JOIN OUR RALLY: Sat 3rd SEPT, 12.30-2pm Meet at Greenway Centre, Southmead, BS10 5PY

Wednesday, 14 September 2011

Bristol slated in Demos research for cuts to front line social care services

Demos has just produced a disability cuts map of all UK local authorities. Bristol City Council is rated in the worst category group of local authorities and ranks 147th out of 152 local authorities.  The reason for the authorities exceptionally poor performance in this league table is its inability to protect front line services from budget cuts.  The Demos verdict on Bristol:
Cuts Level: Very High
Coping Level: Very Bad

See for yourself at

Update - the care, no sorry, CAR Boot Sale Banner at Amerind Grove has disappeared!!

Yesterday's blog mentioned that BUPA's Amerind Grove Nursing Home promoted itself as a car boot sale venue with an enormous banner outside its front gates.  After a damning CQC report in March 2011, BUPA managers and Bristol City Council chiefs had assured residents and local people its care standards would improve.  Seeing a car boot sale banner, along with many long hours, minimum wage job ads for untrained care workers at Amerind Grove raised concerns that quality care might not be as genuinely valued as claimed.

This morning . . . the banner has gone, disappeared, it is no more!

. . . it would be great if staff receive a pay rise just as swiftly

Tuesday, 13 September 2011

On Homecare - politicians not brave enough to confront the truth

A perfect storm is a term used to describe a situation where a range of negative circumstances come together all at once. It is a term perhaps appropriate for Bristol City Council's Lib Dem plan to privatise its homecare service. In combination, the factors detailed below show how an already dire situation will be made far, far worse if the privatisation goes ahead.

1. Instability in Private Sector Businesses and Public Sector Cut Backs

Companies who run residential homes are laden down with debt at a time of drastic local authority budget cuts. Cut backs have reduced the number of care home beds that Councils book for respite care. Councils are imposing lower prices be paid 'per bed' and the number of residential home companies going bust is at an all time high.

Council's are shifting their focus away from residential homes towards providing homecare support as an alternative. This policy has been in operation for over a decade, widely supported by organisations who represent older people's interests and applaud efforts to keep people in their own homes for as long as possible. However, the ethics which underpinned the policy move towards at-home support have now been replaced by an urgent desperation to cut costs.

Last week, a Bristol job centre was advertising a full time homecare job for £100 a week. This is during the same week when the Association of Directors of Adult Social Services described the system in place for providing adult social care as 'bust'. Three quarters of all Homecare workers in the private sector have NO guaranteed hours of work. They work on zero hours contracts and their weekly income is unstable. They are routinely bullied into working long hours. Many private sector homecare jobs are advertised as paying £7.50 - £8.50 an hour but the pay packet that workers end up with rewards them with much less than that. Because they are only paid for the minutes they spend in a service users home, a twelve hour shift can produce only seven or eight hours pay. Unsurprisingly, many are struggling with personal debt problems. At least 10% of jobs in social care pay less than the national minimum wage. Abuse of their employment rights is commonplace. 

These workers deal with the most intimate aspects of people's lives, bodies and personal finances. Treating care workers badly does the service users no favours whatsoever. When CareMark Bristol went bust recently, it was the Council's own Homecare Service that stepped in to ensure that service users were not left stranded. This is not an isolated incident.

The UK Homecare Association has reported big safety concerns for service users and homecare workers. Adult social care is in a massive mess across the country. Homecare, as a solution for looking after older vulnerable people, is coming under more and more pressure. Care homes are closing down, either because they are mired in disgrace for abusing those they are supposed to care for, or no longer financially viable to maintain, or because Councils are turning to homecare as a much cheaper alternative.

2. Loss of Public Confidence in Private Care

There has been a massive loss of confidence in private sector care provision and Bristol has been in the public spotlight. The potential to accumulate great wealth from running a private care business was clear from the lavish wedding celebrations shown in the C4 Dispatches programme about the Dewani family, well known in Bristol for their impressive business acumen in the care sector. However, scenes of abuse at Bristol's Winterbourne View (nothing to do with Dewani and run by Castlebeck) were broadcast to the nation on Panorama. What we witnessed as viewers was reminiscent of the torture of Iraqi prisoners at Abu Ghraib. 

Soon, the care workers exposed will face trial at Bristol Crown Court. They will have the opportunity to explain themselves, the criminal charges against them are very serious. The national media will be camped outside Bristol’s Court on Small Street. The directors of the company concerned remain in their jobs and, so far as I am aware, may have been disgraced in the court of public opinion but they face no personal criminal investigation. Castlebeck is still in business.

It’s only a few weeks since staff at Bristol's Rose Villa were investigated on allegations of abuse - the home's owners decided to shut it down rather than contemplate any potential remedies for institutional malpractice.  Bristol's Amerind Grove Nursing Home, a big home in the City which has nearly 200 beds, received a terrible inspection report in March 2011. They were found to have failed on 11 essential standards for which they have a direct responsibility in law to maintain. It was found that residents had suffered 'pain and injury', their 'right to safe care' had not been protected, they were 'frustrated, ignored and upset'. Staff had not received any training in dementia care or the Mental Capacity Act, were inexperienced, in a rush and not 'always competent'.

Amerind Grove is run by an organisation that the public would not necessarily think of as a bunch of uncaring, money grabbing spivs, but by BUPA. BUPA trades on its reputation as a not for profit organisation which exists for the benefit of its members. Mark Elliott, Regional Director of Bupa Care Services said of Amerind Grove that since the inspection, ‘significant improvements’ were made immediately, the home now has a 'professional team' delivering 'the highest possible standards of care.’ 

Councillor Jon Rogers, the politician at Bristol City Council responsible for Health and Social Care confirmed BUPA's story to the local newspaper and added that Amerind Grove is now: ‘a more effective home, staffed with trained carers who show real pride in the valuable job they do.'

Two weeks ago, I just happened to pass Amerind Grove Nursing Home. I was struck by the BANNER ADVERTISEMENT across the entrance to the Home promoting A CAR BOOT SALE TO BE HELD IN THEIR GROUNDS. Unimpressed, it did not scream out to me that they were desperate to gain respect for offering the highest possible standards of care.

