Homecare Campaign Public Meeting

Save our homecare services!

Speakers and discussion.

Gilmerton

7pm Wednesday 27th  October 2010

The Hub, Gilmerton New Church;

Ravenscroft Street, Gilmerton.

Rushed carers going back to finish duties in own time

Edinburgh Evening News

Published Date: 18 February 2010

By GEMMA FRASER

UNDER-pressure carers have claimed they are being forced to go back to patients’ homes in their own time because they no longer have enough time during the day.

Unions and care workers today said that the allocated time slots given to them were too short to carry out all the duties required in elderly people’s homes – including administering medication.

They said carers often had to return to homes at the end of their shifts to finish tasks they should have had time to do earlier.

The Evening News revealed on Tuesday how home helps claimed they no longer had enough time to prepare a freshly-cooked hot meal for old people after the time they could spend with each person was cut from an hour to 30 minutes.

Now it has emerged that even the 15-minute medication slots are too short as carers are being given more responsibilities.

Marlyn Tweedie, Unison’s health and social care spokeswoman, said that previously pharmacists would prepare all medication for patients in a dosette box and carers would simply have to administer the pills, which were already measured out.

However, she said pharmacists were increasingly unable to take on the extra workload and carers were being left to work out the dosage of medication and dispense it themselves, without being given any more time to do it.

Ms Tweedie said: “Carers are having to do more medical tasks which is more time-consuming, especially as it can include putting in eye drops or creams.

“Some of the elderly can be on 15 or 16 tablets which again takes a lot of time to give them all out.

“Carers’ workloads have virtually doubled, with 14 or 15 people on a schedule whereas before they would have about eight.

“What Unison is saying repeatedly is that the amount of tasks are impossible to do in the amount of time given and this impacts on staff health and wellbeing and service delivery.”

Ms Tweedie added that unexpected “emergencies” can often take place when a carer arrives at an elderly person’s home, which takes them away from their normal duties.

She said: “You can get to somebody’s house and they have fallen and you have to deal with that.

“More often than not if you phone up to ask for someone to cover your next job, the organiser doesn’t have anybody so sometimes people are doing it in their own time.”

The time which carers can spend in each home was scaled back in 2007 as part of a money-saving shake-up of home care provision.

One Edinburgh carer, who asked to remain anonymous, said there were frequently problems with the time slots for both preparing meals for elderly people and administering medication.

She said: “We do report it and sometimes we are allowed longer but not always.

“More often than not we either run late, putting stress on other carers, or even go back on our own time for which we can be sacked.

“It will get worse but its going to take some poor soul to get malnutrition through us not being able to check they’ve actually eaten before someone does something.”

David Griffiths, chief executive of ECAS – a city-based group supporting disabled people – added: “It’s very unfair for the carers, as well as the cared for, to be put in a position where they are not finishing a job to the standards they wish and but they have to leave.”

A council spokesman said only 1.7 per cent of home care packages in the last year have involved visits of 15 minutes and that if staff were having problems they should report that to their manager.

He added: “The administering of medication is one part of a very important but usually wider care package that delivers a broad range of support, normally over several hours.

“The level of support needed varies from one person to the next with some requiring only a reminder to take medicines and others needing more help.

“We have very robust procedures in place and our staff get full training to ensure that this important task is carried out safely.”

Home helps forced to give OAPs cold food

FROM EDINBURGH EVENING NEWS – 16TH FEB

HOME helps who used to cook hot food for elderly people in Edinburgh now only have time to leave cold sandwiches and microwave meals.

Previous council cutbacks mean that the carers are able to spend just 30 minutes in each home instead of an hour.

And critics say that means that once they have attended to an elderly person’s other needs, there is no time left to prepare a meal.
Labour’s Leith councillor Gordon Munro said he was shocked to find one of his constituents being left a piece of bread, a yoghurt, a cheese sandwich, and a microwaveable macaroni cheese to survive on for the day.

