Helen Martin: There’s better care in prisons

Home care in the community doesn’t work except for a lucky few and the more able. It is a flawed concept and is not a feasible way of caring for vulnerable and dependent old people.

Even if council and agency carers across the country did everything they were supposed to in a half-hour care visit, it still wouldn’t work. That’s because life, even very aged life, is about more than being washed, dressed, fed and put to bed. There are hours and hours of lonely, isolated misery in between.

Very often, carers fall way below even that minimum. I have seen it for myself when my mother received council “care” – in a local authority other than Edinburgh, I must say.

For every one good carer there were three whom I wouldn’t trust to feed my cat. Rightly, because on one occasion they neglected to feed my mother. When they did, it was with no care for taste, balance or presentation. She was put to bed unreasonably early and her breakfast visit was unreasonably late – up to 16 hours later. Dishes were left for up to a week in the sink, the microwave – for that was all they would use – was never cleaned, and most visits lasted about 12 minutes, during which time they were usually on the phone to their office rather than talking to her.

After a couple of complaints led to no improvement, I concentrated on getting her out of there and into a decent nursing home near me as fast as possible.

Carers – council and agency – are paid peanuts in most cases. They have more responsibility in that job than some of them will have had before in their lives and they appear to have minimal training to shoulder it.

They are almost always overworked and pushed for time, many afraid to whistleblow because they need the job in a jobless market. It’s hardly surprising, then, that even the best are tempted to cut corners or give up  altogether.

It may surprise you to know that I don’t feel care agencies or their staff are ultimately to blame. That role belongs to he who pays the piper – the government and local authorities.

Home care’s only obvious advantage is that it is cheap, which is why so little thought has been put into overhauling the whole system and making good residential care cheaper.

A different system of home care could work – if there were many, many more carers who were much more highly qualified and experienced, had hours rather than minutes with clients, were paid very well and encouraged to complain when they knew the service was inadequate.

Dream on. The cost is too high. But sometimes money, or lack of it, is no argument.

Some people may have good experiences, some agencies may be better than others and some staff may be genuinely caring and conscientious.

But all the checks and balances which are supposed to be in place, all the Care Inspectorate investigations, all the outraged astonishment of politicians at the tragic outcome of the Edinburgh case don’t change the reality – prisoners have more care lavished upon them, while the elderly endure a “caring” service that would not be considered good enough by the Dog and Cat Home or the Scottish SPCA.

Can you imagine either of those organisations condoning an old dog being left alone inside a house for a year or two, having strangers coming in twice a day to provide food and water, medication, clean bedding, perhaps a bath now and then, and an occasional ten-minute visit from a vet? That’s about all we can really promise our elderly with home  care.

Surely we don’t need inquiries – or any further tragedies – to tell us this is wrong. So wrong.

Counting the cost

IT’S good to know former city council staff or contractors who are convicted of fraud or corruption in our property departments could be legally pursued for damages. It might offset just a bit of what it has cost the ratepayers and the homeowners concerned.

But meanwhile, with council obligations on conservation and public property also suspended, we are simply storing up major backlogs and problems for the future as buildings continue to degrade, ultimately costing owners and the public purse even more.

It is also punishing everyone else in the local construction industry who is innocent and depending on these council contracts to struggle through the recession and keep on employing tradesmen.

When a company in the private sector discovers rotten apples in their barrel, they don’t have the luxury of just downing tools until they get it resolved. They have to come up with dynamic solutions to keep on working, find replacement staff urgently, stay in the market, bring the money in and keep the business afloat.

Things are clearly a lot more laid back when it’s only public money at stake.