I have also noticed that the adverts at the job centre which offer not a penny more than minimum wage of £5.93 an hour to work in a care home are at, you guessed it, Amerind Grove.   Since no experience is required for these jobs, it puts pay to the 'trained carers' explanation. As for the, 'pride in the valuable job they do', dreams of Cllr Rogers . . . dream on. Amerind Grove could not legally demonstrate any lower valuation of these jobs than £5.93 and in three weeks time this value will become unlawful because the national minimum wage increases to £6.08. Perhaps BUPA will now have to offer a children’s face painting service during October half term to boost attendance at the car booters?

In 2009, Sunnymead Manor Residential Home in Southmead, owned and operated by Mimosa Healthcare, was exposed for poor care standards. The then Executive Member for Health and Social Care at Bristol City Council attempted to reassure the public by making a personal visit to the home. Her inspection was so rigorous that she offered the local newspaper this breathtaking line: ‘we spoke to quite a number of residents and they seem contented enough.’ It took until the following year, for the facts to surface again. In November 2010 a member of staff blew the whistle on Mimosa for disgusting conditions, poor care, lack of attention, poor infection control and dirty facilities at Sunnymead. In December 2010, the same company issued a public apology for appalling care standards at another of their homes, Kingsmead Lodge, in Shirehampton, Bristol.

In May 2010, June Davies was convicted in Bristol Crown Court of abusing a resident in her care at the Honeymead Care Home in Bedminster. Two weeks ago, Kirsty Green was sentenced at Bristol Crown Court for stealing £46,000 from a bedridden older person in her care. Kirsty worked for Stepping Stones Homecare, as did Jane Hoy who was convicted for the same offence a year before.

Before you jump to many conclusions about the wickedness of care workers, it is worth pondering for a moment that both Bristol City Council and the Care Quality Commission regulate these outfits. If you feel sickened by stories of older people being abused or are cross about companies that fail to provide the care they are paid for, you should also be asking questions about regulation.

3. A crisis in regulation

In a race to the bottom, the system of private sector care regulation has been watered down by successive governments. Last week, members of the UK Care Homes Association decided they no longer had confidence in the Care Quality Commission (CQC). The Royal College of Nurses are currently surveying their members about similar concerns.

Today, it is reported in Community Care Magazine, that the CQC are, yet again, reducing their regulation. This time they are reducing not the frequency, but the scope of what they decide to inspect. There are 16 quality standards and providers will now only be tested on a few of them. 

Their approach to regulation from now on will 'assume' providers comply with these standards and only look further if there is evidence they might not. This means that providers will not have to demonstrate that they meet the standards, the inspectors will simply assume they do unless they see evidence indicating otherwise. As things stand, businesses providing social care are regulated ONCE EVERY TWO YEARS. That is how 'light touch' the regulation is.

Further, in June 2011 the CQC disclosed it is so short of staff that it is carrying 128 vacancies for inspectors. Despite the continual massive shift in provision away from care services which are owned and run ‘by the public, for the public’ towards the private sector, the CQC runs on a budget which is 65% of what regulation cost back in 2006.

In the six months between October 2009 and March 2010 the CQC carried out 6,840 inspections. Between October 2010 and March 2011 the CQC carried out only 2,008 inspections. The number of inspections had fallen by 70% in just a year. In October 2010, the system of rating providers with an inspection star score (one star, two star, three star) was abolished. The Association of Directors of Adult Social Services said this was a dangerous move which would reduce the safety of older people receiving services.

The alleged purpose of this weak system of regulation is to reduce 'bureaucracy' and increase local accountability. It is intended that Councils should produce ‘local accounts’ on the standard of services in their areas and be held to account by user-led groups and local people.

A conclusion - brave enough to confront some truths?

Bristol City Council plans to privatise what remains of its Homecare service in the eye of this 'perfect storm'. On average last year, Councils across the UK cut back on the number of Homecare Assistants they directly employed because they preferred to buy more cheaply from the private sector. The proportion of services provided directly by Councils fell to 16%.

Bristol currently has 15% of its homecare provision delivered by its own in-house team of Homecare Assistants. However, it is putting these women out of work, despite them being the most well qualified, experienced and necessary team of care workers in the City. Bristol City Council’s own homecare workers are either being forced to accept a supposedly ‘voluntary redundancy’ package (which may not even materialise) or they are being asked to accept other work in the Council. This 'other work' is often totally inappropriate for them or is with Council services which are facing imminent closure, like residential homes. Homecare Assistants since August have been facing up to the distress of going to out work, only to find their service users have been taken away.  The people they care for, in some cases for many years, are handed over to private agencies whilst the Council carers themselves are sent back home with no more work to do.

Right across the UK, Councils are putting pressure on private providers to continually reduce costs and Bristol is no different. This is achieved by reducing pay, watering down on regulation, turning a blind eye to poor quality provision, and expecting workers and service users to tolerate an ever higher risk of danger. Bristol certainly does not have a glorious reputation for regulating the private sector. The evidence speaks to the fact that it does not, and perhaps can never, ensure that only good quality private sector care is provided for taxpayers money.

It is perhaps unfortunate for Bristol to be singled out, but it is nevertheless a fact that Bristol has come under the national spotlight for care failure.

Lib Dem politicians at Bristol are woefully ignorant about the reasons why their own Homecare Service costs more than the private sector. They are also astonishingly naïve and out of date in their understandings of the employment terms and conditions of their own workforce. They are acting outside of the law in refusing to consult with trade unions about redundancies and not undertaking an Equalities Impact Assessment. They engage in warm words and platitudes when serious failures in care standards are uncovered.

This happens because it is precisely in their interests for the care companies to keep going, to keep on providing cheap care and for no-one to ask any awkward questions. Indeed when awkward questions were asked by Conservative Councillors at the Full Council meeting of 6th September, the Lib Dem response was to repeat falsehoods and misinformation. Who can blame them really? It worked. The Conservatives changed their minds about voting against the privatisation plans.