He said: “It is increasingly happening because home helps are restricted to half an hour and in some cases it’s taking all this time just to get people up and dressed. It exposes the sham that half an hour is enough time to do everything.

“Before they would have time to make a pan of soup or another hot meal but they can’t do that anymore because they’ve only got half an hour and there’s not enough time to do everything.

“The nutritional value of these meals hasn’t been worked out because the home helps are just throwing together what there is in the person’s house.

“This doesn’t surprise me because I think the time allocated is inadequate for home helps to actually get people up, washed, dressed and cook them a proper meal.

“They have got to gauge what the most important thing to do for the person is, and I certainly wouldn’t want to be in that position, making that kind of judgement. Basically the choice is between making sure the person is dressed in warm clothing and is presentable or preparing a meal for them.”

The time which home helps can spend in each home was scaled back in 2007 as part of a money-saving shake-up of home care provision.

One health and social care insider said home helps used to have time to make meals such as omelettes or stew, but now it seems that microwave meals were being increasingly accepted as a suitable alternative.

She said: “They don’t have time to even make porridge now.

“The director’s guidance is that they get one hot meal a day, but that is a frozen meal re-heated in the microwave. Microwave meals have always had their place but there should be some variety along with that. For people to have the only hot meal they are given in a day as a microwave meal is not acceptable.”

City council bosses agreed that the case of Councillor Munro’s constituent was not acceptable but insisted half an hour was long enough to prepare a decent meal.

A spokesman said: “There should be no reason why a meal like this is served as half an hour is plenty of time for a healthy and nutritious meal to be prepared and the council has expert dieticians who can advise on achieving this balance.

Report from Council Meeting 17th December

As happened last year, there were several deputations to Edinburgh Council the Thurs. before Xmas.

This year there were deputations on the primary school closures  – Fort; Burdiehouse; Drumbrae; Royston  (I think)

Also on the closures of 4 of the creche facillities at swimming pools

And Unison and Unite spoke of the difficulties; deterioration in service etc if the Council chose what is euphemistically called “Alternative business models”  i.e. code for more privatisation.

Homecare was also being discussed. The Council were being asked to approve a document which would only have one third of what is called “complex care” provided by in- house.

Previously – as I understood – all complex care would be in-house as well as Re-able ( service-users get a re-able service for 6 weeks and then it goes to the private sector)

This proposal seems to me to be worse  i.e. more rather than less to the private sector.

I’m not sure from the document if the proportion of private/public is still 75%/25%.

Dread that it might be more.

Anyway the deputations were all impressive  – well researched; intelligently put; etc.

I’ll give a brief outline of Homecare dep. and the questions and responses.

Outlined the experience of the campaign  – through staff; the public; service-users etc. that there is consistent evidence of staff not turning up; being continuously late; not knowing what the tasks were.

e.g. one carer from a private agency had 3 visits scheduled for 9.30pm

An example was read out of one service-users experience over 3 – 4 weeks which involved day after day of simply not getting it right resulting in the person concerned not getting up; not being cared for while her husband became more and more stressed.

Points were made that co.’s know how to tender- they write what’s needed to “tick the boxes”  and it’s only when they fail that they may not get the contract renewed but in the meantime how much have vulnerable people suffered?

The Labour group had an earlier amendment  for 45% in house and 55% private but this was defeated. It would have represented a considerable improvement in 25% in house  75% private.

This Council, it was pointed out, run a real risk of allowing the private sector to dictate the terms and up their prices in the years to come.

Councillors were reminded that it was that generation of elderly who fought so hard for our welfare state  – from which we’ve all benefitted who are now being denied basic dignified care. They can no longer fight. We have to pick up the baton.Our Council has to make a stand.

Questions;  Councillor Eadie -  Was  the campaign aware that the Labour Admin. group started this process?  This is factually wrong. The Homecare campaign started in Nov. ’07 following a document from the Director of Health and Social Care which spoke of the 75%/25% split; spoke of “maximising 30 min slots;” spoke of “only 1 hot meal a day  – frozen meal re-heated  in 30 mins”

That was 6 months after the SNP/ LD coalition was formed!

