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Britain's Pensioner Care Scandal: Channel 4 Dispatches

One of the country's leading home care providers has been forced to close its Haringey branch. Secret filming, shown in Dispatches tonight, reveals concerns about home care provided to older people in the borough and to others around the country.

National home care provider Sevacare, which looks after more than 8,500 people in their homes around the UK, was ordered to close down the service by the Care Quality Commission (CQC) on Thursday.

In a joint investigation between Dispatches and The Sunday Times, Jackie Long examines the crisis in home care for older people. New research reveals hundreds of thousands of missed visits and millions of late visits along with evidence of pensioners not being washed or dressed for days, waiting hours for dinner and mistakes being made with medication. Almost 300,000 older people in this country receive home care and our findings suggest many are facing serious difficulties with the quality of the care that they receive.

Hidden cameras installed in one 87-year-old, blind woman's home exposes serious problems with her home care. Meanwhile an undercover reporter, working as a home carer at Sevacare, also discovers an overstretched service, workers cutting short appointments and falsifying log books. Three days after the introduction of the new National Living Wage, the film uncovers fresh concerns about home care workers not being paid the legal minimum. Once travel time was factored in our reporter was paid just £3.89 an hour. Most councils in the UK contract out their home care to private companies, which are inspected and regulated in England by the Care Quality Commission (CQC). However their own figures show more than 3,000 branches have never been inspected.

The United Kingdom Homecare Association (UKHCA) now warns that the market is increasingly unviable. Council funding has been cut by around £20billion in the last five years, which means that council spending on homecare for the over 65s has fallen by £436million. Dispatches looked at the accounts of eight major care providers and discovered that the CEOs earn, on average, more than £300,000 per year, three earning more than £500,000.

Undercover Carer:

Our undercover reporter worked as a care worker for Sevacare. The biggest provider of care in Haringey, North London, Sevacare is paid nearly £2million a year to look after 182 people. He discovers an overstretched service, concerns about pay not meeting the minimum wage and workers cutting short appointments and falsifying log books. Despite having no relevant experience the reporter was immediately hired, and after three days of classroom training he went out to shadow experienced Sevacare employees, where he observed repeated bad practice.

Sevacare provides both council and privately funded home care. In 2014 it made just over £500,000 profit, while its CEO Ravi Bains, paid himself £4.9million between 2011 and 2014. Haringey Council paid Sevacare £1.98 million per year to look after 182 vulnerable people. In two previous reports the CQC warned about the quality of care provided by the branch, and said it put clients at risk of “inappropriate or unsafe care”. On the back of these reports, our undercover reporter was sent in to find out if things had improved.

During his shadowing period he went to 16 home care appointments, shadowing six different carers. Only two of the visits lasted the scheduled time as assessed by the council.

Senior staff members were seen to condone the practice of cutting visits short, known in the industry as “clipping”. He also witnessed six log books being falsified, which means that the council are unable to monitor whether those clients are receiving the appropriate care and that the taxpayer is getting what they pay for.

If the same proportion of visits that we observed being cut short was applied across Haringey’s entire arrangement with Sevacare, it would mean that £1.1million of tax payers' money is lost to “clipped” visits each year in the borough.

This is a national problem, and no-one can know the true financial cost of these shortened visits. Lynne Phair, an Independent Consultant Nurse of 35 years' experience specialising in the care of older people, said: “Those five minutes actually could be what's the most important part of that whole visit for that person because that's the bit that combats the loneliness. If they're only getting physical sustenance and are not getting that emotional support, that spiritual support in whatever shape or form that looks like, they will be harmed by that.”

After three days of shadowing, our undercover reporter was allowed to visit clients alone. He discovered concerns with clients' care plans, essential documents that set out what care they require. One plan was missing from the client's home, and in total there were inaccuracies in the plans in more than half of the homes he visited. His schedule included back-to-back appointments, allowing no time to travel between addresses, which would have forced him either to arrive late for appointments or clip his visits short. He raised his concerns with a care coordinator, who adjusted his schedule.

Our reporter was paid £7.20 per hour, to spend just over five hours of “contact” time with clients per day. However, he was not paid for the time spent travelling between appointments. His first appointment started at 6.30am and his last finished at 9pm. Once travel time was factored in, his pay equated to £3.89 per hour, £2.81 below the minimum wage then in force. Dispatches also discovered that the staff turnover rate for home care workers is nearly three times the national average.

Colin Angel, Policy Director at the United Kingdom Homecare Association (UKHCA) said: “We have certainly seen examples of care workers under paid the national minimum wage in the care sector, not a position that I would defend at all. I couldn’t find you an employer that wouldn’t like to pay their care workers more.”

Dispatches made Freedom of Information requests to local councils. The responses revealed:

  • There were than 500,000 missed home care visits in the past year
  • There were 6,500 medicine errors in the past two years
  • There were just under three million late visits in the past three years

Hidden Camera in Pensioner's Home:

Dispatches sets up hidden cameras in one pensioner's home to find out more about the standard of care she receives. Edith James is 87, blind, diabetic and is in the early stages of dementia. Her son Ray was concerned about substandard levels of care she was receiving.

Her home care provider Care Outlook was paid £1.5million this year by Hillingdon council to provide over 120,000 hours of homecare.

Our cameras were in situ for three days, when Edith should have received four thirty minute visits per day, with a four hour gap in between appointments.

Day 1:

8am: Visit missed – Edith should have been washed, dressed and given her medication

0945am: Son Ray gives Edith her medication

Just before midday: Carer arrives, Edith cannot be given her medication due to having it late, carer stays for 12 minutes, writes 30 minutes in log book. Edith is left in her nightdress

Around 2pm: Carer returns to administer medication

Around 4pm: New carer arrives, doesn’t check log book and administers medication too early. A note on Edith's care folder clearly instructs carers to allow a four hour gap between each dose of medication. Edith spits out her pills, which is noted three more times. Carer doesn't notice, despite instructions in her care plan to watch Edith swallow her pills.
Out of a scheduled two hours of care that day Edith received 34 minutes.

Day 2:

8:40am: First appointment is around 40 minutes behind schedule; Edith is given crackers with cheese. Edith is up and about but the carer writes in log book that Edith refused to leave the bedroom. Edith is not offered a wash.

Midday: Edith given cheese on toast for lunch

Around 4pm: Care plan states that Edith should have a hot meal for dinner; she is given cheese and crackers.
Out of a scheduled two hours of care that day Edith received 44 minutes.

Day 3:

8am Edith is washed, for the first time in three days. The carer then sits in silence with her for 20 minutes before leaving.

Sevacare response:

“Every year we are proud to support more than nine million care visits… We apologise that proper process was not always followed by individual carers and we have taken action… to suspend the individuals involved…

[the clients filmed]…confirmed they are happy with the support they receive day to day, demonstrating that these are isolated examples, rather than common practice."

Care Outlook response:

"We have responded to the concerns raised by Mr James, suspending two… care-givers pending further investigation.

Mrs James now has a designated care-giver with more time allocated to meet her specific requirements.

Care Outlook trains its staff to adhere to high standards… we are sorry that these have not been met…

We have strengthened our procedures to ensure that no other family has similar experiences."

BRITAIN'S PENSIONER CARE SCANDAL: CHANNEL 4 DISPATCHES Monday 4th April, Channel 4, 8pm

Producer/Director: Alison Ramsay

Executive Producers: Chris Shaw & George Waldrum

Production Company: ITN Productions
Co-production with The Sunday Times

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