The idea that local people can hold private care providers to account is astonishing. Our elected Councillors rarely know what they are talking about on Adult Social Care. It is not in their interests for local people to be any the wiser.

One thing that ALL politicians in Bristol do know however is that people in our City do not want Homecare to be further privatised. All politicians know that with a certainty. They shudder at the prospect of being in the unfortunate position of having to carry the can for unpopular decisions.

The Lib Dems know they lost the 8th September by-election in Southmead over the privatisation issue. The Conservatives and Labour also know they picked up votes because both parties told voters they would fight to keep the in-house service. The Lib Dems leader herself has said as a result of the defeat that they ‘are listening to local people’.

Well if you are listening, listen to this. When looking into the eye of a storm in which older people are subjected to ever increasing risk and care workers are regarded as expendable fodder, nobody wants a coward to represent them. Privatising your own homecare service is far from a brave political decision. It is a decision taken in ignorance, irresponsibility, and with a cavalier disregard for what is actually taking place underneath your own noses.

If you do not have the courage to act as people who elect you require, if you do not have the courage to face up to hard truths which include your own ignorance, if you are simply not brave enough to confront the truth – you should stand aside.

Saturday, 10 September 2011

Today, Dr Rogers, IT IS 'SATURDAY'!

Dear Dr Rogers
No matter how many times you say it differently, today remains a Saturday.  I’m not suggesting you attempt to deceive about the name of today, more that you might not know.  Your 'not-knowing what day of the week it is' might cause you to go to Church, or take your kids to school, or do other things not normally associated with a Saturday. If I could alert you to the true day of the week, what you were doing ought to change.
Homecare staff are NOT, as you comment in response to a previous post, paid double-time to work on Sundays.  This error reveals potentially significant flaws in your approach to Homecare.  Either:
 a) you don’t know what your staff are paid so you make a wild guess, because you’re a doctor and hey, that makes you pretty smart and authoritative.
 b) you do know what your staff are paid but you chose to tell lies in order to ratchet up anti-public-sector propaganda to justify privatisation
c) someone told you what your staff are paid, you don’t know any different, so you just repeated it because you thought it was true
And, because that I am reluctant to believe either a) or b), please be assured that today really is Saturday, Homecare staff don’t get double time for weekend working and you should not take your kids to school today because you’ll look a fool.*
*    Of course I realise that your children might go to private school, so there’s a chance they have school on a Saturday morning, but that’s not really my point

Friday, 9 September 2011

Caring is a Civic Duty - and other nuggets

Ive been asked to post a couple of letters which have appeared in the local press and comments on websites so that you all can see them in one place, so here goes:

Caring is a civic duty, not about making a profit

COUNCILLOR Rogers is once again in your newspaper putting forward his statistics to make a case for closing our Homecare service. He conjures up from nowhere "hundreds" of people who he says support his arguments. Firstly, that care from the private sector is equal to the in-house council care service.

Consider the profile of a private sector carer. I have much personal experience and up-to-date knowledge from indisputable sources.  The private sector carer works for an employer who is in the business of caring to make a profit. This is the nub of their problem. The employer must take on the cheapest labour they can find. They must get in and out of their clients' home as quickly as to get on to the next one and the next one.  The cheapest labour available at present is young women from ethnic backgrounds. The problem this causes is that many cannot communicate fully with elderly people who often have difficulty making themselves understood in normal circumstances. This lack of communication contributes highly to an inferior service.

There is a very high turnover of private sector carers. It is an arduous job and can be very upsetting for a young woman learning as she goes along (often the case). Some of the tasks call for a strong stomach and the carer leaves.  The high turnover impacts severely on the client who depends heavily on continuity, the same faces turning up day after day and understanding what is being said to them.

Compare the above with the profile of a council in-house carer. Mature women in the main with an average age of 45 to 50 years. Many have been caring for the elderly for 20 to 30 years.  They have a reliable back-up service, continuity of call patterns, know each and every one of their clients well, never rush their calls and always try to leave their clients feeling wanted and serene. Nothing fazes them. They have experienced just about everything that could possibly happen. They provide a vastly superior service.

The council-run service is a 24- hour, seven-days-a-week service provided by the "caring at home teams" and the all-night "out of hours" teams. The private sector cannot match this.

Now to come to Cllr Rogers' other main contention. The cost of care. What the councillor fails to disclose is that taken from the Homecare budget is a healthy slice of money to cover all other council overheads, thus pushing up the cost per hour for carers. These overheads include the salaries and expenses paid to executives and pay for councillors such as you, Cllr Roger.  It also includes, of course, huge payments made to so-called "consultants" called in to advise on 'crazy' schemes thought up by the council.

The private sector is not saddled with such costs. Often they have an office and one or two admin staff. In some cases, they work nine to five and perhaps a Saturday morning. They have no overnight cover.  If an emergency arises when their office is shut, for example on a Sunday evening, no one can be contacted until Monday morning. There is no comparison between the different levels of service provided.

Caring is a civic duty, Cllr Rogers, it is not about making a profit. The two are not compatible. When will you get that message?  When will you get the message that you get what you pay for? The cheapest option, where care for the vulnerable is concerned, creates low standards and shoddy performance.  The carers and those that need caring for have had enough of you.

Mr R Taylor
Sole Carer


I AM a Homecare assistant of many, many years' experience. I am feeling very depressed and let down at the prospect of losing the job I have carried out loyally, with my clients' best interests at heart, on every call I make.

When the threat of closure of Homecare originally came about carers were told to keep quiet about it. Not to tell their clients about it or the media. I wonder why?  It is only now in recent weeks that the union has stepped in. The wool was being pulled over their eyes too by the council.

Now we are campaigning again, just as we did four years ago, this time with only half the workforce as the council split Homecare into two parts and created a group called "star" who do a necessary job for about six weeks with patients newly discharged from hospital setting up a care needs plan so that these patients can then be passed on to the continuing care at home council team.

But what in fact was happening was that the council deceitfully arranged for these new clients to be passed to the private sector. Their reason was to deplete the work for the care at home team.
What the council is doing is wrong. They are trying to deploy carers into jobs we don't want, for example join the "star" team where just a few vacancies still exist or work in a care home or day care centre as such jobs become available.