He also made the point that these concerns should be taken to the Homecare Modernisation Board.

The campaign will – and would take these concerns there – there’s no objection in principle  – but there is the matter of demands on time given work; Trade Union demands etc.

And they have been taken  – like a stuck record – to various forums.

Where the concerns are taken is surely not the issue.

Question   Not sure who asked this  – one of the Liberal Democrat Councillors I think.  Anyway the gist was that Unison ; the campaign; was decrying their fellow members in the voluntary sector.

The answer given was, alas, not sharp enough. This from a Council that was on the brink  – and may still – tender out the voluntary sector!

Our fight is not with voluntary sector organisations. To our knowledge, organisations like Penumbra; The Action Group; Garvald; Link have not got contracts to provide domiciliary care for the elderly and disabled that was formerly provided by Social Care workers and Home Helps.

We’ve not heard of them. We hear of organisations like Carewatch; Advantage; Call in Homecare etc. i.e. private businesses  – some small (and some of the smaller ones have a good reputation); some large.

The Labour group asked re. a survey which clearly showed service-users preference for the in- house service. It was helpful to be able to provide information.

Deputation was worthwhile. The campaign needs to continue voicing it’s experience and challenging the ideas that everything’s fine and people are being well cared for.

Next campaign meeting  Wed. 13th Jan. ’10     6pm     City Chambers

All welcome

From Edinburgh Evening News

Care homes ‘put patients at risk’ with feeding tube stance

Published Date: 06 January 2010

By John von Radowitz

CARE homes were accused today of putting elderly and infirm patients at risk by forcing them to be fitted with feeding tubes.

Many homes are said to be closing their doors to patients who do not have “nil by mouth” tubes inserted into their stomachs.

Although they claim to be acting in patients’ interests, the motive may be to cut costs and save on staffing, say the authors of a Royal College of Physicians report.
The disclosure came as the college issued guidelines urging doctors and nurses to view artificial feeding as a “last resort”.

An audit of 719 PEG procedures published in 2004 found 19 per cent were “futile” and did nothing to prolong life.

The finding suggests large numbers of patients are being fed “nil by mouth” inappropriately.

A 2008 survey showed in the previous year, 39,000 people in the UK were artificially fed outside hospital, either at home or in residential care.

Dr Rodney Burnham, who co-chaired the working party that produced the guidelines, said increasing numbers of care homes were refusing to take patients not fitted with feeding tubes.

“We come down very strongly on any blanket refusal on those grounds,” he said. “They may cite patient safety but there could be a hidden agenda on grounds of staffing or costs.”

He was unable to say what proportion of homes imposed the PEG rule, but added: “It is fairly widespread, because every hospital and every nutrition team you talk to will have had that experience.”

PEG procedures were invasive and involved a significant element of risk, he said. Death rates of patients given PEG tubes were 6 per cent on average after 30 days and in some cases as high as 30 per cent. Nearly a third of patients suffered ill-effects.

Professor John Saunders, from Nevil Hall Hospital in Abergavenny, who co-chaired the working group, said: “I think if a patient is not in a position to make that decision and tube feeding is futile, it is unethical on a legal basis.”

The professional guidance was issued against a background of 39 per cent of hospital in-patients in the UK being malnourished.

Feeding by mouth was recognised as essential to quality of life, and worth preserving even when a patient had difficulty swallowing.

“Nil by mouth should be a last resort,” said the report.

A Department of Health spokesman said: “The use of intrusive interventions, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative’s agreement.”

PUBLIC MEETING 7PM WED 25TH NOV PORTOBELLO

Old Parish Church, Bellfield Street.

