Highland Social Worker: ‘I Am Ashamed Of Care We Provide’

In February The Inverness Courier revealed how blind 98-year-old George MacDonald from Haugh Court in Inverness was told his home help was being withdrawn because of budget constraints.

{mosimage}Today Highland Council social worker Alison Napier tells why, after 14 years in the profession she loves, she feels so demoralised that she is considering giving up.

I entered social work in 1993 with my eyes open, knowing full well that this is a solid, well-intentioned job rather than a radical one.

We try to provide care to vulnerable people, within the constraints of a local authority budget.

Straightforward enough thus far. So why have I become so deeply ashamed of my job and of my employer that I am considering leaving a field of work that I have enjoyed for so long? Here are a few stories that provide an answer to that question.

Mrs Stewart has a council home-help who comes in for half-an-hour, seven mornings a week. She is in her 80s, lives alone, and finds it hard to get dressed and washed in the mornings because of stiffness, angina and anxiety, so the carer helps her to have a shower and dress.

Mrs Stewart rang me last week and left a message saying it was urgent that I phone her. I phoned. “They’ve said I can’t have my home-help at the weekends any more. What will I do? I’ll have to stay in bed.” I listened. Then she said: “Oh I’ll just cancel the whole lot. I’m a bother to everyone. I’ll just cancel the lot and stay in bed.”

“No don’t do that,” I replied. “See if the home-help will work privately for you. Then write to your local councillor and your MP.”

For 15 years, Mrs Stewart herself was a carer. She saved the council thousands and thousands of pounds by taking on caring responsibilities. Now she is the one who needs some care. But the UK, the fourth richest country in the world, has told her that her needs are too great — or too unimportant — to be met from the budget.

Here is another story. Jimmy is 17 years old, and has profound physical and learning disabilities. He exhibits “challenging behaviour”, has no decipherable speech and expresses himself by lashing out and screaming. He lives with his mum and dad and three younger sisters, and his parents have been asking for residential services for their son for five years.

First, there was no money. Then his case got lost as staff changed jobs and vacant posts were left unfilled. Now there might be some funding but there are no vacancies in any suitable places that will cater for his needs at the right price. Jimmy’s lashing out means he has appeared at his day centre with bruises, leading to an urgent vulnerable adults case conference. Now he might get a placement. Now his parents might get support, although they have lost any remnants of faith they may have had in social work and are speechless with rage and betrayal. Now Jimmy is a vulnerable adult with bruises.

Recently, all the community care social workers in the local authority were summoned to a meeting with an embarrassed messenger from headquarters. “Go back to all your care packages, reassess the needs, go over them again with a finetoothed comb and see if there are any aspects of the care that could perhaps be pruned back,” he said. “For example, did it really need two people to get Mrs Grant out of bed and bathed every morning? Perhaps one person could manage it?” This is, of course, causing a little friction between us and our managers.

I have got lots more stories. There are cases of local authority home carers, heroes and heroines (but mostly heroines) who enable many vulnerable people to stay in their own homes rather than go into a residential care home. They do this without guaranteed working hours per week, which makes monthly budgeting a bit dodgy. Mr X dies and Mrs Y goes into a care home, so their hours plummet and so does their pay. Little wonder they take other jobs where the hours are guaranteed (even if they pay less than a home carer’s pay, which is £6.44 an hour). Home care vacancies, like the poor, are always with us.

Home care used to cost the service user about £5 an hour. Now it has doubled, so lots of people just stopped it. Respite care used to be provided for up to four weeks at about £60 a week, regardless of income. With no intrusive financial assessment for the first four weeks, this was just enough to give carers a decent break throughout the year. More respite might be available if it was needed, and was financially assessed — fair enough.

But those four weeks were frequently all that was needed. But that was stopped too. There are now financial assessments from day one. And guess what? People cancelled their respite in droves.

I spend much of my working days staring intently at a computer screen, which was not what I had imagined would be the life of a social worker. I have interminable conversations about “delayed discharge classifications for weekly statistical returns”. Today, I had a conversation with a home care manager that went something like this: “Hello, can we get a home carer for Mr Macleod? It’s for this weekend, on Sunday morning, we don’t have anyone and he’ll have to stay in bed otherwise.”

“I don’t think there’s anyone who can do it. One hour on Sunday morning? No one wants to work on a Sunday morning.”

“How about if we bring a carer in from one of the outlying villages?” (This is relevant — home carers are not paid for the first five miles of travel. Mr Macleod lives six miles outside the village. Therefore a home carer from a village 20 miles away will be more likely to be able to feel she can afford to do the work as he or she will get mileage for 35 of the 40 miles travelled, ie 87 per cent of his or her claim, whereas the local one will get 16 per cent of her claim.)

These are the conversations I have throughout the day.

“We can’t do that, sorry. We can’t pay that much mileage…”

“Ah.”

If Britain cannot provide for the most vulnerable people, and we condone the constant shifting of the goalposts, such as the definition of “vulnerable”, then we should all be deeply ashamed. I know I am. And if I look around at all the wealth in the UK and can still look someone straight in the eye and tell them that their care package is to be cut back due to lack of funds, then I have betrayed every single one of the principles and ideals that brought me into this job in the first place.

There is a clause in my contract that states I must not bring the good name of my employers into “disrepute”. My employers may consider that I am doing just that. To which I can only reply: “No. You are managing to do that all by yourselves.”

* Names and details have been changed.