They are reluctant to offer redundancy. They say they haven't got the money. I love my job. I have been dedicated for years. The best years of my life. I thought I would be looking after my people and many other people with similar needs until I retired. This is what I am good at. This is what I want to do.  Now I face an uncertain future due to a council that don't care a jot for the likes of me, devalue me and leave my life in tatters. They have no shame.


LIB DEM VOTERS VIEW.  AJT77 writes: As a Liberal Democrat member I am appalled by their action on this. Homecare privatisation has been a disaster in Bath and North East Somerset with profit being put before care. I feel upset and let down by my party and salute the Labour Party and the Greens for trying to stop this.”

PRIVATE AGENCY CARERS' VIEW  Pimmilini writes:  Its funny how so many people judge private home care companies when we actually provide a very high standard of care, spend the full amount of time required with every service user and work for a far lower wage than Bristol City Council. The team I work with are all dedicated to their roles as carers and do a fantastic job. People only read the negative things about companies who have let the care industry down and do not look into the positive feedback from service users and family members.

What really makes me sick is the fact that all the day and respite centres are in line for closure but we can afford 2 million pound for a bendy bus, what is that all about!  These vulnerable adults are being let down and will soon have no where to go and socialise many of whom have served this country.  I think we need to look at all this from their point of view not from a money making scheme which is what the Bristol City Council are doing. If their staff were not over paid and didn't have half the perks they did then maybe they wouldn't have overspent on their budget.
Mrs T (lw)”

IN RESPONSE A VIEW ABOUT DECENT CAREWORK  Bristol62 writes: Mrs T - its not funny.  Your team, I have no doubt, are marvellous.  Two days ago the Bedminster job centre were advertising a full time homecare job for £100 a week FACT!  The Association of Directors of Adult Social have today described the system in place for providing adult social care as 'bust' FACT!  Four days ago the UK Homecare Association said they had big safety concerns for service users and homecare workers FACT!  Adult social care is in a massive mess across the country.  Homecare, as a solution for looking after older vulnerable people, is coming under more and more pressure because care homes are being closed FACT!  Three quarters of all Homecare workers in the private sector in the UK have NO guaranteed hours of work FACT!

None of this is happening because of Council employed homecare workers.  They are NOT OVERPAID, they are paid £7.11 basic per hour and they get an enhancement for weekend working.  This is in line with what decent private sector providers pay.  They deal with the most intimate aspects of people's lives and bodies as they struggle at the end of their lives - and soldier on just like your team does no doubt. However, right now, is the time Bristol Council is choosing to get rid of it all of its Homecare Service.  You express concern about money spent on bendy buses.  I suggest now is not the time for Homecare workers to start picking a fight with each other but to wake up and realise that Homecare workers are being treated very badly.  Decent homecare providers, whether Council run or private, are facing competition from poor homecare providers.  In a race to the bottom, the system of regulation has been watered down by sucessive governments.  Last week, members of the UK Care Homes Association decided they no longer had confidence in the Care Quality Commission.  The Royal College of Nurses are currently surveying their members about similar concerns.

Treating care workers badly does the service users no favours whatsoever.  I am grateful that you and your team provide such a tremendous service to our City.  Thank you.

LABOUR PARTY SUPPORTER VIEW.  TurnBristolRed Writes: Whilst much of homecare is carried out in the private sector 50% of it is low level unskilled work such as shopping, taking bins out and doing clothes washing.  The inhouse care is the very skilled highly sensitive work such as changing catheters.

At first glance the unit costs of in house homecare is higher than private BUT NOT when you take into account there are homecarers who are being paid but deliberately under used. This is the reality and the lesson the Labour Party has learned and this is why we support the BCC in house homecare team

If u take just 2 minutes to read paragraphs 4 & 5 on this link

you'll see how bad this under use is and how it is seemingly deliberate.  In my opinion Jon Rogers knows how to bring down the unit cost of in house homecare (use 6,500 hours a week of it) he just won't for ideological reasons. Playing politics with peoples care is a lousy thing to do.

IN RESPONSE PRIVATE AGENCY CARER VIEW 'Guest' writes: That's absolute rubbish!!  I have been working as a Home Care Assistant for a private company for the last three years.  Myself and every single one of my collegues at work also provide quality care to the most vulnerable members of our society. We ensure that the people we care for have taken vital medication, we assist them to get up in the morning, wash and dress, ensure they eat a nutritious meal. We change catheters and colostomy bags, dress bedsores (we HAVE received appropriate training to do so) and we act as an advocate for the individuals we care for, liaising with the benefits centre and other organisations to help them access and secure extra services .We always look out for their well-being, working with an holistic approach always. WE CARE TOO!

PRIVATE AGENCY CARE HANDOVER VIEW Guest(2) writes: I can't believe that Dr John Rogers thinks that quality services at reasonable prices can be obtained by letting private companies take over all care. I work for a private agency, they get away with whatever they like, they use the most vulnerable members of society as a money making commodity!

This evening, I visited a client who we had only just started to provide care for today. He has just lost his Council Home Care Assistant after many years. I am not a manager or supervisor, just a 'regular' care assistant. I am the first to visit him.

There was no 'handover', no care plan in place that I could read to establish his needs, my manager could tell me nothing about him other than his address. He is lost, depressed and quite frankly bewildered about what is going on.  When I called my manager to express my concerns about the absence of a care plan, risk assessment or indeed any information about him, I was told "You're an experienced carer, I'm sure you'll figure it out".....


Wednesday, 7 September 2011

Privatisation and a full time homecare job in Bristol for £100 a week

At last night's full Council meeting, the Conservatives announced their full support for Labour's call for privatisation plans to be scrapped.  Yet as votes were taken, the Conservatives changed their minds and abstained.  As a result, the minority Liberal Democrat administration defeated Labour and the privatisation plans stand.  Labour supporters may view this turn of events in light of the old adage 'never trust a Tory', but I won't be relying on its explanatory powers. Instead, I offer these words of Martin Luther King:
"Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity".

