Problems and complaints about Borders homecare changes

CHANGES to the homecare service in the Borders are the first part of a long term plan to improve care for the elderly but as far as some carers, clients and their families are concerned it has hardly been an auspicious start.

Scottish Borders Council’s social work department’s ideas for changing services for the elderly in the Borders, to enable more older people to be cared for in their own homes for longer while at the same time making 5 per cent savings, are currently up for discussion and a series of public meetings is being held so that everyone’s views can be heard.

By 2020 the number of people in the region over the age of 85 is expected to rise by 57% and the number of dementia patients is expected to rise by the same amount.

Social work staff were in Coldstream last week to explain to people what changes they were proposing but they were met with a catalogue of problems and complaints about the homecare changes.

Following the official presentation by the social work team they were left in no doubt why many of the 50+ members of the public had attended, Eddie Paterson telling them: “Most people here want to discuss the changes that have already been made.

“The problems haven’t been ironed out. The main proposals are fine – it’s very positive – but I think people are interested in home care changes.”

Carers now work set shifts in teams of four in order to provide consistent care to clients while at the same time giving the carers a degree of financial security by guaranteeing them a set number of hours.

This has resulted in some clients getting different carers, which has proved difficult for many of them, particularly those with dementia.

Sandra Toyne told officials: “When the changes came in letters were sent to say it was going to change, then who the carers were going to be. But carers didn’t know what duties they had to do and sometimes they couldn even get into the house.

“You had a 93-year-old women letting strangers into the house. There is no communication.

“It has been very unfair, especially when you are dealing with elderly people who get very confused.”

And a number of homecarers themselves are also unhappy as their hours, far from being guaranteed, have been irregular, with some even considering giving up. After the meeting one carer, on guaranteed 27 hours, spoke about the previous week when she had been given less than 10 hours while a carer was brought in from Duns to Coldstream to do over50 hours a week – and others confirmed they were experiencing similar problems.

One of the aims of the review of services is to make sure that there are enough care staff available to provide the future services provided: “They need to have the right skills and training to deliver good quality care service, including for people with dementia. The council will plan to make sure that the right people with the right skills are in the right place at the right time.”

Arthur Parsons pointed out: “From what I have seen the carers don’t know whether they are coming or going – that has to be a priority because they underpin the whole system.”

Acknowledging that the initial changes to homecare services had not gone smoothly, particularly in certain pockets including Coldstream, Elaine Torrance, of SBC head of service (social care and health) said: “We have been having on-going discussions with the home care staff here and staff meetings are coming up.”

As the population in the Borders gets steadily older, more and more people are going to require care, and the social work department has to do a careful balancing act – working out how to provide services for all those who need it while keeping within budget.

Changes being looked at are: accommodation with care; home care; intermediate care (short term rehabilitation for people leaving hospital or to avoid admission to hospital or a care home); day services and hospitals; preventative services; improving first contacts with social work services.

In Berwickshire a number of changes are under consideration based on predicted needs over the next ten years, with much of the focus on Saltgreens at Eyemouth.

“It is proposed to commission a new type of care facility in Eyemouth that can support people who need nursing and enhanced care, as well as provide extra care housing in the town,” says the review report.

“Saltgreens will be redesigned to provide a mix of specialist residential care for people with dementia, enhanced care, residential short breaks, intermediate care and assessment beds. The number of places will reduce from 30 to 27.”

Area wide services for Berwickshire include dementia beds (8) at Saltgreens, Eyemouth; short breaks (6) at Saltgreens; intermediate care at Saltgreens, day services in Eyemouth, and dementia day care at Duns and Eyemouth.

Social centres, that social services hope will be run by the voluntary sector, are proposed for Eyemouth, Duns (Turnbull Court) and Coldstream (Rodger Hall).

Places are required for nursing care at Eyemouth and Duns while at Coldstream social services have earmarked Lennel House to provide it.

Enhanced care (for those with high levels of need and dependency but who do not require nursing 24 hours a day) is proposed at Eyemouth (Saltgreens), Duns (places required) and Coldstream (Victoria Lodge and Carham Hall); and extra care housing (places required at Eyemouth, Boston Court at Duns and again places are required at Coldstream).

Further meetings are scheduled for: Volunteer Hall, Langtongate, Duns on Thursday, September 3, 2009, 6.30 – 8.30pm; and Church Hall, Victoria Road, Eyemouth, on Wednesday, September 9, 2009, 6.30 – 8.30pm.
Scottish Borders Council will consider the review and consultation responses when they meet on December 19.