Home care

Carers UK member Margaret Gilmour lives in Bolton, Lancashire, and cared for her mother in her own home. Her mother died in January 2006, just a few weeks before her 100th birthday. Here Margaret tells us why she wants to see a national plan for improving home care services.

Until home care services are radically improved and redesigned, there will be no benefit from all the well-meaning campaigns to help carers improve their lives. Without enough properly trained help available, carers have neither the time nor the energy to do many ordinary things that non-carers take for granted.

Why spend money running stress-busting sessions or better health campaigns for carers? Why not use that money to improve home care services, so that carers' stress levels and health can become better naturally? If more people are to be cared for at home, there needs to be a new, properly thought out, fully-funded nationwide training, recruitment and operating plan for home care services. This is needed now.

Stretched

Existing home care services are fully stretched. They are kept going largely by the goodwill of staff. Pay is poor, and there is no real career structure. Beacuse of the often long and unsocial hours and the travelling involved, staff turnover is high. Home care staff are largely unsupported and are dealing with increasingly complex care needs.

At present, the cart is before the horse, with home care staff out doing the job, usually alone, while studying in theor spare time for a vocational qualification. This is like giving a potential nurse some basic training for a few days, then sending them out to be a district nurse, with no firm base of knowledge or experience. Surely home care should include working in residential care before going out to people at home?

Outcry

The recent creation of the new grade of assistant practitioner health worker may help. However, these staff will be paid more than existing home care workers. So unless local budgets are increased, the already inadequate number of home care hours will drop even further.

Four visits a day from home care might sound a lot but it simply scratches the surface of care needs. Large numbers of vulnerable older or disabled people are currently left alone for long periods every day and night. If children were left alone like this, there would be a national outcry. Caring is about being there, as well as doing the practical tasks.

Understudy

We need reorganisation of how home care staff are used. My idea is that carers should have a nominated understudy, preferably two or three. These understudies would learn the carer's routines - all of them, as carers can't pick and choose what tasks to do. The understudies would then supply regular, planned periods of care, giving both carer and cared-for confidence in the service, and time off for the carer. They would have the necessary all-round experience to be able to deal with an emergency, such as a carer's illness.

Without a properly coordinated and funded national strategy for training and deploying home care staff, the future will be bleak, both for carers and for the many who need care in the community and who have no family or friends for support. Carers and cared-for deserve better. The whole home care situation needs urgent action. Do other carers agree?