There were outright admissions of sincere ignorance in the Council Chamber last night.  Cllr Janke was 'baffled' that the inhouse service was so much more expensive than the private sector, Cllr Jon Rogers gave an emphatic 'I do not know' as his answer to the same question.  Cllr Keilly offered the explanation that 'every other local authority has privatised' and Cllr Hopkins posed a pragmatic dilemma: 'People have a choice of where to spend their money and can make that choice.  I ask you to consider the reality, who would make that choice when one (ie private sector) is half the cost'?

Cllr Rogers informed members that if they wanted to make the Council's own service competitive, 'the only way is to tear up employment contracts and offer them (Council workers) the same as the private sector.'  However, it is the appalling terms and conditions of employment in the private sector which make the services so unsafe.  Read what the private homecare companies themselves have to say (UKHCA research report discussed in detail in blog post below).

Cllr Rogers told us a lovely story about recruitment practices by Brunelcare.  Having checked the Brunelcare website I notice (even though they have no current vaccancies) that they offer a basic hourly rate of £7.00 plus enhancements, benefits, pension, training and mileage allowance.  Currently, Bristol City Council staff receive a basic hourly rate of £7.11 plus enhancements, benefits, pension,  training and mileage allowance.  It made me wonder: if Brunelcare are so ace (and I have no reason to think they are not), why does Cllr Rogers think 'the only way' to improve Bristol Homecare would be to 'tear up' employment contracts?  Why not transfer Council Homecare workers to employment with Brunelcare with a contract to run the lot?

It took me no more than a couple of minutes to find these advertisements in the job centre today.  Homecare worker jobs in Bristol, one offering £100 for a 37 hour week.  It is advertised as an 'apprenticeship'.  This means the employer avoids the National Minimum Wage.  This 'apprenticeship' involves working ALONE, unsupervised in older people's houses, toiletting, dressing and bathing them.  The other job advertisement I happened across offers pay just above national minimum wage for working a 15 hour stretch each day (remember Homecare is physically hard work and can be emotionally draining).  You may be interested to note that all workers are entitled IN LAW to 11 hours break between shifts to safeguard their health and safety.

Job No:
SOC Code:
£100 per week
37 per week, Monday-Sunday, between 8am-8pm
Bristol, Avon BS3
Date posted
17 August 2011
Pension details
No details held
This is an Apprenticeship. To train and develop in Health and Social Care to level 2. Duties include working without supervision in the homes of service users, providing support as part of the care package. Preparing meals and snacks and assisting with feeding, undertaking shopping and minor financial transactions, to assist with social activities and promote or assist with personal hygiene task which could include toileting bathing or dressing. To prompt taking of medicines prescribed. A car driver is preferred and must be 18+ as you will be working alone in service users homes. You will be enhancing the day to day life of the elderly residents by providing support for their daily living and activities. Successful applicants are required to provide an enhanced disclosure. Disclosure expense will be met by employer.
Job No:
SOC Code:
Date posted
07 September 2011
Pension details
No details held
We are currently seeking an experienced carer to join a team of people providing 24hr support to our client. The hours of work are 0700-2200 each Saturday and Sunday.Whilst this vacancy is being advertised with one person in mind our client is prepared to accept two carers on a job share basis. You will be required to provide general support, personal care, and companionship. If you are committed to providing only the best standards of care and have a proven track record in a paid healthcare setting we would like to hear from you. You will be required to start during the first week of October. Successful applicants are required to provide an enhanced disclosure. Disclosure expense will be met by applicant but partly refunded after a qualifying period.

I have no desire to comment further about these advertisements, they speak for themselves.

For the sake of clarity, across England, local authorities have contracted 84% of homecare services out to the private sector.  This is also the current proportion of private sector provision in Bristol.  The plans under discussion last night will take Bristol into the realm of the 'all-eggs-in-one-basket' privatisers and destroy the last vestiges of mixed-service provision. 

It was unfortunate that Cllr Hopkins confused personalised budgets with in-house homecare provision.  Personalised budgets offer disabled people, particularly younger disabled people, the opportunity to exercise more control over how their support needs are met. Their choice is restricted, they are not able to choose to spend their budget with Bristol Council's own Homecare Service.  The older people served by Bristol Council's Homecare workers DO NOT HAVE PERSONAL BUDGETS and they are unlikely ever to have them because they are too ill, too old, too alone, too vulnerable.  (Please note:  It has been brought to my attention that Bristol City Council do intend for all service users to have personal budgets at some point in the future and it is more accurate if I refer to the concept of direct payments in this paragraph.  So I can rephrase:  The older people served by Bristol Council's Homecare workers DO NOT (all) HAVE PERSONAL BUDGETS (yet) and will never use direct payments because they are too ill, too old, too alone, too vulnerable.

Cllr Rogers talked of a 'proper transition' as service users were moved between the Council's own service and private agencies.  He even mentioned that older people were getting 'parallel provision' as both Council carers and agency workers acted together during a handover period.  This is not happening.  It might concern Cllr Rogers if he was aware that Homecare workers simply do not recognise his 'parallel provision'.

Cllr Keilly told us a heart warming, personal story about the quality of  private sector residential care homes in London.  'Home care' and 'care home', two words, used two ways round, identify two very different services.  Residental homes require heavy capital investment in a property portfolio and Councils, from the 1980's onwards, have lacked the cash to upgrade their own homes.  The motivation for the privatisation of home care is to reduce the wages of workers who need very little by the way of equipment, technology or buildings to carry out their work.  I suggest anyone wishing to avoid falling into conscientious stupidity reads today's article in Public Finance magazine about the massive 49% increase in residential care home insolvencies in the first half of 2011 .  Local authorities have shifted their money out of residential care and moved it into home care because it is a much cheaper care solution. Care homes and home care are not two interchangable words but competing solutions for supporting older people.

