Which? exposes failings in home care systemShocking examples of poor care of older people 

16 March 2012

A Which? investigation has exposed shocking examples of poor home care of vulnerable people, suggesting a system that is at breaking point.

Which? asked 30 older people to keep diaries during one week in January. These diaries showed a distressed older lady left in the dark, unable to see her food or drink, a man's vital diabetic medication forgotten and rushing careworkers.

See what else we found in our video: 
 

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Video transcript

Mum is in distress when I arrive and she's in the dark. No light put on. can't see her sandwiches to eat them and hasn't touched her drink so she can't see those either. I can't express how angry I feel at the carers There's a printed note on the front door about putting the light on at 4 p.m. As well as a note from me in the kitchen beside the Care Book.

It's also in the Care Plan. What more can I do? And it isn't the first time. Mum tried to phone me but she couldn't see [xx] instead of kind man. He was so distressed at mum's distress that he rang the police, thinking that mum had fallen. The police first tracked down my phone number, but I was already with mum.

I say to the policewoman that the only way to be sure you're loved one is cared for and safe is to watch over them 24 hours a day and never have home or residential care. the agency totally missed a day just after Christmas when they'd entered the days we did not need care incorrectly into their database.

I covered but unfortunately mom did not contact me til early evening by which time she needed a lot of cleaning [xx] You wonder about the elderly with no relatives. There are times when my dad who's diabetic hasn't had his insulation on time which is vital medication patient. When I voiced my concerns to the care agency, I was told to find another agency.

When Which? investigated the quality of care given to vulnerable people in their own homes We found some examples of excellent service, but we found many disturbing ones too. We uncovered a worrying level, missed and rushed visits. Leaving elderly people without the support they and their families need.

We don't get paid for our traveling time anymore so it's rush, rush, rush. the time I spent travelling is taken from each customer. Fifteen minutes used to be check calls or to give medication. Now we've got to microwave a meal, empty commode and travel to the next person in that time as well. It's an impossible ask.

we're under a huge amount of pressure to find savings, and it's increasingly difficult not to have a negative impact on service delivery. Our margins are so that we have no spare capacity to provide support for carriers on call if things go wrong. Are we really offering quality of life to people now assessed as needing home care.

I think what's missing is an honest debate. As people stay at home for longer and are frailer, the relative risks get higher. In of the cases we saw, vulnerable people only received a decent level of service after repeated complaints. This isn't right or fair The human impact of a failing care system goes largely unseen will be all too easy for the next missed visit, the next forgotten medication or the next care worker rushing through.

to be the cause of the next human tragedy.

Safety concerns

Our experts analysed the diaries alongside a survey of 926 Which? Connect Panel members (January 2012). 

They were concerned that, as people are living at home with increasingly complex care needs, safety is being jeopardised by poorly managed care.

However, they did also see some excellent care, showing how it can be done.

Complaints

In many cases, respondents' diaries showed that a good service was only received after making complaints. 

One daughter said that improvement came after 'continuous phone calls' and a 'constant battle' with the agency. But many receiving care are reluctant or afraid to complain. 

One survey respondent told us: 'My mother wouldn't hear of me complaining because she was frightened.'

The home care system

Which? also interviewed key stakeholders in the home care system, including commissioning managers, home care managers and careworkers.

Commissioning managers told us of the huge pressure to make savings and the difficulty in not compromising on service delivery. 

Home care managers spoke of tightening margins and the struggle to maintain a quality service, while careworkers described bearing the brunt of increased responsibilities and low pay.

Missed visits

The human impact of this system is of great concern, and problems can take their toll on family members, too. 

One daughter told us:  'They [the agency] missed a day just after Christmas. They incorrectly entered into the database the days we didn't need care. I covered, but Mum didn't contact me until early evening by which time she needed a lot of cleaning up.' 

Our survey showed that 47% of respondents reported a missed visit in the past six months, and 62% of these were not warned in advance.

Action needed

Which? executive director Richard Lloyd says: 'The Government can no longer claim to be shocked as report after report highlights the pitiful state of care for older people. 

'If they are serious about ensuring vulnerable people are treated with dignity, then we must see real action because every day they delay is another day older people risk being neglected.'

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