Low pay for carers endangers the old, the sick and disabled

Published by The Independent (24th August, 2013)

The care home was judged ‘inadequate’ for safety, leadership and effectiveness. The five residents were moved after it emerged they were abused, sworn at, ridiculed and ‘inappropriately’ restrained by staff. A fire door did not open, there were no seats in toilets, health needs were not properly monitored and the centre breached various regulations. One man is on bail after being arrested for assault.

Welcome to the woefully misnamed St Joseph’s Specialist Care Home in Chesterfield, closed on safety grounds three months ago and condemned for its inadequacy by the Care Quality Commission (CQC) watchdog last week. It was run by a firm with the warm-sounding title of Aspire and fraudulently promised ‘a warm, welcoming and enabling environment’ for young adults with learning difficulties.

Once again, a place supposed to provide sanctuary ended up closer to a nightmarish prison. Yet the distressing saga barely made ripples in the media. For the story of St Joseph’s is just the latest in a depressing series of horror stories revealing care home staff of seriously neglecting and endangering their vulnerable charges. We need only look back as far as Winterbourne View to remember the shocking cases of verbal and physical abuse in our carehomes. And most of the scandals only come to light thanks to undercover work from journalists or hidden cameras placed by fearful relatives, making it impossible not to wonder how widespread such mistreatment is in these homes.

Only the previous week, there was a scathing report into Berkshire nursing home, Birdsgrove, where 22 elderly people were stuck in a dismal unit found to be unsafe, uncaring and badly-run. One was heard shouting ‘Please help me’ when inspectors called Last year, several staff were sacked after Panorama exposed appalling events at an Essex care home, including a partially paralysed woman with dementia being slapped and a bed-ridden resident left lying in his excrement with the call bell switched off. As these scenes were secretly filmed, the hapless CQC gave the centre a clean bill of health.

These sorry events reflect a society in which people with learning difficulties are routinely bullied, feared and ostracised, some even murdered because of their differences, while the elderly are seen as such burdens that a respected broadcaster can say he will kill himself rather than become ‘a gibbering, sad old freak’ without causing a fuss. This is the dangerous backdrop to the debate over euthanasia. And this corrosive contempt for human beings that need help was highlighted  in discussions about the minimum wage.

The Chancellor George Osborne deserves credit for introducing a national living wage. Yet five major care providers, looking after 70,000 people in 1,200 properties between them, responded by warning him they will be forced to close homes because of plans to make them to pay their workers £9 an hour by the year 2020. They argue this will cost the sector an extra £1bn, with staff soaking up at least 60 per cent of care costs, although they claim not to oppose the measure.

Leave aside the fact that while staff are stuck on the minimum wage, managers of care homes have seen salaries rise twice as fast as the average employee in Britain over the past decade. Behind this lies a far more fundamental question: why do we so devalue caring for the old, the sick, the disabled and those with learning difficulties that we pay those caring for them so little? Indeed, thousands of those delivering assistance fail to even receive the minimum wage, since many making home visits are not paid for travelling between tasks while others in residential units are given accommodation.

These low wages devalue a difficult and delicate job, especially given the lack of training and career structure. ‘You need higher qualifications to cut hair than care for old people, let alone the requirements needed to look after children during the day in nurseries,’ said Judy Downey, chair of the Relatives & Residents Association. Yet many elderly people in homes suffer not just dementia but severe health conditions, while one-third of social care spending goes on people under 65 with serious disabilities.

No wonder one in five carers leaves their post each year, undermining continuity for their charges. Or that abuse is so rife – 30,000 complaints in the first six months of this year alone – when caring for vulnerable people with complex needs is put on a par with stacking shelves in supermarkets. Indeed, it is remarkable so many dedicated people become carers given the poor rewards and social status, although the gaps have been plugged increasingly by immigrants.

This is, remember, a profession that demands great intimacy and immense trust on a daily basis. Yet given the low pay, high stress and antisocial hours, combined with the callous attitudes prevalent in our society, it is unsurprising dreadful cases of mistreatment flare up with such depressing regularity. ‘How can you keep a profession free of abuse when you treat staff with such little value?’ asks Kaliya Franklin, of People First England, an advocacy group for those with learning difficulties. Sadly, she is right.

At the heart of this problem lies the artificial distinction between health and social care; the average annual salary in the NHS is, after all, about £30,000. So while health spending is rightly protected and rising, social care budgets at local authorities slumped 15 per cent under the Coalition. Yet as our population ages, the King’s Fund think-tank predicts the numbers needing care will rise almost two-thirds over the next 15 years. The stresses in our dysfunctional system can only grow worse, while the strains on families increase.

Governments have kicked these problems into the long grass for decades. Only last month came another broken promise over capping privately funded care costs. Yet most residents are state funded and, according to new figures from analysts LaingBuisson, English councils pay £91 a week less than is needed for fully compliant provision. Behind all this lies a woeful lack of joined-up thinking that keeps people with learning difficulties in £3,500-a-week medical units despite post-Winterbourne View pledges to move them into cheaper and safer community provision. And it leaves thousands of old people blocking hospital beds because of inadequate services. But does anyone really care?

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