in Hampshire is expected to reach 134,000 by 2017.
Yet cuts in public funding saw the county council lose 14 per cent of its government grant last year and a further ten per cent in 2012-13.