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By Debbie le Quesne

Care call times again: Let’s have some vision, please

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Will someone please change the record? We now have the National Institute for Health and Care Excellence criticising short care visits.

Yes, we all know that commissioning visits of 15 minutes and some with even smaller time slots, are under fire. The problem is that most local authorities have outsourced their ‘dom care’ responsibilities and in the same way residential care is underfunded, so is this essential expression of humanity.

Speak to any of my community care providers and they’ll unanimously agree care slots should be longer, but sadly our Government won’t fund them at a rate that represents the true price of the service.

Staff who undertake social care visits to 470,000 mainly elderly people a year must spend 30 minutes helping to keep them well, says Nice.

It wants an end to the situation where many visits are so short and rushed that recipients have to choose between getting washed or dressed. I know, it’s a horrible dilemma.

But it must be noted there is a place for 15-minute calls – check visits and meds calls spring to mind immediately. The economies for employers, however, are mad as travelling time either side of such visits now has to be paid.

If adopted, Nice’s guidance would transform many care calls. I just don’t get it . . . all the evidence points to good social care reducing demands on stretched NHS budgets, but we desperately need a bit of vision here to see how investment with ring-fenced monies at this sharp end could work out.

In its first ever guidance on social care, Nice says that contracts that local councils in England sign with social care providers should allow workers time to provide a good-quality service, including having enough time to talk to the person and their carer, and to travel between appointments. I presume it also says they should be paid properly for this too.

“They should also ensure that workers have time to do their job without being rushed or compromising the dignity or wellbeing of the person who uses services,” says Nice.

It’s all very laudable. Nice describes itself as an independent Government body, but I wonder how much clout it will muster in this latest endeavor and whether politics will eventually see its teeth pulled. After all, isn’t Nice funded by the Government?

With councils facing average budget cuts of 40 per cent, I can’t see much chance of the Nice reforms being carried through any time soon.

I read that between 2010 and 2011, eight councils commissioned 593,000 care visits lasting five minutes or less, and three-quarters of councils commission care workers to visit for just 15 minutes. Goodness knows what the latest figures are.

I find it deeply worrying that already I’m hearing cries of “idealism” over the Nice proposal. Surely our elderly and frail are worthy of proper care and not least, social care idealism.

Can we afford to just carry on they way we are going? I think not. Our careers do a great job in the community, with many giving over and above what they’re actually paid for. It’s been referred to as “emotional extortion” and I hate the term because it infers some kind of financial racket or leverage. Truth is, most carers do what they do because they’re genuinely lovely people working in a financially screwed profession.

The cheap option – cutting back on care package times – is terribly short-sighted as the amount of first line care intervention will reflect, I believe wholly proportionally, further up the care ladder. As I’ve said, it’s all about vision and not least expectations. Often the call time is crammed in a desperate attempt to meet care plan outlines . . . and personal commitments to just trying to do the job properly.

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