Speakers John Murdoch – disabled activist and a speaker from UNISON

Edinburgh’s Save Our Homecare Services Campaign will holding a public meeting in Portobello as we continue to fight against the Council’s cost cutting and privatisation agenda that has left some of Edinburgh’s most vunerable citizens at risk. As the City of Edinburgh continues its drive to privatise 75% of homecare services and moves to extend service cuts to those with learning disabilities and mental health conditions we continue to recieve reports of the devastating effects on service users. These include elderly people having to go with inadequate food as support slots are cut to 15mins and an increase in medication and meals getting missed altogether as low cost private care companies frequently fall short of care standards.
Please attend this public meeting and get involved in the campaign.
Remember, most of us will experience old age or disability at some stage in our lives. We need to act now to defend services before its too late.

COUNCIL ADMINISTRATION SUFFERS FIRST EVER DEFEAT AS SOCIAL CARE SERVICE-USERS CLAIM VICTORY

“People power” yesterday forced City of Edinburgh Council to suspend its plan “to sell 777 of the city’s most vulnerable residents to the lowest bidder.” Hundreds packed into the City Chambers on 19 November as the Council voted to suspend till 3rd December its plan to remove Care and Support services from existing local providers.

A support worker from SWAN stated “It was a great victory but now we have a busy two weeks ahead until the next decision day of 3rd December. ” The Finance and Resources Committee meets at 10am that day to decide the future of hundreds of people with serious mental and physical disabilities.

Carers and service users condemned the Council’s money-saving plan as a drastic attack on the quality of life for such people with learning disabilities, physical disabilities, mental health conditions and hearing impairments. Many of those directly under attack participated in the lobby wearing “I’m not for sale” T shirts.

Deputation after deputation denounced the sell-off to the full Council meeting.
“My daughter is profoundly handicapped. She can’t talk or walk. She’s incontinent. She’s in a wheelchair, she has fits. When we take her to the Doctor she screams in pain, and we have to try and work out what’s wrong, she can’t tell us. She needs trained professionals to care for her. We are very pleased with the care she’s getting now. You can’t pull people off the streets on the minimum wage and expect them to care for people with these kinds of disabilities.” said a speaker from Share Scotland

This and other contributions were met with loud applause from the packed public gallery and the equally packed overflow room, where an estimated 300 people avidly followed the proceedings through loudspeakers.

 

 

NO CHOICE NO CARE

One support worker in attendance said:
“The company that stands to win the biggest contract if this tendering process is allowed to go ahead is Choices Care. They pay their staff £6.05 per hour. There is no way you can retain good, dedicated, qualified staff over a long period of time if the role of support worker is devalued to barely above minimum wage. This would be disastrous for us and the people we support”.

Ian Hood from Learning Disability Alliance Scotland pointed out that Companies who had won the Council contracts had been rated by the Care Commission as “barely adequate” and “must improve”.

A user of learning disability services stated in a letter to LibDem councillor Jim Lowrie:
“I want my staff to keep on working with me. Don’t make them go away. Leave the staff alone and let them get on with their work”.

Edinburgh Support Workers Action Network : ” The Council’s proposal aims to wipe out several local voluntary sector organisations that provide good quality specialised services and replace them wth 8 companies, the biggest winners being low cost, large scale private companies with questionable track records (one was the subject of a Panorama documentary entitled Britain’s Homecare Scandal.)”

“What’s proposed is a cut of over 30%. The contracts awarded mean a cut of 21%, then the companies concerned will take at least another 10% profits on top of that.” explained the speaker from SHARE Scotland.

DIRECT PAYMENTS DENIED

People who need care have a legal right to “Direct Payments” to enable them to pay for the kind of care that they choose themselves.  But the City of Edinburgh Council has been refusing to pay out these Direct Payments, to try and force people into the arms of the profit-driven winners of the tendering process.

The outrage at this policy has now forced the Council to partially back down. The amendment passed at today’s Council meeting declares that the Council will now process Direct Payments applications.

But the crucial question of the level of payments that they will pay has still to be decided. competitive tender bids” it has received.

WHAT DOES THE COUNCIL DECISION MEAN?

Learning Disability Alliance Scotland summarised the main points of the successful amendment passed yesterday as:
* 2 weeks for another report
* Major issues on the direct payments to be addressed
* Other councillors like Lesley Hinds will be critically involved in directing officials.
* No guarantees but there will be more options.

