"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:
BEG/41796
SOC Code:
6115
Wage
£100 per week
Hours
37 per week, Monday-Sunday, between 8am-8pm
Location
Bristol, Avon BS3
Duration
Permanent
Date posted
17 August 2011
Pension details
No details held
Description
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.
THE OTHER ONE
Job No:
BEG/41944
SOC Code:
6115
Wage
EXCEEDS NATIONAL MINIMUM WAGE
Hours
30 HOURS OVER TWO DAYS SATURDAY AND SUNDAY
Location
BRISTOL BS3
Duration
Permanent
Date posted
07 September 2011
Pension details
No details held
Description
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'.
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 http://networkedblogs.com/mGl9C . 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
I am not at all surprised by those job advertisments. I work in the private sector and they can get away with whatever they want. There is NO REGULATION whatsoever in the private sector, as the events in Winterbourne Hospital proves.
ReplyDeleteIt really makes me sick to my stomach that both the vulnerable people and the staff who work for these agencies are exploited in such a vile way. I love my job and the people I care for but I seriously think I have to quit as my morale and self esteem are at an all time low, I am exhausted and frustrated beyond belief.
It's about money pure and simple, nothing else. The guy who owns our company has just finished building his million pound mansion while the vulnerable elderly of this country are left sitting in their own waste!
Doesn't it make you proud to be British?
I used to work for a local homecare provider in the office. I can tell you several reasons why the private sector may be able to offer a cheaper service. In the first place, the terms and conditions of contracts are barely legal. The majority of our staff were on an "available hours" contract. This means that they told us what hours they were available in any given week, and we would offer them slots in those hours. They were only paid for the actual slots they worked, but the contract stipulated that in order to get the work they had to be "ready and waiting" throughout the entire "available hours" period. This basically meant they would get a few half hour slots at peak times (breakfast, lunch, tea, bedtime) but in between they'd be sitting around for hours, or driving between visits, unpaid, but unable to do anything else in case a call came in with a visit they had to do. So the average pay would work out at far, far, less than the minimum wage over the entire shift.
ReplyDeleteAnother employment practice was to tell homecare workers that they couldn't leave the company to work for a better paying provider because there was a 'no poaching' clause in the contract which said they couldn't work for another provider in a 20 mile radius. Clearly unenforceable, but believed by sufficiently many to achieve the desired effect.
Other charming feature of private sector homecare was not factoring travel time into the rota. This meant you could charge the local authority for a half hour slot, 50% or more of which was spent in rush hour traffic. So the service user gets to make lovely choices, like would you like to wash today or eat breakfast? Nice.
The manager used to deliberately doubled book some slots so the same carer would go, for instance, to see two clients (usually neighbours or living in the same household) within the same half hour. They could then charge the council twice, but only pay the carer once.
Honestly, I could go on and on. The agency wasn't all bad. The carers really really cared about the clients, sometimes it felt like they cared a lot more than the social workers. But to be honest, I was never convinced that the managers in their sportscars (yes really) gave a flying toss about the clients or the staff.
I'm not going to give my name, or that of the provider, because I'd put good money on them bidding for the Bristol contract.
I called ACAS yesterday and was told that under the Working Regulations Act 1998 my company should be paying travelling time. When you are travelling between clients you are on 'company business' and should get paid as such.
ReplyDeleteOf course the company gets out of this by using the clause in the contract "your place of work is the service users home" - therefore you are constantly travelling to your place of work and so they don't have to pay out! They refer to the service user as an "assignment" and state "You do have the right to refuse any assignment"...
Yesterday, I worked 7am -10pm, three of those hourse were made up of travelling time for which I will not get paid. Between the hours of 7am - 10am alone, I provided care to 8 "assignments", each one is supposed to receive 30 minutes of quality care, that also includes travelling time between calls of course!
How can Janke be "baffled" by and Rogers "not know"about a simple set of expenditure accounts?
ReplyDeleteAll they need to do is obtain the management accounts for the home care service in spreadsheet form and look at the column marked 'expenditure'. This will detail precisely what they are spending their/our money on.
Have they not seen them? Can they not read? Can't the Chief Exec on £180k pa or the Head of Resources on £140k pa explain? Or are they all completely baffled by a column of numbers under the heading 'expenditure' in a spreadsheet?
Many thanks for your detailed and informative analysis.
ReplyDeleteI have copied it to officers for their comments, but meanwhile here are some observations of my own.
I will make comments as separate comments if I may?
(1) "..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?"
JR] An interesting possibility. First can I apologise. I think that I overstated the need to tear up the contract, but I think it would need major changes to become competitive. That is a potential fruitful area to discuss with the Unions and staff in due course. It would be good to discuss how Brunelcare can offer excellent service and competitive prices. I used them as an example to show that good quality is absolutely possible in the independent sector. My guess is that they do not support sick leave arrangements that give a minimum of 6m full pay and 12m half pay, coupled with 14 days per person annual sickness on average? I also suspect that they do not pay double time to staff on Sunday even if they are sick. Then paying a second member of staff double time to cover, and finally giving a day off in lieu (which also needs to be covered by yet more staff).
JR] Additionally, in Bristol we don't cut costs to the bone. We have a minimum rate of £15 plus enhancements, and then service is judged not by low cost, but by quality. I have heard other LAs cut rates well below that amount. We do not need to save money by jeopardising service quality.
(2)"It was unfortunate that Cllr Hopkins confused personalised budgets with in-house homecare provision."
