GPs, district nurses, wardens in sheltered housing and social workers have been expressing concern for some time that budget cuts to social services were resulting in some of the most dependant and vulnerable people having their support reduced.

‘The standard visit used to be an hour but budget cuts and the increased number of very elderly people living at home has resulted in a worrying increase in use of the 15 minute call.’

The findings by the Leonard Cheshire organisation that the majority of social service departments are commissioning 15 minute “pop in” calls to replace the traditional hour slot of home care gives undisputable evidence to back up the concerns of professionals and relatives. Is this inadequate support another factor in the many factors resulting in increased pressure on hospital emergency departments?

Fifteen minutes is a long time if you’re waiting for the final whistle. It’s a long time hanging on to the other end of the phone, or to hold your breath under water. But according to Leonard Cheshire the largest voluntary sector providers of care to people with a disability it’s not long enough.

Struggle for services

As a result of data gathered through a Freedom of Information Act request, the charity as been able to put accurate figures against how much use is being made of “pop in” calls by local authorities. For a number of years social workers, relatives, GPs, district nurses, housing officers and home care providers themselves have been expressing concern about local authorities trying to save money by reducing home help visits and crucially the length of visits to elderly and disabled people.

The standard visit used to be an hour but budget cuts and the increased number of very elderly people living at home has resulted in a worrying increase in the use of the 15 minute call.  

‘It’s the type of care that if it was provided in a reidential or nursing home the inspectors would close it down’

As local authorities struggle to maintain services while cutting budgets, it is politically easier to reduce the length of visits rather than reduce the frequency of visits. In most cases we are talking about very dependant people who need help to dress, wash, go to the toilet and be given a hot drink and meal. These individuals need help to get up in the morning, help to go to bed at night, someone to make them a drink and a meal during the day and ensure they take their medication. Four visits a day, seven days a week involving a combination of family, friends and the local authority funded home help and carers.

To remove a service from people who are so dependant and vulnerable would cause a public outcry, a media campaign and probably a judicial review, but with less money and increasing demand local authorities can’t afford four hours a day.

Impossible task

So the four visits are maintained but the length of time spent with individuals is reduced.  A visit now can be anything from an hour to 15 minutes. Leonard Cheshire identified that six out of 10 local authorities now commission on 15 minuet slots. Of course 15 minutes might well be long enough to check someone has taken their tablets is given a drink and is safe and comfortable. But an elderly person’s bladder cannot be regimented so easily.

As the budget gets tighter the visits get shorter and more use is made of “popping in”. What this means in practice is an elderly lady sitting on the toilet while being given a sandwich, cup of tea and her tablets. It means cares are rushed and people risk being treated like objects to be feed and watered. It means there is insufficient time to prepare appetising hot food. All too often it means sitting in wet and or soiled under garments and when help arrives it’s a quick wipe round with a damp flannel. And possibly a telling off from a carer who hasn’t got time to be finding clean clothes and cleaning them up.

It’s the type of care that if it was provided in a reidential or nursing home the inspectors would close it down. But you can’t only blame the staff; no one could provide decent care in a 15 minute slot.

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