Elderly and disabled put at risk by poorly trained home care workers

The safety of elderly and disabled people who rely on home care is being put in jeopardy by the inadequate training being given to home care workers, according to a new study.

The UNISON survey of more than 1,000 care workers employed by councils and private firms across the UK, found that staff are increasingly being asked to perform intimate procedures that would previously have only been carried out by registered nurses.

Changing catheter bags, peg feeding, stoma care, administering medication and looking after patients with dementia are just some of the difficult tasks that home care workers carry out, even though many receive little or no training.

Inadequate training can leave people receiving the care in significant discomfort and vulnerable to infections. Even worse, UNISON warns that insufficient training on how to administer medication could lead to fatal overdoses.

Fatal consequences

Dave Prentis, UNISON general secretary, said: “If home care workers aren’t receiving adequate training to carry out complicated tasks, there could be fatal consequences for the people they care for.”

He blames it on the cut in funding that the Government gives to councils for social care, which has forced many local authorities and private companies to skimp on training.

“It is a stark illustration of the lack of dignity that is being afforded to both care workers and the people who rely on home care,” said Mr Prentis.

He also believes that plans to integrate NHS and social care services “are doomed to failure while we have a social care system that treats home care workers with such contempt, and the people they care for with such disregard”.

The survey revealed that nearly six in ten (59 per cent) home care workers had received no training in how to attach or change a convene catheter.

Almost a quarter of staff (24 per cent) administering medication had received no training, despite some of them distributing drugs such as liquid morphine and insulin.

While more than two thirds (69 per cent) said they cared for people who suffer from dementia. Despite this, more than a quarter (27 per cent) had received no training in how to work with people with this illness.

People with dementia being profoundly let down

George McNamara, head of policy and public affairs at Alzheimer’s Society called it a “disgrace” that two-thirds of people with dementia live in the community and they are “being let down so profoundly”.

He said: “We hear countless stories of people with dementia being denied care because a lack of understanding means their needs are not assessed properly. It can also have devastating consequences if care workers don’t have enough training to be able to appropriately communicate, with people with dementia often ending up in hospital as a result.

“Home care should be about good quality care, designed to meet individual’s needs. Pressure placed on staff to conduct shorter care visits, in order to meet budgetary targets is unacceptable.

“Visits lasting fifteen minutes or less cannot possibly provide people with the dignified good quality care and wider support they need and deserve. Care workers tell us that they want more training and it must be made mandatory that all staff are provided with the right support. That’s why, as part of our Dementia Promise, Alzheimer’s Society is calling on political parties to protect dementia training time for care workers.”

More than three-quarters (78 per cent) of respondents had asked for extra training to help them carry out their increasingly demanding roles, but less than half (49 per cent) had received any.

One of the home care workers who responded to the survey said: “The worst thing was trying to help a lady with a catheter have a shower. Neither she nor I could work out a way to do it that did not leave her with a soaking wet catheter bag chafing against her leg.

“I also didn't have a clue how the catheter was supposed to be strapped to her leg when I started. Neither did the colleague who was supposed to be mentoring me, and it was several weeks before a district nurse showed me how the elastic bandage was supposed to be threaded through the catheter bag.”

Huge rise in dementia and mental health home care

Another home care worker found that the number of dementia and mental health cases has increased dramatically. She said: “Whilst I have had basic training in dementia care, I have not had any in mental health. I have requested this many times but nothing happens. I have been to paranoid schizophrenics, been threatened with a knife twice, had no back up from management and felt totally frightened, let down, alone and vulnerable.

“My colleagues and I frequently ask to work in pairs for these clients, especially at night, and when working in rough areas but this is ignored. Today I was hit by a dementia client again. Who cares about us care workers?”

UNISON believes that the Government’s new care certificate – which came into force this month – does little to address the increasing lack of training for care workers.

It is only aimed at new employees and merely provides a basic induction to care and is not mandatory. The training provided by the employer is neither monitored nor assessed.

This lack of training is compounded by the fact that home care workers are increasingly being forced to carry out their roles within shorter periods of time, as a growing number of councils use 15-minute visits. Many employees are not being allocated the same care users, preventing them from building relationships with any of the people they care for. Despite being expected to carry out increasingly difficult tasks with more responsibility, many home care workers are being paid below the national minimum wage. This is because non-payment of travel time and care workers having to pay for their petrol, uniforms and mobile phones.