Home care in Scotland failing the ill and the aged

The elderly and the sick are suffering shocking care at home including being stranded in bed and not receiving their food and medication.

A Sunday Post investigation has discovered scores of home care providers have been slated by watchdogs for failing those who rely on them.

The problems uncovered by the Care Inspectorate include frail pensioners being left to sleep in soiled beds.Support our Care Home campaignThere were also issues with private firms cancelling or missing appointments or simply turning up for just a few minutes at a time.

Doug Anthony, of Age Scotland, warned that vulnerable older people are being “very poorly served” by home care providers.

He said: “It’s simply unacceptable for services to be delivered at high speed as if the person’s home is a Formula 1 pitstop. The potential dangers of unnecessary medical problems and malnutrition arising for want of a few extra minutes’ care are shocking and unacceptable.

“Late, rushed and missed appointments can be extremely stressful for older people. Indeed, where the carer is the only visitor the individual might receive, these issues could actively compound isolation and loneliness.”

Councils in Scotland spend around £400 million each year providing home care. However budgets in some areas have been slashed as central and local governments tighten their belts. In many cases the work is sub-contracted to the private and voluntary sector.

The organisations involved are regularly inspected, but it’s rare for the worst performing to be publicly exposed. However we can reveal that 10 home care providers have been graded “weak” across all assessment categories.

Inspectors found staff from one company missed 20 appointments over a three-month period. Many carers were said to have cut appointments short, sometimes spending just 10 minutes with patients who were scheduled for half an hour of help. There were also cases of staff turning up late, leaving vulnerable patients in “physical discomfort”. One report highlighted complaints that soiled beds had gone unchanged while another raised concerns about a lack of support for someone who was at risk of malnourishment. The lapses in basic care also saw vulnerable people not being given their medicine.

Inspectors noted that staffing levels at some companies were “stretched” and that many carers were “exhausted”. Other concerns raised include home care providers frequently changing staff and the standard of care falling at weekends.

Dave Watson, Scottish Organiser for Unison, said increasing demand for services and declining council budgets means services are being squeezed and described the consequences as a “national disgrace”.

He said: “Home care workers, often paid little above the National Minimum Wage, employed on zero or nominal hour contracts, are literally running around our communities trying to look after some of the most vulnerable members of society. The only way for some staff to finish the day is to cut corners in what are already inadequate care packages.” He called on the Scottish Government to review social care procurement guidance to ensure contracts specify decent employment standards.

A Scottish Government spokeswoman said integrating health and social care will improve care for people in communities and help reduce inappropriate use of acute and institutional care.

She added: “All support services that provide care in people’s homes are also subject to annual, or more frequent if necessary, inspections to ensure that any concerns about standards, and quality of care, are addressed swiftly and effectively.”

The Care Inspectorate received 110 complaints about home care providers last year of which almost two-thirds were upheld. The figures are believed to be the tip of the iceberg as many OAPs suffer in silence.

The Inspectorate said it is working “intensively” with failing providers to help them improve.

Have you had a complaint about home care upheld by the Care Inspectorate? Call us on 0141 567 2722.

These are just some of the organisations found wanting in the Care Inspectorate reports:

Allied Healthcare: Following an inspection in July, the Care Inspectorate said staff from Allied Healthcare in the Scottish Borders missed visits and were late. Inspectors also found evidence that visits were shorter than they should have been. They added that several missed visits had not been recorded by staff, including times when clients had missed medication.

Allied Healthcare’s branch in Inverness has also been graded “weak” across the board. It saw its quality grades fall from good in 2010 and 2011 to weak when it was inspected in November 2012. Clients said staff did not always arrive on time, that visits were too short and that on some occasions nobody turned up. One person said staff were late “at least once a week”. Inspectors also found “significant areas of weaknesses” when they assessed Allied Healthcare, Glasgow, in March.

Allied Healthcare said it didn’t think the Inverness report was truly representative of the service it provides. It added that it has been working hard to improve standards in the Borders.

The Mungo Foundation: Services being run by The Mungo Foundation came under scrutiny in November 2012 and February 2013. Inspectors warned that medication errors “continued to be reported” and raised concerns over “gaps and inconsistencies” when they examined some records about allegations of staff misconduct and abuse. They also noted that it was unclear what supports had been put in place for a person who had “significant needs in relation to risk of malnourishment”. The Mungo Foundation said subsequent inspections of the services had taken place and had indicated an increase in grades.

Supported Living: Following an inspection last October, Dumfries Supported Living was criticised over “serious staffing shortages”. Inspectors said that medication errors were still occurring despite the issue having been raised with the company before. Many service users were not receiving their full support hours on a weekly basis due to shortages of staffing. Inspectors also described staff as “exhausted”. A spokeswoman for Voyage Care, which owns DLS, said key improvements had been made, including staffing levels and a review of training needs and medication processes was under way.

Independent Living Services: Inspectors ruled that staff from ILS Borders had caused “significant stress” by missing appointments. Following an inspection in May, the company was criticised for visits beginning later than scheduled or being cut short and even being missed altogether. Problems with unchanged beds and concerns about the skill levels of staff were also cited. People using the service also complained that staff seemed “rushed”. Staff themselves told inspectors that a lack of travel time on their schedules meant they were late to visits or had to cut them short to stay on track. Meanwhile clients of ILS Ayrshire complained about missed visits when the service was inspected in March of this year. Alan Long, executive director of Mears Group, which bought ILS in April, said the company has put significant effort into addressing the problems raised in the reports.

Transitions Care Ltd: Transitions Care was criticised by inspectors for its “serious staffing issues” following an inspection in June. Watchdogs highlighted the fact that there was no permanent manager in post, a team leader had just left, and insisted the business didn’t have enough carers. One concerned relative said there had been problems with care staff “not turning up”. Another said that staff were always in “a rush”. The Sunday Post contacted the company for a comment but did not receive a response.

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