Cllr Rogers informed the Chamber that trade unions had failed to make any statement over the Lib Dem's privatisation plans when a report was accepted in October 2010.  Yes, Cllr Rogers, this is because the report does not say anything about service users being taken away from the inhouse service and handed over to private agencies.  The report does not say that the traditional homecare service (called Continuing to Care or CTC in Bristol) will be abolished.  The report does not say that homecare workers will be made redundant.  The report signals an intention to merge the intensive homecare service (known as STAR) with the CTC service and to offer CTC staff specialist dementia training.  This was a plan which had full union support.  Cllr Rogers promised Cllr Abrahams, leader of the Conservative group that Bristol's Homecare Services would continue to provide emergency back up cover when private sector agencies go bust.  But Cllr Rogers, there was no mention of retaining an emergency care function in the October 2010 report, just as there was no mention of closing down the CTC service.

When Conservative leader Cllr Abrahams said: 'we support mixed service provision, private should be the majority player but we want a Council in-house service', Cllr Janke and Cllr Rogers both assured him 'that is what is proposed'.  And this is where the ill-informed arguments come full circle.  It is exactly because the unions were led to believe that the proposals in 2010 would retain a CTC, long term traditional homecare service in Bristol (albeit with an additional dementia specialism) that the unions did not raise any objections about the report.  What has happened in practice during 2011 is:

1.  In April, staff were told that the CTC will close, they were sent letters to say their jobs were redundant
2.  In May, these letter were withdrawn
3.  In July, the unions realised that CTC was not being 'merged' but closed down
4.  In August, staff were asked to identify if they would accept voluntary redundancy or redeployment - there is no option to stay with the CTC service
5.  Since the beginning of August, service users have been forced, yes forced, to accept new private agency carers to replace the Bristol Homecare Service.

Cllr Janke claimed that their plan was the 'most consulted of any proposal'.  There has been NO  consultation with trade unions about plans to 1) make homecare workers redundant or 2) to stop taking new service users into the CTC/take existing service users away.  NOT ONE MEETING.  It is an employers' legal responsibility to enter into consultation with trade unions over redundancies, regardless of whether they are compulsary or voluntary and Bristol City Council has not done so.

If you would like to make any comment about this post, please do so below.

NOTE:  The blog has had lots of comments from Jon Rogers, Executive Member for Health and Social Care at Bristol Council.  All of them are pubilished below, just click on where it says comments underneath here.  I will follow up on what he says in the next blog later today.  Just bear in mind for the moment that some of his points about terms and conditions of Council staff need correcting because they are wrong.

Also, please note the issues which Cllr Rogers has responded to versus the points I raise which he hasn't touched on.  Further comments from Care workers ARE ESPECIALLY WELCOME.  YOU CAN KEEP IT CONFIDENTIAL, YOU DONT HAVE TO GIVE YOUR NAME and we now know CLLR ROGERS IS READING WHAT YOU SAY

Tuesday, 6 September 2011


5pm this afternoon (Tuesday) Homecares are meeting up outside the Council House ahead of a full Council meeting where we hope (fingers crossed) the privatisation of Bristol's Homecare Service will be up for a debate.  The Council meeting begins at 6pm.  I know Homecare workers are looking forward to seeing some of their 'old favourites' from the public gallery.  Lets get some collective spirit going and show the Council that we really care about Homecare and the future of service provision in Bristol.


Monday, 5 September 2011

Private Sector Homecare Providers Speak Out Over Safety Concerns

The UK Homecare Association (the professional body which represents private sector homecare companies) speaks out over ‘safety concerns’ today in their latest research (reported in Community Care Magazine).[1]  The Social Care Association weighs in behind them about the enforced recruitment of ‘unsuitable people’ as homecare workers.  The fears of UKHCA stand in stark contrast to confident declarations by Bristol’s own good doctor Cllr Rogers, head of health and social care in the City.[2]  Cllr Rogers plans a total privatisation of continuing homecare services in the City and promises this is ‘safe’.  In the face of safety concerns from private sector agencies, on record as unable to cope, Rogers claims his privatisation will ‘halve the cost but preserve the quality’ of homecare in Bristol. 

The UKHCA research covers 111 local authority and health trust areas. In more than half, private homecare agencies have been forced to make their care even cheaper. Cheap care, claims Cllr Rogers, is achieved by cutting ‘bureaucracy and red tape’. The businesses who actually deliver these cheap services do not agree. Their care on the cheap involves paying little more than the national minimum wage, not paying homecarers for their travel time between each service user, making workers put in very long hours and tolerating them taking on second jobs to make up their pay. The Chair of the UKHCA, Mike Padgham, reports on a situation ‘which isn’t ideal.’

Adult care funding and provision is at breaking point in the UK. In Bristol, the Council’s own Homecare Service currently provides a safety net for independent providers and have stepped up to the mark to deliver excellent care when local firms have gone bust in recent weeks and months. Independent providers are struggling to cope with new market pressures, shortages of qualified staff and high rates of staff turnover, as well as maintaining the standards expected in the provision of good quality care. The interests of homecare workers and homecare service users are intimately intertwined.

Cheapening care is a very risky business indeed. When an older or disabled person needs two homecare workers to lift them out of their wheelchair, to get them out of bed, to ensure they don't slip in the shower, to clean soiled linen - they are ending up with only one homecare worker from private care agencies.  This is a guarantee of inevitable accidents: hoists will not be used when they should be, older people will fall and break bones, homecare workers will suffer irreversable industrial injuries. This information cannot possibly qualify as the 'deliberate distortion' of 'improvements' to homecare in Bristol which Cllr Rogers has complained about. This admission comes from the private homecare companies who are fully aware that they are sending workers out to care in circumstances which are UNSAFE.

Bristol City Council meets in a full Council session tomorrow evening at 6pm. This is surely an important moment for the future of decent care provision in our City.

