Clients left 'heartbroken' by overhaul in delivery of local homecare

Carers in the North Derry area claim an overhaul in the delivery of local homecare, which is set to come into effect next week, has left local clients 'heartbroken'.

The new homecare rota system, which is co-ordinated by the Western Health and Social Care Trust, will commence in the Dungiven and Limavady areas on Monday, September 5.

The Trust established the Homecare Optimisation project in 2019 as part of its Delivering Value strategic priority.

They say the objective of the project is to optimise domiciliary care services on a Trustwide basis ensuring a 'safe, effective, accessible and affordable service'.

They hope it will help to stabilise domiciliary care services and also address emerging pressures within the sector, in particular workforce planning.

The project was 'successfully' introduced in the Enniskillen and Irvinestown localities earlier this year, according to the Trust.

Carers, who contacted Derry Now, claim the changes to their rotas mean they have been assigned new clients and have less time to spend with them during their visits.

They say the shake-up has not only upset staff but also their clients, who they say are expected to be informed of the changes by letter this week.

One carer said the service users are distressed about the prospect of having to get to know a new carer.

“Hardly any of our original clients are on our rotas, it's nearly all brand new clients. Our original clients are used to us now and for them to start and build up that trust with a new carer will take some time and will obviously leave them distressed,” said the carer, who prefered not to be named.

The carer claims that they were informed by management not to tell clients about the upcoming changes.

“The clients have not officially been informed but the Trust are sending letters to them this week to tell them about the proposed changes,” continued the carer.

“They (Western Trust) told us not to be telling the clients this information but I felt they should know.

“It's the clients who are going to suffer because of this. Some of them are really heartbroken about this news and they don't know how they are going to cope. When one of my clients found out she sat crying all weekend. They had to get her neighbours to come in and sit with her to console her.

“Another client's wife suffers from mental health problems and when carers first came into her husband it took him four months before he trusted us enough to let us wash him. His wife is so upset to learn that his carers are now going to be changed, she's done nothing but cry since.”

The carer also claims that more service users have been added to their rota with people who have since passed away or moved into a care home also being included in their calls.

“Most of the girls were doing nine or ten calls per shift but now they will be doing 16 to 18 calls per shift,” continued the carer.

“They have added more clients into the new rotas and have even put people on them that have passed away and other clients that have gone into nursing homes more than 18 months ago.

“The times they have been allocated per client has also been cut. The majority have been cut to just 20 mins per client and that includes your travel time. That means if I'm with a client for 8am, I have to be with my next client at 8.20am. Within that time frame I am expected to put on PPE, wash and dress the client, maybe empty a commode, tidy the bathroom, make them their breakfast and get them their medication. If it's a male client I would have to shave them in that time too. By the time I would get my PPE on and get the client to the edge of the bed ten minutes will already have passed.

“The time has been halved essentially. It used to be 40 mins per client and now it's just cut in half. No two clients are the same and some do require more time than others.”

Another carer, who spoke to Derry Now says night carers will now be expected to drive up to 50 miles per shift due to 'poor planning'.

The carer said: “One of the carers I know has her first call in Drumsurn at 7pm where she has to get her client washed and into their nightclothes and is expected to be at her next call in Gortnaghey by 7.20pm. She is then supposed to return back to Drumsurn for her next call and then to Drum and back to Drumsurn again for her last call. It works out at 50 miles or so. The rotas have not been distributed right. Some carers are doing seven to eight miles per shift while others are doing 50 miles per shift. There has been no communication or consultation between the carer and management.”

The carer has also claimed that agency carers have had work taken off them by the Trust resulting in staff losing their jobs.

“Calls have been taken off the independent sector and some of those girls working for the independent agencies have now lost their jobs as a result. Why should these people have to lose their jobs? One of the girls who has been put on her notice was crying the other day when she found out and is now wondering how she's going to be able to pay her mortgage.”

The carer continued: “I would love to know how much it has cost the NHS to set this up?

“We are getting little more than the minimum wage - £10.19 per hour. We have been fighting for the last six years to get moved to Band 3 pay. Carers in other Trusts are on Band 3 so why make a difference with us?

“They call this change in rota 'Operation Delivering Value in the Community' – who's it value for because it certainly isn't the client?”

The carers have now called on the Trust to stall their plans to introduce the new rotas and have appealed for them to consult with the staff.

“We want to get it stalled so the Western Trust can get the rotas sorted out the way we want them. All we ask is that they consult with us. It's not just one carer's rota we are talking about here, it's a lot,” said the carer.

“Why don't the managers in the Trust come out on a shift with us and see what we are actually doing and see if they could do it within a 20 minute window.”

Responding to the carers' claims, a spokesperson for the Western Health and Social Care Trust (Western Trust) said: “The Trust’s Homecare Optimisation Project Team continues to engage with all stakeholders to ensure a smooth transition to the new and improved service arrangements which come in to effect on 5 September 2022.

“The Project Team working in partnership with Social Work colleagues are liaising closely with affected individuals and providers to ensure any disruption is appropriately addressed.  It is important to note that service users will not have a reduction in services.

The Spokesperson continued: “We would advise any staff that have concerns to raise these with their Line Manager in the first instance.

“Additional service users have been allocated to rotas where it is evident that there is existing capacity to accommodate these calls.  Draft rotas were recently shared with staff as part of a validation process for the purpose of ensuring that there were no anomalies prior to implementation.  This quality assurance process highlighted a very small number of adjustments that needed to be made to the rotas.  These rotas have been amended to reflect these changes.  This validation process will continue up to and beyond the implementation date to accommodate any adjustments that need to be made.

“The times allocated to service users reflect the actual time required to undertake the designated tasks and to cover travel between calls. 

“The changes in the Limavady area affect the Trust’s in-house service and the three independent sector homecare providers that the Trust contracts with in the area.  The Trust has worked positively with these providers on a partnership basis.  The Trust has not been made aware of any potential job losses as a result of these changes and has a contingency arrangement in place to ensure that there is sufficient staffing in place to meet existing and future demand across the Limavady locality and beyond.

“The changes to Limavady homecare services were originally planned to take place in November 2021.  Implementation was deferred on two occasions due to operational challenges and Covid-19 pressures.  There has been ongoing engagement with staff throughout this time period.

“The Trust will monitor these changes closely and will provide support necessary to address any issues that emerge.”