ReplyDeleteJR] I think this is a misunderstanding of the confusing terminology. Cllr Hopkins is right that personalised budgets will apply to homecare provision. Every H&SC service user will have a budget. Only a minority will hold the budget themselves (currently about 10% of people who have been assessed, elderly and others) - that is known as "Direct payments".
JR] See http://www.bristol.gov.uk/node/3591#jump-link-6 for more details.
(3) "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."
ReplyDeleteJR] I specifically double checked that this is happening. If you have examples where this is falling down then please email me at jon.rogers@bristol.gov.uk as I have been assured that the transition is being well handled.
(4) "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."
ReplyDeleteJR] This is my understanding of what has been done. The STAR and CTC merging was to use the combined staff to deliver a new dementia service and enhance the STAR service. This was explicit in the October report.
(5) "Bristol's Homecare Services would continue to provide emergency back up cover when private sector agencies go bust.
ReplyDeleteJR] The emergency services will clearly need to continue to be provided. This is not changed by the decision in 2010, hence I don't think any mention needed to be made. I will check this understanding (and indeed all I am saying) with officers in case I am misunderstanding anything. This is currently done by in-house staff and independent or agency staff. I expected that our inhouse STAR service would provide such cover and our contracts with independent sector providers do include provision for emergency care. It is vital that people are covered at all times.
(6) "the unions were led to believe that the proposals in 2010 would retain a CTC, long term traditional homecare service in Bristol"
ReplyDeleteJR] There does seem to have been a misunderstanding, and I am aware that it has caused upset. This was raised with me in May, and we brought the issue back to Cabinet for clarification. The specific phrase in the October 2010 report available at...
https://www.bristol.gov.uk/committee/2010/ua/ua000/1028_5.pdf
was...
That the Continuing to Care Service be merged with the STAR service by March 2011.
4.1 The functions of the new, combined service will be two fold
(a) promoting rehabilitation and Intermediate Care within the community in order to reduce rates of residential care and hospital admission, and to facilitate timely discharge from hospital.
(b) to develop a specialist service to support people with dementia living within the community.
I have checked again, and there is no mention of a CTC service as part of the function.
This evening I paid a visit to a client who has just lost his Council Home Care Assistant after many years. This was the first visit from our company. There was no 'handover' at all, no care plan in place in order for me to know his needs. The office could tell me nothing about him, I am the first to visit him - we took on his care package only today,(no manager has undertaken an assessment yet).He naturally is bewildered and very depressed about the whole situation. I reported to my Manager that I really was concerned about the absence of a care plan and risk assessment to be told "Your an experienced carer, I'm sure you're figure it out".
ReplyDeleteThe shape of things to come.
It is not the figures that baffle me. I do not understand why the costs of in house service have not been brought down. Instead they have increased every year since 2005.
ReplyDeleteThe unions blame the managers for not managing properly.
The managers say it is the terms of service, the high levels of sick leave, the fact that some staff walk between calls.
I accepted last year that I was no more likely to resolve this conundrum than my predecessors, so I worked with Cabinet colleagues, officers and David Johnstone to develop the new merged arrangements that we agreed at Cabinet in October 2010. Those plans also went through cross-party scrutiny as well as being shared with the unions and of course the general public.
Rogers has treated me - what is he playing at?
ReplyDelete@ Dr John Rogers. I have sent you an email this morning, giving an example from experience of where parallell provision is not happening. Looking forward to your response.
ReplyDelete(I'm the poster from 16.33) Councillor Jon Rogers - when you tender out the contract will you be asking about employment practices? Homecare services are notorious for poor - and often illegal - working conditions. In my view, this is how they drive prices down.
ReplyDeleteThe effect of poor working conditions is also felt by service users. The company I worked for had relatively high staff turnover (the sector as a whole has high staff turnover). The employer didn't want to take on too many staff because of the overheads involved, so sometimes we were getting by with less than the minimum needed to fill the rota. On some occasions we even sent out new staff who weren't trained or CRB checked. On one particularly alarming occasion, one new member of staff was out lone working when her CRB check came back to the office. It was as long as your arm, and most of the offences on it related to stuff that had occurred whilst working...
Oh, and CQC rated us as a "good" provider, whatever that means these days.
The same thing happens in the private company I work for. They just seem so desperate to win over all the care packages that have arisen from Council Homecare being abolished. One collegue told me that she was sent out to work before her CRB check came back, they haven't checked my references after 7 months. I don't even have a contract of employment yet.
ReplyDeleteFunnily enough, I just got of the phone to the CQC regarding the job advertisments posted here. They didn't seem very interested, stating that it seemed genuine enough if it was being advertised as an 'apprentiship'
Today, I telephoned the Bedminster job centre and was transferred to the department who deal with employers advetising positions with them. I explained that I was a Care Assistant and could not believe my eyes when I read the job description as if the level of exploitation for both service users and care staff in the private sector wasn't bad enough - a full time job being advertised for £2.50 an hour under the 'guise' of an apprentiship really topped it all.
ReplyDeleteHe asked me for the job reference number and immediately reported how suspicious it looked, not seeming like a genuine apprentiship at all, especially stating that the applicant must be 18+ and a driver. He put me on hold whilst he was speaking to his manager, he then told me that the advertisment would be removed as it was so suspicious.......
Checked a few minutes ago and it's gone.
"The managers say it is the terms of service, the high levels of sick leave, the fact that some staff walk between calls [that explain high cost of in house service]."
ReplyDeleteJon, the point is that if you read and interpreted the accounts yourself, which is simple to do, you'd realise your managers explanation is, to say the least, partial.
Terms of service, sick leave and walking between calls do not push unit costs up by £16 an hour.
The claim is absurd. It appears to be trying to blame staff for management decisions and blunders.