[2] see previous post for Roger's leaflet which contains all the quotes used here

Sunday, 4 September 2011


Homecare in Bristol is far from ‘safe’ as Jon Rogers, the Councillor responsible for care in the City, claims (see leaflet). His choice of the word ‘safe’ is very interesting because it is over the issue of safety that the Lib Dems and the Council’s homecare workers are in dispute.
The Council’s current use of private Homecare in Bristol is in line with the national average at 84%.  The Lib Dems plan to go far beyond this and get rid of ALL its direct provision of long term Homecare.   I am reminded that the Titanic was ‘safe’, until it sunk.  Many, many people are concerned about the state of social care in the UK and this concern is based upon their experience of privatised care.  Furthermore, even members of the National Care Homes Association (the operators of private sector residential care homes) now say the regulation of social care is inadequate.  Nurses too have lost confidence in the Care Standards Commission.  It is only a few weeks since Panorama exposed appalling institutional abuse at Winterbourne View in Bristol, that Rose Villa in Bristol closed down because it was ‘failing’, and three private homecare companies in Bristol have either ‘failed’ or gone bust in the past few months.  Safe, Mr Rogers . . . are you really so certain?
To be eligible for homecare support from the Council’s Homecare Service means that the person concerned is either very ill with limited life expectancy or considerably disabled.  One does not choose to be in need of homecare, but Mr Rogers offers us his assurance of safety based on ‘customer surveys’ - as though talking to GCSE business studies students.  Mr Rogers approaches homecare like it's some sort of lifestyle choice where the only issue at stake is a matter of logos or branding.  Indeed, it would not look out of place if his leaflet carried a banner saying ‘NEW IMPROVED HOMECARE, 100% MORE EFFECTIVE, 9 out of 10 CATS PREFER PRIVATISED CARE, WASHING MACHINES LIVE LONGER WITH CARE CO’.
People in Bristol know that attempts to cheapen the care service in the City are merely being spun as offering ‘more choice and control’.  Frankly, the idea of offering a choice of homecare companies for critically ill people to (and I quote) ‘enjoy’ is total nonsense.  The notion that this gives them ‘control’, borders on the downright offensive.  Families who are currently experiencing the distress of losing their regular visits from Council homecare workers and being transferred over to private sector providers know that Mr Rogers' claim of a ‘smooth handover’ is untrue.  A smooth handover is supposed to mean that the Council homecare worker who knows the service user well actually attends a handover meeting with the private care agency.  This is vital for the safety of service users (for reasons that are so obvious I don't need to spell them out).  To the union’s knowledge, this has not happened on a single occasion in Mr Rogers' so called, ‘improvement to home care services’.
Instead, the people involved: the homecare worker, the service user, their family members, are having their caring relationships ripped up in front of their eyes.  Homecare workers are simply instructed that they are no longer to visit, they are not permitted to say goodbye nor to attend handover meetings.  And lets be frank, these ‘people’ are mainly women.  Most workers are women, most service users are women and most family members who take responsibility for care arrangements are also women.
Despite having a legal duty to conduct an Equalities Impact Assessment of the decision to remove Council services from service users, Bristol City Council has not done so.  Let’s be clear about what this means.  The Council has a legal obligation arising from the Equality Act 2010 to promote equality and reduce discrimination.  The case law is crystal clear that the Equality Impact Assessment must be done before a policy decision is taken.  The groups who are entitled to consideration via this special legal duty are (amongst others) women and disabled people.  Where a risk of discrimination is uncovered, immediate action should be taken to reduce that risk.  Mr Rogers is so certain of safety that he has decided not to comply with the law. 
This is not the only legal pickle the Council are heading towards, from an employment law perspective they are acting in breach of their obligations on redundancies too.   No consultation over collective redundancies has yet taken place with trade unions because the Council, wrongly, are proceeding on the basis that voluntary redundancies do not really count as job losses.  Homecare Services in Bristol are so ‘safe’ that Mr Rogers has not even identified how many Council homecare workers will be made redundant.  Just one of the many reasons for this is that Homecarers have been offered ‘alternative employment’ in care homes which are ear-marked for closure – hardly a promising employment offer.
Mr Rogers relies heavily on a mantra of ‘you’re safe, I am a doctor’ and offers us assurance of his credibility by drawing on the reputation associated with his profession.  His latest leaflet makes a tempting offer: ‘If you are aware of any problems, at all, please contact me’.   Yet seven days ago, Mr Rogers was informed by the union about a service user who had been left for three days at risk of dehydration, urinary tract infection and a deterioration of his psychological health.  This very elderly man had been transferred from a Council homecarer to a private homecare agency and the agency had failed.  The response of the good doctor Rogers was: ‘I am not sure that it is appropriate for you to be contacting me on this issue’.  
And finally, don’t be fooled by Mr Rogers' repeated assertion that 85% of homecare services are already delivered by private companies.  He keeps trotting out this line to make the concerns of homecare workers, local communities and service users seem like a fuss about nothing.  Please bear in mind that half of this ‘85%’ is not the same work that the Council’s own homecare staff specialise in.  About half of the work undertaken by private sector companies is on contracts for washing laundry, collecting pensions, cleaning houses and low-level care tasks.   The Council’s own Homecare Service delivers personal care – it’s the tricky stuff of dealing with incontinence, open wounds, bathing the disabled, checking medication for stroke victims and dressing dementia sufferers.  This is the work which is being transferred to the private sector and it doesn’t look like ‘waste and red tape’ to me. 

Saturday, 3 September 2011


What a brilliant day - loads of support, interesting speakers, and NO RAIN!  Here's the highlights, brought to you with the pictures.  Firstly, although upbeat and confident that we can win this dispute, the issues at stake are very serious.  The expressions of the Homecare workers attending the Rally say it all - they are deeply concerned about Council plans to close the Homecare Service and what this means for them and their service users.
 As Steve Preddy of Unite commented  “we were delighted to be joined by both Conservative and Labour MP’s who shared a platform in opposition to the closure of the Homecare Service.  It tells you that even politicians with opposing political views appreciate how damaging the Council's plans are for service users.  It also testifies to the fact that the people of Bristol are firmly opposed to the total privatisation of the Homecare Service and the politicians know it.”
Conservative MP for Bristol North West Charlotte Leslie spoke of the importance of the high quality care provided by Bristol's Homecare Service.  She pleaded with the Lib Dem run Council to reconsider their plans to close it down.  Charlotte is in no doubt that vulnerable older and disabled people in the City need the security and reassurance of knowing their Council employed homecare workers will be here to stay for the future.  Her contribution was followed by Kerry McCarthy, Labour MP for Bristol East.  Kerry called for the Lib Dems to abandon their plans.
Kerry drew on her concerns about the privatisation of the NHS, to highlight the importance of homecare services for enabling older people to live in their own homes and not remain in hospital for any longer than necessary.  Far from being costly, Homecare services provide a massive saving to the health budget.
It was excellent that Dave Matheson, Unite Executive Member for Public Services was able to join us, all the way from Hull.  Dave spoke about the union's committment to fighting all cuts and campaigning for decent community services.  John McInally, National Vice President of PCS (public and commercial service union) spoke about the importance of unions working together to defend jobs, communities and, in our case, the best quality care services in the City.  Peter Allenson, Unite's national secretary for Public Services, offered his fulsome support and congratulated Bristol's homecare workers for their excellent campaign and fighting spirit.

