YOU ring on the door bell and the stop clock starts.
On the other side is a frail vulnerable woman that might need feeding and taking to the toilet.
As a carer you have just 15 minutes to be in and out, before rushing on to your next call. What would be going through your mind?
Colette Hemstritch-Johnston, the managing director of TrueCare (New Forest) Ltd, knows the answer.
She has shunned new per minute billing contracts Hampshire County Council has rolled out as she believes high quality of care cannot be provided at the flat rates offered for such short visits.
And she has questioned how a 15 minute slot is long enough to prepare a meal and dish it up, let alone offer the vital pastoral care a visit from a carer brings many lonely and isolated elderly
The Daily Echo, backed by charities and campaigners for the elderly, has called for Hampshire councils to commit to giving the elderly the dignity of at least 30 minutes of care during visits to
their own homes.
Both the county council and Southampton City Council commission just 15 minutes of care from private firms for some frail and disabled
pensioners still living at home in a bid to save money.
Other councils have a minimum half-hour period, for example Bristol and Gloucestershire.
Ms Hemstritch-Johnston, whose firm covers the Waterside and is one of the few three-star providers in the area, said the family of one client who has a 15-minute lunch call provided by the council
was also paying her privately for another 15 minutes.
She said while her company does provide 15 minutes calls, they are strictly restricted to safety checks, reminders to take medication or to fix a drink.
A quarter of an hour may also be enough time to toilet someone, depending on the mobility of the client, she said.
But Ms Hemstritch-Johnston insists preparing a meal in that time would mean using a microwave, putting the food on a plate and rushing it out to leave the elderly client alone to eat.
“This this is not what care should be about,” she said. “To provide care to the elderly it is more than task driven.
“For a lunchtime call to work properly a minimum of 30 minutes is needed.
“This enables the carer to go in and greet the client, make sure that they are OK, prepare a microwave meal, dish up, wipe surfaces, communicate with the client, make a drink and possibly leave a
further drink for that client.
“There are lots of issues with leaving clients alone to eat especially those with dementia who have a tendency to wander and forget to eat.
“Above all a majority of these clients are living alone and the friendly face of a carer is all they see from one visit to the next or one day to the next. The social interactive is very important
to ensure the well being of the elderly."
Ms Hemstritch-Johnston claimed some elderly clients were buying microwaves to accommodate fleeting visits, rather than having a more nutritious and tasty hot cooked meal.
She said she welcomed the monitoring of calls to address attendance problems – including carers missing visits – but she questioned the savings proposed by Hampshire County Council. Ms Hemstritch-Johnston said the new lower flat rates could drive down standards as wages and training costs are squeezed.
Hampshire County Council aims to save £3.2m a year by only paying for the care that is delivered, and is rolling out electronic monitoring of the time when private agency carers start and end home
The council says the new system of clocking-in by phoning from the homes of each elderly person they visit, will cost around £700,000 over three years to implement.
Councillor Alan Dowden, Liberal Democrat opposition spokesman on adult care services, has called for a £2.1m underspend, due to be reported to Tory county council leaders on Monday, to be used to
extend the time of visits to include more pastoral care.
Hampshire County Council says only one in seven of its home care visits last 15 minutes.
Executive member for adult social care councillor Felicity Hindson said care packages were agreed by everyone involved before suitable care is commissioned.
She said: “The £2.1m Cllr Dowden mentions refers to a one off sum that has already been committed to other projects.
“Moving to a half hour minimum visit would be an ongoing cost, assuming agencies have sufficient staff or are able to recruit to cover the additional care time.
“Visits for 15 minutes could include checking someone has taken their medication, checking a client has not fallen, putting something in the microwave or helping a client to the toilet, taking into
consideration the client may not wish to have a longer visit.”
She said 15 minutes was sufficient for these tasks and said the new hourly rates paid to care providers for services between 7am and 10pm were “reasonable” given scarce public resources.
Cllr Hindson added she wanted to look at working with some of the 100 good neighbour groups in the county to provide extra companionship time to those elderly people who wanted it.
Southampton City Council has been commissioning 15-minute slots for years but insists its priority is to provide ”good quality care to support people to
stay in their homes.
Both councils said most home care calls are 30 minutes or longer to provide personal care such as washing and dressing.