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Zero-hours contracts, 15-minute visits and neglected elderly people. This is the reality of care Zero-hours contracts, 15-minute visits and neglected elderly people. This is the reality of care
(6 months later)
Since 2009, Karen Lowry has been a care worker in her hometown. Out of the house at 6.30am to medicate, wash and feed elderly people in their home. Over the past three years, she has witnessed first hand what she describes to me as “the change”: outsourced care, neglect and cut corners.Since 2009, Karen Lowry has been a care worker in her hometown. Out of the house at 6.30am to medicate, wash and feed elderly people in their home. Over the past three years, she has witnessed first hand what she describes to me as “the change”: outsourced care, neglect and cut corners.
Related: Plans to hand control of £5bn benefit to councils 'could restrict older people's care'
“A lot of the elderly haven’t got a voice,” Lowry, 43, says. “But what’s going on… it’s disgusting. Someone needs to talk about it.”“A lot of the elderly haven’t got a voice,” Lowry, 43, says. “But what’s going on… it’s disgusting. Someone needs to talk about it.”
Karen Lowry is not her real name (she’s afraid of being identified) but – as the Conservatives gut £4.5bn from the sector – this is the disturbing reality of social care under austerity.Karen Lowry is not her real name (she’s afraid of being identified) but – as the Conservatives gut £4.5bn from the sector – this is the disturbing reality of social care under austerity.
To Lowry, “the clients” – often in their 80s or 90s – are “like my grandad or grandma”. She talks painstakingly about their needs – labelling each pill correctly, using medical equipment, logging relevant information – but, as budget cuts came in, the time for each call shrank: “There were more ‘15 minutes’ … Then they all were.To Lowry, “the clients” – often in their 80s or 90s – are “like my grandad or grandma”. She talks painstakingly about their needs – labelling each pill correctly, using medical equipment, logging relevant information – but, as budget cuts came in, the time for each call shrank: “There were more ‘15 minutes’ … Then they all were.
“It’s ‘take people to the toilet, do their medication, and give them something to eat – only something in a microwave or a sandwich. Every day. All in 15 minutes,” she says. “The elderly people put up with it. They’re scared it’ll get taken off them all together. A lot of them just need a chat – an extra five minutes to know someone’s there for them. You could see it on their faces as we left.”“It’s ‘take people to the toilet, do their medication, and give them something to eat – only something in a microwave or a sandwich. Every day. All in 15 minutes,” she says. “The elderly people put up with it. They’re scared it’ll get taken off them all together. A lot of them just need a chat – an extra five minutes to know someone’s there for them. You could see it on their faces as we left.”
Lowry says many clients with more complex medical needs – who previously had 30-minute calls – have had their longer slots cut without any form of assessment. “A lot of the carers spoke up and said ‘that won’t be enough’, but it didn’t seem to matter,” she says. “They needed to save money and they weren’t thinking about the 90-year-old who can’t really move. We’d beg our managers and supervisors for more time. The clients who needed it never got it.”Lowry says many clients with more complex medical needs – who previously had 30-minute calls – have had their longer slots cut without any form of assessment. “A lot of the carers spoke up and said ‘that won’t be enough’, but it didn’t seem to matter,” she says. “They needed to save money and they weren’t thinking about the 90-year-old who can’t really move. We’d beg our managers and supervisors for more time. The clients who needed it never got it.”
She tells me about one elderly man. For over 18 months, she tried to get his 15-minute slot extended. “He needed his catheter bag emptied, his medication marking off individually – that took about 10 minutes – and something to eat. We’d stay behind to feed him but not get paid,” she says. “He never got the extra time. His health’s deteriorated now. The less they could speak up for themselves, the less help they’d get.”She tells me about one elderly man. For over 18 months, she tried to get his 15-minute slot extended. “He needed his catheter bag emptied, his medication marking off individually – that took about 10 minutes – and something to eat. We’d stay behind to feed him but not get paid,” she says. “He never got the extra time. His health’s deteriorated now. The less they could speak up for themselves, the less help they’d get.”
In this climate, the name of the game becomes how to save cash, not how to careIn this climate, the name of the game becomes how to save cash, not how to care
She pauses. “Sometimes we haven’t had time to take them to the toilet. They were hungry so we had to feed them instead. I’d go back at the end of the day and they’d be sitting in their own mess. Their skin… it’s fragile, so it gets all sore.”She pauses. “Sometimes we haven’t had time to take them to the toilet. They were hungry so we had to feed them instead. I’d go back at the end of the day and they’d be sitting in their own mess. Their skin… it’s fragile, so it gets all sore.”
