The perils of under-resourcing

One of my family members who is now rather frail but insistent on staying in her own home has carers to visit her four times a day, to get her in and out of bed and to prepare meals and attend to other needs as necessary.

Obviously we have to deal with the agencies providing the carers and it may surprise you to know that we are now employing the third agency in about four months.

The first two agencies were a disaster. Their visiting times were erratic and sometimes they failed to come at all, leaving the poor lady in bed until lunchtime as we only later found out. They failed in many other irritating and occasionally unfortunate ways, but I will spare you the details.

Some of those agency employees were indeed caring. They explained that things went wrong because they were understaffed and trying to cover too many clients. They had no back up if one had a major problem with a client and could not send a relief person to deal with the next client on the list, which was why our relative was left to lie in bed until lunchtime on that occasion.

Finally we were referred to another agency, who it has to be said are a bit more expensive. They have a smaller staff and fewer clients, but even so they have more than enough employees to cover all their clients' requirements. Our invalid is very happy. She doesn't worry about when the next visit will be. We don't worry because we know that she is at last in good hands and we will not get that telephone call to go to the rescue at whatever time of the day or night.

There is a business lesson here, it seems to me. The first two agencies were chasing every bit of business they could and accepting everything flung at them by the local authority. They were never honest and said “we are at full capacity and we haven't the resources to meet your or the clients' needs.” That means that they will continue to fail and they will always lose clients as quickly as they get them. Even though it is a narrow sector they have a high client churn rate and lose what should be long-term business.

The current agency charges more. They provide a great service, which is why they get referrals rather than have to fight to stay afloat. They have the staff to cope. They do not have to tout for business; it finds them. They take away the clients' pain and they take away our pain in terms of worry.

Most of us are in business to take away our clients' and customers' pain. If we can provide a great service we will get more referrals and we will be able to charge more too, because relief from stress is what everyone wants, and the price is worth paying. Don't you agree?

© Jon Stow 2010

Care for the elderly

We currently have a situation in which an elderly lady home from hospital via a respite care home is unable to cope. It is true that she needs a lot of care and the social services have appointed a care agency to send in someone four times a day. Unfortunately these people, some of whom are clearly caring, are too rushed to do a proper job. They do not arrive early enough to get the lady out of bed and to the toilet, and they leave her with her breakfast but without removing the tray on her trolley to allow herself to attempt to get to the bathroom. During the day they do not ask if she needs to go to the toilet or take account of the fact that as she is confused she may not be able to ask. They do not ensure having disposed of one incontinence pad that they have given her another. You can imagine the result of such a failure. They do not ensure she has taken her medication and in general they are not doing their job.

The lady is frightened to be left on her own, mainly because she is not offered enough opportunities to get to the bathroom, and in her most lucid moments has asked if we can find her permanent care, which we must do because we cannot be there for her every minute of the day, and because we cannot ensure that the care provided by the agency through the social services is even adequate, let alone good.

How does she get to find a permanent care home? Apparently we need a broker, who has visited, but it takes time. We haven't got time, though my wife spends many hours a day with her. The lady is frightened and vulnerable now. To get interim respite care apparently we need another broker but she doesn't answer her telephone, any more than the care agency did this morning after another serious failing.

Why does it all take so long to get anything done? If there is a shortage of staff perhaps they could tell us. Could they give us a timescale? How many agencies do we need to get an old lady some comfort?

When we thought the lady might be able to manage at home we asked about a bath lift and were told the wait was five months for her to be assessed. This about gives the flavour of the situation. I am not apportioning blame. I do not know who is to blame because no one is taking responsibility apart from us except a couple of volunteers who shouldn't have to.

Gordon Brown said last Thursday in the Sky News leaders' debate “Now when we look at the needs of pensioners it is absolutely true to say that we need help with urgent needs, social care in the home and that is what we are introducing over the next few months so that people don’t have to go in to old people’s homes if they want to stay at home, they can get the home helps and the health visitors that are necessary for them so that they can have comfort in their own homes.”

It is a pity that as of now, our elderly lady has not been afforded any dignity by the social services and agencies that are supposed to help. She has no confidence left to allow her to stay at home even if it were a viable option.

Have you experience in this area? What do you think?