It was fantastic to hear too from film-maker Ken Loach who spoke about the importance of the welfare state to working people.  He recognised that Homecare workers found it very difficult to take industrial action - after all, if they came out on strike they would be hurting the service users they care for.  He urged us to work together and use our political voice to make change happen.
Perhaps best loved of all, was the speech by Mr Bob Taylor, the husband of a service user who has provided stellar support to the campaign to keep Bristol's Homecare Service.  A massive thank you has to go out to everyone who supported us today.

Friday, 2 September 2011

‘Homecare scandal’ wastes £7 million plus 500,000 un-used care hours over three years at Bristol City Council

A trawl of Bristol City Council’s online paperwork has revealed financial and operational mismanagement has wasted £7 million over 3 yrs and left hundreds of thousands of homecare hours unused.  Unite claims the Authority has consistently failed to use its own workforce to provide homecare services in the City and has chosen to place additional expenditure with private agencies in a cynical effort to break in-house provision. Local support for the retention of Bristol City Council’s own homecare service was strong enough to bring down the Lib Dem administration when they last attempted to privatise it in 2007.  Unite’s Regional Organiser Steve Preddy is outraged: ‘The Lib Dems are in control of the Council again and as the monopoly purchaser of homecare services in the City, the Council can make or break any service provider.  They have attempted to break their very own Homecare Service, which they themselves manage.  In the process they have wasted millions of pounds of public money and left hundreds of service users with no Council carer to turn to.’

Bristol City Council’s has a weekly target of 6,500 hours of care to be provided by its own workers in caring for older people in the City.[1] Latest available data shows the Council used only 4,481 hours a week in 2010/2011, leaving its homecare workers with no service users to provide care to for the remainder of the time.[2]  Unite claims this waste of over 2,000 hours of care every week has failed to make use of £2.9 million worth of annual resources invested in staff and costs.[3]  Over three years this mis-management has eaten up approx £8.7 million in wasted care.  Unite alleges that the Council instead opted to purchase alternative hours of care from private sector agencies to make up the shortfall.  Paperwork dating back to 2009 reveals this practice costs £44,000 a week, a staggering £2.3 million each year.[4]  Steve Preddy explains: “This scandalous waste of resources – hundreds of thousands of unused homecare hours and £7 million of extra cash to buy services in from agencies - is the key explanation for Lib Dem claims that the service is too expensive.  The expense has been entirely manufactured by management incompetence and political negligence. A Homecare workers’ basic wage is £7.11 per hour, that’s a modest wage for the best trained, most reliable and experienced homecare workers in the City.  If the Council met its own commissioning targets, the cost per hour of care would dramatically drop.  Managers and politicians both know full well that the less they use their own workforce, the more expensive their care appears to be.”  

A 2009 analysis by Bristol’s Director of Health and Social Care, Cathy Morgan, debunked the myth that the Council’s massive overspend in the Homecare budget was caused by an increase in demand.  She explained to Councillors that Bristol City Council was not purchasing enough homecare from its own service:  Homecare packages [from Bristol City Council’s own Homecare Service] are not meeting planned levels, which may result in a reliance on commissioning from the independent sector’.[5] Indeed, during a previous 12 month period, Council purchase of homecare hours from the private sector had increased by a massive 35% (4,500 hours per week), which was a ‘much larger increase than had been experienced in the two years previous’ resulting in a ‘significant, unaccounted for demand on the independent sector homecare budget’.[6]  At the same time, Morgan reported a steady fall in the number of older people that the Council had referred to its own Homecare service.[7]  The Director acknowledged the Council’s own Homecare Service had 2340 hours of un-commissioned care time each week,[8] which, if used, would ‘reduce dependence on independent sector homecare provision’.[9]

In 2010, a new Director of Health and Social Care, David Johnstone recommended that contracting and procurement by Bristol City Council could be improved because the size of home care packages purchased from the private sector was too high.[10]  Johnstone noted that more staff and resources were needed to support older people to live at home.  Achieving this would ‘not mean we will be cutting services’.[11]  He explained his intentions as: ‘Firstly, . . . to focus our in-house home care services on people with high levels of need. Secondly, to ensure we are as efficient as possible, and that we get more care for the same amount of money.[12]  Johnstone left expectedly in March 2011.  In April, the Council issued letters to homecare staff and service users stating that the Council’s Homecare Service was to close and service users moved to private providers.  Unite challenged the Council on the grounds that these notices were unlawful and the Council withdrew them.  Steve Preddy explains the current situation: “Bristol City Council is continuing to turn older people in need of Homecare away from its own, directly employed Homecare workers and yet continues with the myth that their service is too expensive to retain.  If the Council truly wants ‘more care for the same money’, as they claim to, they would make a good start by actually using the hours at their disposal within their own workforce.  All Homecare workers changed their contractual hours to accommodate management demands, they have done everything asked of them.  This is an appalling scandal of waste, incompetence and negligence.”

For further information contact: Steve Preddy, Regional Officer, Unite

Mobile: 0776 446 7443, email: Appendix 2 para 1
[2] Based on sample taken for Department of Health 6th Sept 2010.  3541 hours CTC section, 940 hours STAR section.
[3] The service is comprised of two sections Continuing to Care (CTC) provides standard long term homecare support to older people and STAR (Intensive Rehabilitative homecare).  The CTC budget is £6.7m and STAR £2.6m appendix 3
[12] para 4.6