The amendment was backed in the Council meeting by Labour, the Greens, and the Conservatives, and with Liberal Democrat counsellor Gary Peacock abstaining due to financial interest, this proved enough to outvote the ruling Liberal Democrat – SNP coalition and inflict their first defeat since taking power 2 ½ years ago.

 

ACT NOW

Edinburgh Support Worker Action Network declare:
“The Council was not so worried about cutting costs when it bailed out its “arms length” property companies to the tune of £70 million.

We have to make them change their priorities.

Otherwise, in years to come, we will be watching TV documentaries, reading newspaper articles about how appalling these services have become, how they are wrecking lives, as has been the case in care of the elderly in many places.

And we will wonder how this was allowed to happen.

We must act now before it’s too late.”

Edinburgh Support Workers Action Network
http://www.swanedinburgh.org.uk/ swanedinburgh@yahoo.co.uk

Learning Disability Alliance Scotland http://www.ldascotland.org/

Edinburgh Homecare Campaign http://edinburghhomecarecampaign.wordpress.com/

Full text of the amendment agreed at the Council meeting on 19 November at http://www.ldascotland.org/

Edinburgh Social Care Protest – Wed 11th Nov

PROTEST THE TENDERING OF SOCIAL CARE SERVICES AND THE BLOCKING OF DIRECT PAYMENTS

DEMONSTRATE 4.30PM,
WEDNESDAY 11TH NOVEMBER
CITY CHAMBERS,
HIGH STREET EDINBURGH

Join Edinburgh Support Workers Action Network, the Learning Disability Alliance and the Save our Homecare Services Campaign in calling on Edinburgh Council to;

- Stop blocking Direct Payments to social care service-users

- Guarantee funding at a reasonable level that allows service-user choice

- Stop the selling off of vital services to low cost private companies through its
competitive tendering process

PUBLIC MEETING 7PM WED 25TH NOV PORTOBELLO

Old Parish Church, Bellfield Street.

Speakers John Murdoch – disabled activist and a speaker from UNISON

Edinburgh’s Save Our Homecare Services Campaign will holding a public meeting in Portobello as we continue to fight against the Council’s cost cutting and privatisation agenda that has left some of Edinburgh’s most vunerable citizens at risk. As the City of Edinburgh continues its drive to privatise 75% of homecare services and moves to extend service cuts to those with learning disabilities and mental health conditions we continue to recieve reports of the devastating effects on service users. These include elderly people having to go with inadequate food as support slots are cut to 15mins and an increase in medication and meals getting missed altogether as low cost private care companies frequently fall short of care standards.
Please attend this public meeting and get involved in the campaign.
Remember, most of us will experience old age or disability at some stage in our lives. We need to act now to defend services before its too late.

Defend the care of Our Elderly and Disabled

Cuts and privatisation put Edinburgh’s most vulnerable at risk

Two years ago Edinburgh council announced its intention to privatise 75% of its homecare services. Since then agencies have been bidding for services with those that can provide them cheapest winning contracts.

A public campaign against this disgrace was set up 2 years ago.

What do the cuts and privatisation mean?

Elderly and disabled citizens are not receiving adequate care.

Care slots have been slashed to 30 minute visits. This is not enough to manage the tasks of getting up, washing, dressing, breakfast, medicine etc. Service users are only provided with one hot meal per day – a microwaved frozen meal.

The impact of these policies is that care has plummeted while conditions and pay for staff, especially those employed by agencies, are terrible – long hours, low pay, far too many people to care for on a shift with inadequate training.

Service-users are frequently missed and/or don’t receive proper care. He have heard of cases where elderly people have been left for one or two days without food or medication.

Staff describe the tasks and pressure as hellish, exhausting and unbearable.

Most of us will face disability and/or old age at some time in our lives and will depend on these services.

What can you do?

Get in touch with the public campaign opposing the trashing of care for vulnerable citizens. Everyone is welcome.

If you’re interested please phone 078111 85610