I speak to Lowry from her home in the north-east but she could just as easily be talking to me about Bradford, Leicester or London. Three-quarters of local authorities are now insisting on 15-minute visits to the elderly, ill and disabled people, according to recent Unison research.I speak to Lowry from her home in the north-east but she could just as easily be talking to me about Bradford, Leicester or London. Three-quarters of local authorities are now insisting on 15-minute visits to the elderly, ill and disabled people, according to recent Unison research.
The UK is heading towards the bottom of the OECD’s league table for spending on care as a proportion of GDP. Ambulance calls to the over-90s rocket while the government gets ready to transfer more responsibility to cash-strapped local councils – this time, control of a £5bn social care benefit. In this climate, the name of the game becomes how to save cash, not how to care: ever-cheaper private contracts, and a shift to short-term, insecure labour. 92% of all home care in England is now delivered by the private sector and, as Unison confirms, the vast majority of them deal in zero-hour contracts.The UK is heading towards the bottom of the OECD’s league table for spending on care as a proportion of GDP. Ambulance calls to the over-90s rocket while the government gets ready to transfer more responsibility to cash-strapped local councils – this time, control of a £5bn social care benefit. In this climate, the name of the game becomes how to save cash, not how to care: ever-cheaper private contracts, and a shift to short-term, insecure labour. 92% of all home care in England is now delivered by the private sector and, as Unison confirms, the vast majority of them deal in zero-hour contracts.
Lowry says that, at her council, she’s seen the result is simply that “a lot of the carers don’t care. Some of the care workers are the only ones in their family working. So the office will call saying ‘I’ve got five more for you’ and they fit them in regardless of whether an old lady needs something. But others… they’d throw tablets at them. Their clients were hungry and they’d ignore them. Everyone turned a blind eye.”Lowry says that, at her council, she’s seen the result is simply that “a lot of the carers don’t care. Some of the care workers are the only ones in their family working. So the office will call saying ‘I’ve got five more for you’ and they fit them in regardless of whether an old lady needs something. But others… they’d throw tablets at them. Their clients were hungry and they’d ignore them. Everyone turned a blind eye.”
Lowry, who has a diploma in healthcare for the elderly, has been on a zero-hour contract for the past five years and – like the clients – was expected to switch to whichever firm the council outsourced to. As she puts it, “the elderly get passed over and we do too.” In the hunt for savings, her council switched providers a number of times in the past seven years.Lowry, who has a diploma in healthcare for the elderly, has been on a zero-hour contract for the past five years and – like the clients – was expected to switch to whichever firm the council outsourced to. As she puts it, “the elderly get passed over and we do too.” In the hunt for savings, her council switched providers a number of times in the past seven years.
“The good company get the clients taken off them because [another company] puts in a cheaper bid,” she says. “The most recent was the worst firm [yet].”“The good company get the clients taken off them because [another company] puts in a cheaper bid,” she says. “The most recent was the worst firm [yet].”
Last summer, Lowry severely injured her back at work after one of her clients – a partially sighted elderly man – fell on her as she struggled with bags at the supermarket. She hasn’t recovered – she is still on a course of injections – and without a secure contract, last month, she was forced to leave. “I didn’t want to go,” she says. “I told them I was struggling but they didn’t care. The way they see it, carers are 10 a penny.”Last summer, Lowry severely injured her back at work after one of her clients – a partially sighted elderly man – fell on her as she struggled with bags at the supermarket. She hasn’t recovered – she is still on a course of injections – and without a secure contract, last month, she was forced to leave. “I didn’t want to go,” she says. “I told them I was struggling but they didn’t care. The way they see it, carers are 10 a penny.”
Lowry tells me she’s been worrying “every day” about the clients left behind. “I can’t make sure that they’re okay, that they’re getting enough care.” She starts to cry. “I wish the people who make the cuts would talk to us, would talk to the people [who need help]. They deserve a lot better. Enough’s enough.”Lowry tells me she’s been worrying “every day” about the clients left behind. “I can’t make sure that they’re okay, that they’re getting enough care.” She starts to cry. “I wish the people who make the cuts would talk to us, would talk to the people [who need help]. They deserve a lot better. Enough’s enough.”