‘They don’t care about us’ - domiciliary care user

The row over the Western Health and Social Care Trust’s implementation of major domiciliary care changes in Derry’s cityside shows no sign of subsiding.

Service users were informed about the changes, which came into effect this morning (Monday, March 10), in a letter from the Trust’s director of community and older people’s services.

Described by The Trust as the “Homecare Optimisation” element of its “Delivering Value strategic policy”, the changes were labelled a “cost cutting exercise” by one service user who added they demonstrated a “complete lack of respect for the dignity, circumstances and in some cases age for service users”.

The letter also advised any family members of service users concerned about the changes in domiciliary care, to speak to their social worker.

The Derry News has been contacted by a woman caring for her husband who has a dementia diagnosis, who is strongly contradicting this.

The woman, who wished to remain anonomous said: “I am caring for my husband who has dementia. It has taken me a few years to get suitable times for carers to attend.

“I have received a couple of emails recently changing my husband's times for care, the last email on Thursday (March 6) afternoon.

“When I contacted my husband's social worker, she replied by telling me, it was out of the hands of social workers and she was not back in her office until Monday morning.

“This is totally unacceptable,” she said.

Also speaking to The Derry News, following the article highlighting the issue in Thursday’s paper, community carer, Edel Kelly, said neither she nor any of her colleagues had been approached to sit down with any of the people making decisions about their clients.

Ms Kelly, who has been a carer for 20 years, also criticised the fact that domiciliary care service users were only told about the impending changes on January 30.

“This meant that some of our most vulnerable clients had less than a month to get used to the fact they were, most likely, losing their carers, and, worse again, were not even being kept with the same company that had been providing their care, for many years in some instances,” said Ms Kelly.

“To say this is cruel would be an injustice to the client. Society is measured by how it treats its most vulnerable community. How people treat the vulnerable members of their community is seen as a key indicator of a society’s moral compass and its commitment to caring for its most vulnerable populations.

“Treating them with respect and dignity is crucial for maintaining a healthy and cohesive society.

“We have clients who regard us as part of their family. Sometimes we spend more time with them than anyone else. Our tasks are very personal and often carers are their only source of daily, human connection.

“Carers provide a service, but it is much more than that, especially when we have built up that relationship that is the cornerstone of showing service users they matter, they are valued, they are loved,” said Edel Kelly, who disputed the official reasons given for the changes.

“The decision-makers will say the domiciliary care provision changes will reduce the amount of driving being done by carers and increase the time we spend providing care. In my opinion this is not true,” she said.

“The new rotas, which we were only given late last week, show the time we spend with all of our clients has been reduced to 20 minutes and, shockingly, that 20 minutes includes the time it takes to get from one client to the next.

“Let me give you an example of one of my typical morning calls as an illustration. I come into a home and if the client is asleep, I wake them and give them time to come around. I assist them to the bathroom; toilet them; assist with showering or washing at the sink; dry; apply cream and maybe stockings; assist them to dress; and fix their hair.

“Then I assist them into the kitchen; make breakfast; give medication; wash dishes; put washing into the machine; take out the rubbish; open the blinds; empty and clean the commode; and make the bed, all while having a chat with my client.

“Morning calls determine how a client is going to feel for the rest of the day. I am here to say, 20 minutes, including travel, to do all of this with dignity, respect, encouragement and kindness is just not possible,” said Ms Kelly, who added that all of this was a call with a “fairly mobile client, slow but able-bodied, shown compassion and understanding”.

According to Edel Kelly, most of her clients have mobility aids and a lot have cognitive or sensory impairment or mental health conditions which leave them “confused, emotional or agitated” at times. “Some are lonely and need comfort,” she added.

“This doesn’t include times where we arrive and they are in need of extra care because of sickness, accidents or emotional distress.

“In addition, single carers are covering calls which need to be re-assessed due to a deterioration in the health of the client. Even though they should be provided double carers, single carers have to provide the care until a re-assessment takes place. Sometimes this can take a month.

“Double carer calls involve clients with more complex needs, for example they might need to be hoisted and, again, we are being forced to do all of this in 20 minutes. I would like to challenge the decision- makers on this - the new Commissioner for Older People; those involved with the disability team; RQIA (Regulation and Quality Improvement Authority); and NISCC (NI Social Care Council).

“I would dearly love to know what values they adhered to while making the decision to introduce these changes to domiciliary care provision,” said Ms Kelly.

As a result of the changes carers like Ms Kelly will be expected to deal with three service users in an hour.

“This means that carers like myself will be getting paid £4.02p to look after each client; I think that is also
absolutely disgraceful,” she said.

“So, everyone else gets to go on strike for better pay and working conditions except community carers.

“We don’t get sick pay or bank holidays. We are not reimbursed for nor wear and tear on our cars or helped with the higher insurance costs - only Western Trust carers get this, even though we all provide the same service.

“Carers are constantly told we free up precious hospital beds. Is that what these changes are really about?

I feel sick to my stomach that this is how vulnerable people in our society are being treated. I cannot understand why social workers stood back and didn’t advocate for their clients or MLAs, who are expected to get a £20,000 pay rise haven’t spoken or taken action,” Edel Kelly asked.

Domiciliary care changes branded ‘cost cutting exercise’

Optimisation: Changes to care to come into effect on Monday

Ms Kelly said one of her clients, who will be losing all of her normal carers today (Monday) said to her: “I worked for the health service most of my adult life, providing care for people like I am now, Edel.

“This is probably why I am left in this condition because of all the heavy lifting and long hours I put in, and this is how I’ve been thanked for my service. They don’t care about us.”

Expressing concern about the domiciliary care changes, Foyle MLA Mark H Durkan (SDLP) said they needed to “strike the right balance between efficiency and compassionate care”.

He added: “These changes, intended to improve efficiency, have sparked anxiety among some service users and their families.

“After being contacted by many people worried about the impact of the changes to care packages coming into effect today, I have been in touch with the Western Trust.

“There is definitely some logic behind the changes being made to domiciliary care. However, we must pause and consider the bigger picture.