In 2005 I spent some time working as a care worker for a private company in North West London supplying workers for the “Care In The Community” program. In August 2006 The Big Issue released a feature article based on some of my experiences. Now, some eight years later, as the same issues are returning to the news, I have decided to re-release the article here.
© Jason N. Parkinson 2006
In his council flat in london an elderly Kenyan man sat looking at the uncarpeted floor. He was depressed and said he wanted to die. When I asked if there was anything I could do, he replied, “I want to see a tree.”
The 73-year-old Kenyan’s story was typical of many of England’s elderly. He refused to go in a care home, but had no money to pay for 24-hour home care at a cost of £1,200 a week.
The local social services department said they did not have the budget for his full-time care. I asked for a panic alarm for him, in case of emergency, but the DSS said he was not entitled because he was listed as living with his wife. She had been in hospital for three weeks and there was no sign of her returning.
Apart from four visits a day by home carers, which amounted to three hours, the Kenyan man was alone, imprisoned in his own home, unable to go to the toilet or feed himself.
Earlier this year, NHS head manager Dr Gill Morgan announced fewer beds, not more, were needed in hospital. “Far more people would prefer to die at home if we could offer the, good care,” she said.
This is good news for private healthcare companies, many of whom turnover hundreds of millions a year.
When I started as a home carer in London, it did not take long for my initial fears to rise. After 12 hours training, I received my identification card and was qualified to look after the elderly and terminally ill. Although extra training was offered there was never any pressure on carers to increase their knowledge.
Weekly rotas were incorrect, leaving vulnerable people without essential care on a daily basis, and I was constantly pushed to do two visits in the space of one. The firm still expected each client , or local council, to meet the full call-out charge.
The first, and last, time I agreed to double-up my visits, my co-ordinator said, “Now you’re learning our way.”
The case of one 85-year-old woman highlighted the lack of support by the care company. After suffering weeks of upset from late and unattended visits, leaving her to struggle with her elderly and disabled husband, the woman threatened to commit suicide.
She stored up 100 Coproxamol pills, saying she would force-feed 50 to her husband, a World War Two veteran, and take the rest herself. When I called the support staff, they said it was not my problem and the company would not be held responsible.
That night I listened to the woman for hours as she tearfully concluded if this was how veterans were treated, she no longer wanted to be alive.
The next morning, because no one from the DSS came, she threatened suicide again. Only then was her husband sent to a care home – at a cost of £700 a week to the family.
Another time, I spent two weeks visiting a Pakistani gentleman before his family informed me he had MRSA. I complained, by my co-ordinator said she knew, and I was “not to worry”.
I also had to administer medication, despite having no training in drug side effects. Some carers forgot to give medication and the chemist would issue old prescriptions because they were not informed of updates.
Despite regular complaints to my firm, which should have been passed on to the DSS, the same mistakes occurred. I confronted DSS officers on this. They claimed no complaints were ever received.
For the Kenyan man it was the entire care system that let him down.
On many occasions he was covered in his own excrement, sometimes left by the previous carer, one of whom became February’s ‘carer of the month’. He often fell trying to get to the commode and lay on the hard, cold floor for hours.
My supervisor and a DSS officer explained that as he continually messed himself, no carpet meant it was easier to clean up.
The DSS did finally act after three weeks of constant complaints. They increased one carer per visit to two – a decision reversed a month later due to a lack of budget.
During the DSS assessment meeting in February I asked why it took so long for them to respond. “Sometimes it takes a crisis to occur for us to act,” the DSS officer said.
On April 14, after the chemist failed to issue his “essential” medication on time, the Kenyan man suffered a heart attack.
Seven days later he was sent home. He was thin and weak and it was obvious to me he should be in hospital. He said all he wanted to do before he died was to see the elephants, trees, grass and sunshine of his native Kenya.
The following week the chemist replaced his new prescription with old. At 7am the following morning, on April 27, I found him in agony.
He had suffered multiple heart attacks from 11pm the previous night. He died as the paramedics put him into the ambulance.
With no 24-hour care, refusal to issue a panic alarm, and being too weak to pick up the telephone, the Kenyan man had no way of calling for help.
Even with daily concerns logged, the care in the community system failed this man.
The system has been cut up and sold off, severing vital communication links between all elements of care for the elderly and vulnerable.
Accountability is almost impossible with so many individual sectors involved in every single case.
My experience taught me that, once privatised, a public service prioritises profit above individual needs and wants.
As the company branch manger once told me: “This is a business first and foremost.”
© Jason N. Parkinson 2006